Назва наукового напрямку (модуля):
Семестр: 10
Акушерство та гінекологія Тести
Опис:
5 курс 10 семестр
Перелік питань:
1.
A. *
B.
C.
D.
E.
2.
A. *
B.
C.
D.
E.
3.
A.
B.
C. *
D.
E.
4.
A.
B.
C.
D. *
E.
5.
A. *
B.
C.
D.
E.
6.
A.
B.
C.
D.
E. *
7.
A.
B. *
C.
D.
Chronic hypertension is hypertension which
Detected before pregnancy
Detected after 20th week
Detected at postpartum period
Detected during the labor
Detected after delivery
The diagnosis of pregnancy is based on the following positive signs of prenancy.
Identification of fetal heartbeat
Palpation of fetal outline
Cessation of menstruation
Positive hCG test.
Morning sickness
Which cervical dilation indicates 5 cm contractile ring station above the symphysis?
1 cm
2 cm
5 cm
3 cm
4 cm
What percentages of fetuses are born in the occiput presentation at term?
80%
85%
90%
95%
99%
A woman at 10 weeks' gestation who is seen in the prenatal clinic with presumptive signs and
symptoms of pregnancy will likely have which of the following?
Amenorrhea
A positive pregnancy test
Chadwick sign
Hegar sign
Identification of fetal heartbeat
What is the most common presentation of the fetus?
posterior occiput
breech
Face
brow
anterior occiput
A positive sign of pregnancy is
A positive pregnancy test
Fetal movement palpated by the physician
Braxton Hicks contractions
Quickening
E.
8.
A.
B. *
C.
D.
E.
9.
A.
B. *
C.
D.
E.
10.
A.
B. *
C.
D.
E.
11.
A. *
B.
C.
D.
E.
12.
A. *
B.
C.
D.
E.
13.
A. *
B.
C.
D.
E.
14.
A.
B. *
Morning sickness
Which of the following is characteristic of synclitism?
Sagittal suture is not parallel to the transverse axis of the inlet.
Sagittal suture lies midway between the symphysis and sacral promontory.
Sagittal suture, although parallel to the transverse axis of the inlet, does not lie exactly midway
between the symphysis and sacral promontory.
Sagittal suture rotates 45 degrees from the sacral spines.
Sagittal suture lies closer to symphysis
Sudden onset of severe unilateral lower abdominal pain immediately following strenuous or sexual
activity:
PID (Pelvic Inflammatory Disease)
Ruptured ovarian cyst
Vaginal cancer
Ovarian torsion
Ectopic pregnancy
A woman is at 14 weeks' gestation. The physician would expect to palpate the fundus at which of the
following levels?
Not palpable above the symphysis at this time
Slightly above the symphysis pubis
At the level of the umbilicus
Slightly above the umbilicus
At the level of the xyphoideous processus
Which of the following is characteristic of posterior asynclitism?
Sagittal suture lies closer to symphysis.
Sagittal suture lies midway between the symphysis and sacral promontory.
Sagittal suture, although parallel to the transverse axis of the inlet, does not lie exactly midway
between the symphysis and sacral promontory and lies closer to promontory.
Sagittal suture rotates 45 degrees from the sacral spines.
None of the above.
On physical examination, the physician notes that the lower uterine segment is soft upon palpation.
The physician’s assistant would document this finding as:
Hegar sign
McDonald sign
Chadwick sign
Goodell sign
Braxton Hicks sign
During which cardinal movement of labor the fetal head delivered in anterior occiput presentation?
extension
internal rotation
external rotation
expulsion
flexion
A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. You know
that which of the following findings are considered normal?
Dipstick assessment of trace to -1
< 300 mg/24 hours
C.
Dipstick assessment of +2
D.
E.
15.
> 300 mg/24 hours
This test is not need to perform
Cardiovascular system changes occur during pregnancy. Which of the following findings would be
considered normal for a woman in her second trimester?
Heart sounds (S1, S2) less audible
Increase in pulse rate
Increase in blood pressure
Decrease in red blood cell production
There no any changes in cardiovascular system during pregnancy
When does the internal rotation of the fetal head begin?
in the plane of pelvic inlet
in the greatest pelvic dimension
in the plane of the least pelvic dimension
when the head descents from the plane of the greatest pelvic dimension to the plane of the least
pelvic dimension
on the pelvic floor
A number of changes in the integumentary system occur during pregnancy. Which of the following
changes will persist after birth?
Epulis
Chloasma
Telangiectasia
Striae gravidarum
Chancre
The musculoskeletal system adapts to the changes that occur during pregnancy. Which of the
following changes can expect to experience woman?
Her center of gravity will shift backward.
She will experience increased lordosis.
She will have increased abdominal muscle tone.
She will notice decreased mobility of her pelvic joints.
All answers are correct
Where does the internal rotation of the fetal head finish?
in the plane of pelvic inlet
in the greatest pelvic dimension
in the plane of the least pelvic dimension
when the head descents from the plane of the greatest pelvic dimension to the plane of the least
pelvic dimension
on the pelvic floor
The diagnosis of pregnancy is based on the following positive signs of pregnancy.
Palpation of fetal outline
Visualization of the fetus
Visualization of the fetal genitalia
Positive hCG test.
Delay of menstrual period
Which operation does belong to the birth preparing operations?
obstetric forceps
A.
B. *
C.
D.
E.
16.
A.
B.
C.
D. *
E.
17.
A.
B.
C.
D. *
E.
18.
A.
B. *
C.
D.
E.
19.
A.
B.
C.
D.
E. *
20.
A.
B. *
C.
D.
E.
21.
A.
B.
C. *
D.
E.
22.
A.
B.
C.
D.
E. *
23.
A.
B.
C. *
D.
E.
24.
A.
B.
C. *
D.
E.
25.
A.
B.
C.
D.
E. *
26.
A.
B.
C.
D. *
E.
27.
A.
B. *
C.
D.
E.
28.
A.
B.
C.
D. *
cesarean section
amniotomy
craniotomy
cervical cerclage
Choose indication for cervical cerclage:
threatened abortion
inevitable abortion
incomplete abortion
placenta previa
cervical incompetence
Which operation does belong to the birth preparing operations?
obstetric forceps
cesarean section
amniotomy
craniotomy
cervical cerclage
A major factor for infertility in women is:
Mood
Weight
Anovulation
Unknown
Marital status
Choose indication for cervical cerclage:
threatened abortion
inevitable abortion
incomplete abortion
placenta previa
cervical incompetence
Which operation is performed for fetal shoulders reduction in labor?
amniotomy
embriotomy
craniotomy
cleidotomy
perineotomy
What type of cesarean section is more frequent performed in obstetric?
corporal
transverse lower segment
vertical lower segment
extraperitoneal
intraperitoneal
Women who are trying to conceive should boost their intake of:
Nickel
Lycopene
Potassium
Folic acid
E.
29.
A.
B. *
C.
D.
E.
30.
A.
B. *
C.
D.
E.
31.
A.
B. *
C.
D.
E.
32.
A.
B.
C. *
D.
E.
33.
A. *
B.
C.
D.
E.
34.
A. *
B.
C.
D.
E.
35.
A. *
B.
C.
D.
E.
36.
A.
Protein
Choose the contraindications for cesarean section
anatomic contracted pelvis
endometritis in labor
cefaloopelvic disproportion
deflexed position of the fetal head
breech presentation
What is contraindication for performing of operation of external version of the fetus?
premature fetus
multifetal pregnancy
breech presentation
transverse fetal lie
oblique fetal lie
Choose the indication for episiotomy in labor?
danger for perineal rupture
fetal distress
large fetus
brow presentation
deflexed vertex presentation
Which sexually transmitted disease can result in infertility in women?
Human papillomavirus (HPV)
Genital herpes
Pelvic inflammatory disease
Chlamydiosis
Syphilis
Chose the indication for episiotomy?
breech presentation
uterine inertia
placental abruption
placenta previa
diabetus mellitus in pregnancy
Choose the indication for episiotomy?
scar in the perineal region
placental dysfunction
transverse fetal lie
oblique fetal lie
multifetal pregnancy
Choose indications to corporal cesarean section:
adhesions in the lower uterine segment
breech presentation
oblique fetal lie
deflexed fetal presentation
scar insufficiency in the uterus
If a couple is infertile, this means the couple...
Will never be able to have children
B. *
C.
D.
E.
37.
A.
B. *
C.
D.
E.
38.
A. *
B.
C.
D.
E.
39.
A.
B.
C.
D. *
E.
40.
A.
B.
C. *
D.
E.
41.
A.
B.
C. *
D.
E.
42.
A.
B. *
C.
D.
E.
43.
A.
B. *
C.
Could not conceive after 12 months of unprotected sex
Should look into adoption
Could not conceive after 1 month of unprotected sex
Could not conceive after 3 month of unprotected sex
Choose indications to corporal cesarean section:
breech presentation
large intramural node in the lower uterine segment
oblique fetal lie
scar insufficiency in the uterus
placental abruption
Perineal ruptures of second degree are repaired by:
firstly perineal muscles and vaginal mucous with catgut, after the skin with silk or lavsan
firstly commissural posterior, skin, vaginal mucous
firstly skin, perineum muscles, vaginal mucus
firstly vaginal mucous is sutured, starting from the upper corner, then on the skin silk or lavsan
sutures
all answers are correct
A 35-year-old woman is considered infertile after ____ of trying to conceive.
1 month
2 months
4 months
6 months
12 months
Vaginal lacerations are classified into:
complete rupture of vagina
incomplete rupture of vagina
3 degrees
2 degrees
spontaneous, traumatic
Perineal lacerations are divided into:
complete perineum rupture
incomplete perineum rupture
3 degrees
2 degrees
4 degrees
What can be specified with the indications for applying obstetrical forceps?
Presentation of placenta
Placental abruption
Excessive uterus activity
Contracted pelvis
High standing straight head
Which of the following is correct regarding infertility?
The common cause of infertility is alcohol abuse
Female causes are more than male causes in infertility
Male causes are more than female causes in infertility
D.
E.
44.
A.
B.
C. *
D.
E.
45.
A.
B. *
C.
D.
E.
46.
A. *
B.
C.
D.
E.
47.
A.
B.
C.
D. *
E.
48.
A.
B.
C.
D. *
E.
49.
A. *
B.
C.
D.
E.
50.
A.
B.
C.
D.
E. *
51.
Candida vaginitis always leads to infertility
Infertility is associated to menopausal age, but only in white women
At which term the external cephalic version should be performed ?
By 28 weeks
At 30 weeks
At 32-36 weeks
At 36-38 weeks
At 40 weeks of pregnancy
Danger of perineal rupture is indication for:
Hysterotomy
Epiziotomy
Peryneotomy
Forceps application
Amniotomy
Indicate the definition of infertility:
The inability to conceive after 12 months of normal, regular, unprotected sexual activity
The inability to conceive after 6 months of normal, regular, unprotected sexual activity
Not able to produce enough eggs
Over-producing fresh eggs
Ovarian cyst uni or bilaterally causing the conceive inability
Which type of obstetric forceps are commonly used in modern obstetric practice?
Lazarevic
Nageli
Bush
Simpson
Sims
What of the following is a condition for Cesarean section?
Transverse lie of fetus
Long without amniotic fluid period
Endometritis in labor
Alive fetus
Cephalopelvic disproportion
Which steps are correct in analysis of infertility?
First semen then female factor
Measuring Basal temperature
First semen then after 3 months the female factor
First female factor then semen
A pelvic ultrasound
Which tool is used for cervical fixation?
Hehar’s dilators
Curette
Uterine sound
Forceps
Tenaculum
Contraindications for external cephalic version is:
A.
B. *
C.
D.
E.
52.
A. *
B.
C.
D.
E.
53.
A.
B.
C.
D.
E. *
54.
A.
B. *
C.
D.
E.
55.
A.
B.
C. *
D.
E.
56.
A.
B. *
C.
D.
E.
57.
A.
B.
C.
D.
E. *
58.
A.
Premature pregnancy
Multifetal pregnancy
Pelvic fetal presentation
Transverse fetal lie
Oblique fetal lie
How and when to test for infertility?
Patient comes in after intercourse and check also for mucus ferning on microscopy
Patient comes in after 1 week after intercourse
Patient comes before intercourse
Patients collect the samples by themselves at home
Patient comes before mensis
All of the below analysis should be passed by the woman before C-section EXEPT:
Vaginal microflora
Fetal ultrasound
Biochemical blood analysis
Koagulogramm
Feces examination
What anesthesia is considered optimal for c-section?
Intravenous anesthesia
Epiduralna anesthesia
Spinal anesthesia
Endotracheal anesthesia
All above
How many zygotes are necessary to put into the uterus during the in vitro fertilization?
6
2
4
Many
None
Indicate the gestational period when pregnant woman should attend the female dispensary firstly:
Till 8-weeks of pregnancy
Till 12- weeks of pregnancy
Till 16 weeks of pregnancy
Till 30- weeks of pregnancy
Any time
At first prenatal visit all of the below methods of investigations should be performed in female
dispensary till 12 week EXEPT:
Pelvis investigation
Speculum examination
Bimanual examination
Weighting of the woman
Determination of uterine height and circumference
All of the below methods of investigations should be prescribed in female dispensary for pregnant
woman EXEPT:
Vaginal smear
B.
C.
D.
E. *
59.
A.
B. *
C.
D.
E.
60.
A.
B. *
C.
D.
E.
61.
A.
B. *
C.
D.
E.
62.
A.
B.
C. *
D.
E.
63.
A. *
B.
C.
D.
E.
64.
A.
B. *
C.
D.
E.
65.
A.
B. *
ABO and RhD blood type
General urine analysis
General blood count
X-ray examination of chest
Which examination the pregnant woman should not pass in the second half of pregnancy visiting the
doctor?
Determination of blood pressure
Speculum examination
Uterine height determination
Circumference of the abdomen determination
Weighting
Indicate the gestational period for the first ultrasonography:
8 weeks
11-13weeks +6days
10 weeks
5 weeks
15 weeks
Which parameter in general urine analysis is the most informative during monitoring for pregnant
woman?
Level of epithelial cells
Proteinuria
Amount of sugar
Amount of leukocytes
Transparency
Indicate the gestational age for the first prenatal screening test:
2-3 weeks
4-6 weeks
8-13weeks
13-15weeks
18-22weeks
Indicate the gestational age for the second prenatal screening test:
14-18 weeks
4-6 weeks
8-13weeks
13-15weeks
18-22weeks
When does the pregnant woman obtain vacation before delivery?
22 week of pregnancy
30 weeks of pregnancy
24 week of pregnancy
32 week of pregnancy
35week of pregnancy
What is the duration of vacation for pregnancy and delivery?
120
126
C.
D.
E.
66.
A.
B.
C.
D. *
E.
67.
A.
B.
C.
D. *
E.
68.
A.
B.
C.
D. *
E.
69.
A. *
B.
C.
D.
E.
70.
A. *
B.
C.
D.
E.
71.
A. *
B.
C.
D.
E.
72.
A.
B. *
C.
D.
E.
140
155
180
Which marker is determined in the first prenatal screening?
Progesterone
Estriol
Prolactin
PAPP-A
Oxytocin
Which marker is determined in the first prenatal screening?
Progesterone
Estriol
Prolactin
HCG
Alpha-fetoprotein
Indicate gestational age for the first fetal heart contractions at ultrasonography:
2-3 day after fertilization
2 week of pregnancy
3 week of pregnancy
4 week of pregnancy
5 week of pregnancy
Which disease causes the pelvic deformation?
Rachitis
Rubella
Diabetes Mellitus
Varicella
Measles
Which information about menstrual function can help to determine gestational age of pregnancy?
First day of the last menstrual period
Regularity of menstruation
Duration of menstruation
Age of menstrual cycle beginning
amount of blood loss
Which term indicate normal fetal attitude?
Habitus flexus
Situs longitudinalis
Situs obliques
Presentatio cephalica
Positio I
Which term indicate longitudinal fetal lie?
Habitus flexus
Situs longitudinalis
Situs obliques
Presentatio cephalica
Positio I
73.
A.
B.
C.
D.
E. *
74.
A.
B.
C. *
D.
E.
75.
A. *
B.
C.
D.
E.
76.
A.
B. *
C.
D.
E.
77.
A.
B.
C. *
D.
E.
78.
A.
B.
C.
D. *
E.
79.
A.
B. *
C.
D.
E.
80.
A. *
B.
Which term indicate transverse fetal lie?
Habitus flexus
Situs longitudinalis
Situs obliqus
Presentatio cephalica
Situs transversus
Which term indicate oblique fetal lie?
Habitus flexus
Situs longitudinalis
Situs obliqus
Presentatio cephalica
Positio I
In the first fetal position:
Fetal back is presented to the left uterine wall
Fetal back is presented to the right uterine wall
Fetal back is presented to the anterior uterine wall
Fetal back is presented to the posterior uterine wall
Fetal back is presented to the uterine fundus
In the second fetal position:
Fetal back is presented to the left uterine wall
Fetal back is presented to the right uterine wall
Fetal back is presented to the anterior uterine wall
Fetal back is presented to the posterior uterine wall
Fetal back is presented to the uterine fundus
In the anterior fetal variety:
Fetal back is presented to the left uterine wall
Fetal back is presented to the right uterine wall
Fetal back is presented to the anterior uterine wall
Fetal back is presented to the posterior uterine wall
Fetal back is presented to the uterine fundus
In the posterior fetal variety:
Fetal back is presented to the left uterine wall
Fetal back is presented to the right uterine wall
Fetal back is presented to the anterior uterine wall
Fetal back is presented to the posterior uterine wall
Fetal back is presented to the uterine fundus
Fetal lie is:
Relation of small parts of the fetus to its body
Relation of vertical fetal axis to uterine axis
Relation of fetal axis to pelvic axis
Relation of fetal back to lateral uterine walls
Relation fetal head to the pelvic inlet
Fetal attitude is:
Relation of small parts of the fetus to its body
Relation of vertical fetal axis to uterine axis
C.
D.
E.
81.
A.
B.
C.
D.
E. *
82.
A. *
B.
C.
D.
E.
83.
A.
B.
C.
D. *
E.
84.
A.
B.
C. *
D.
E.
85.
A.
B.
C.
D. *
E.
86.
A. *
B.
C.
D.
E.
87.
Relation of fetal axis to pelvic axis
Relation of fetal back to lateral uterine walls
Relation fetal head to the pelvic inlet
Crossing of the fetal axis to uterine axis under 900 indicates
Habitus flexus
Situs longitudinalis
Situs obliqus
Presentatio cephalica
Situs transversus
Crossing of the fetal axis to uterine axis under 900, and location of the fetal head to the right side of
the uterine wall indicates:
Transverse lie, second position
Oblique lie, second position
Oblique lie, first position
Transverse lie, first position
Longitudinal lie, second position
Crossing of the fetal axis to uterine axis under 900, and location of the fetal head to the left side of
the uterine wall indicates:
Transverse lie, second position
Oblique lie, second position
Oblique lie, first position
Transverse lie, first position
Longitudinal lie, second position
Indicate the best place for fetal heart rate auscultation for longitudinal lie, cephalic presentation, first
position, anterior variety:
From the right, above umbilicus
From the left, above umbilicus
From the left, below umbilicus
From the right, below umbilicus
On the level of umbilicus, from the right
Indicate the best place for fetal heart rate auscultation for longitudinal lie, cephalic presentation,
second position, anterior variety:
From the right, above umbilicus
From the left, above umbilicus
From the left, below umbilicus
From the right, below umbilicus
On the level of umbilicus, from the right
Indicate the best place for fetal heart rate auscultation for longitudinal lie, breech presentation, first
position, anterior variety:
From the right, above umbilicus
From the left, above umbilicus
From the left, below umbilicus
From the right, below umbilicus
On the level of umbilicus, from the right
Indicate the best place for fetal heart rate auscultation for longitudinal lie, breech presentation, second
position, anterior variety:
A.
B. *
C.
D.
E.
88.
A.
B.
C.
D.
E. *
89.
A.
B.
C.
D.
E. *
90.
A.
B.
C. *
D.
E.
91.
A.
B.
C. *
D.
E.
92.
A.
B.
C. *
D.
93.
A.
B.
C. *
D.
E.
94.
A.
B.
From the right, above umbilicus
From the left, above umbilicus
From the left, below umbilicus
From the right, below umbilicus
On the level of umbilicus, from the right
Indicate the best place for fetal heart rate auscultation for transverse lie, first position, anterior
variety:
From the right, above umbilicus
From the left, above umbilicus
From the left, below umbilicus
From the right, below umbilicus
On the level of umbilicus, from the left
Indicate the best place for fetal heart rate auscultation for transverse lie, second position, anterior
variety:
From the right, above umbilicus
From the left, above umbilicus
From the left, below umbilicus
From the right, below umbilicus
On the level of umbilicus, from the right
Indicate the gestational period for the second ultrasonography:
8 weeks
11-13weeks +6days
18 – 20 weeks + 6 days
12 weeks
17weeks
Which presentation is presented in transverse lie:
Cephalic
Foot-link
There is no presented part
Shoulder
Arm
Which presentation is presented in oblique lie:
Cephalic
Foot-link
There is no presented part
Shoulder
Indicate the place for ?-fetoprotein production:
Placenta
Fetal kidneys
Fetal liver and gastrointestinal tract
Decidual mеmbraines
Fetal brain
High level of a-fetoprotein is presented in abnormal development of the fetal:
Cardiovascular system
Kidneys
C. *
D.
E.
95.
A.
B.
C.
D.
E. *
96.
A.
B.
C.
D. *
E.
97.
A.
B.
C. *
D.
E.
98.
A. *
B.
C.
D.
E.
99.
A. *
B.
C.
D.
E.
100.
A.
B.
C. *
D.
E.
101.
A.
B.
C.
D. *
E.
Nervous system
Gastrointestinal tract
Limbs
What is middle weight of uterus at once after labor?
100-200 gr
300-400 gr
500-600 gr
700-800 gr
900-1000 gr
Duration of early postpartum period is:
30 min
3 days
12 days
2 hours
6-8 weeks
Lochia rubra consist of all the following EXEPT:
blood
shreds of the membranes
parts of placenta
decidual membrane
erythrocytes
Lochia alba consist of all the following EXEPT:
blood
mucus
leucocytes
decidual cells
erythrocytes
Uterine fundus on the 1 day of postpartum period is:
2cm below umbilicus
3cm below umbilicus
4cm below umbilicus
5cm below umbilicus
at the level of pubis
Uterine fundus on the 2 day of postpartum period is:
2cm below umbilicus
3cm below umbilicus
4cm below umbilicus
5cm below umbilicus
at the level of pubis
Uterine fundus on the 3 day of postpartum period is:
2cm below umbilicus
3cm below umbilicus
4cm below umbilicus
6cm below umbilicus
at the level of pubis
102.
A.
B.
C.
D.
E. *
103.
A.
B.
C.
D.
E. *
104.
A.
B.
C.
D.
E. *
105.
A. *
B.
C.
D.
E.
106.
A.
B. *
C.
D.
E.
107.
A.
B.
C.
D. *
E.
108.
A.
B.
C. *
D.
E.
109.
A.
B.
Uterine fundus on the 4 day of postpartum period is:
2cm below umbilicus
3cm below umbilicus
4cm below umbilicus
6cm below umbilicus
8cm below umbilicus
Uterine fundus on the 5 day of postpartum period is:
2cm below umbilicus
3cm below umbilicus
4cm below umbilicus
5cm below umbilicus
10cm below umbilicus
Uterine fundus on the 10 day of postpartum period is:
10cm below umbilicus
2cm above umbilicus
4cm above umbilicus
8 cm above umbilicus
At the level of pubis symphysis
Postpartum lochia during the first three days of postpartum period are:
bloody
bloody-serosal
serosal-bloody
serosal
mucosal
Postpartum lochia from 4 to 6 day of postpartum period are:
bloody
bloody-serosal
serosal
serosal-bloody
mucosal
Postpartum lochia from 7 to 9 day of postpartum period are:
bloody
bloody-serosal
serosal
serosal-bloody
mucosal
Postpartum lochia after 10 day of postpartum period are:
bloody
bloody-serosal
serosal
serosal-bloody
mucosal
For breast proliferation response:
prolactin
luteinized hormone
C. *
D.
E.
110.
A. *
B.
C.
D.
E.
111.
A.
B.
C. *
D.
E.
112.
A.
B.
C.
D.
E. *
113.
A.
B.
C.
D. *
E.
114.
A. *
B.
C.
D.
E.
115.
A.
B.
C. *
D.
E.
116.
A. *
B.
C.
D.
E.
estrogens
prostaglandins
corticosteroids
What complication in the future would develop due to the incorrect suturing of cervical laceration?
cervical ectropion;
violation of function of pelvic muscles;
prolapse of uterus;
endometritis;
bleeding.
Which statement is wrong in relation to a colostrum?
production starts on 2nd day after labor;
is the yellow liquid
production starts on 4-5th day after labor;
contains the high quantity of fats;
contains albumens and antibodies.
All of the below factors should be supported for adequate lactation EXEPT:
early breast feeding
correct technique of breast feeding
rational maternal nutrition
“on call” breast feeding
3 hours interval between breast feeding
What hormone is produced by a pituitary gland as a result of nipple stimulation?
follicular-stimulating
vasopressin
progesterone
prolactin
estradiol
All of below belong to the recommendations for postpartum woman nutrition EXEPT:
plenty of fluids
adequate amount of protein
plenty of vitamins, fat, minerals
limitation of the liquid
high caloric meal
What is excluded from the diet of lactating woman?
plenty of fluids
adequate amount of protein
chocolate
milk;
meat.
Uterine subinvolution is:
decreasing of uterine involution
speed-up of the uterine involution
delay of lochia in the uterine cavity
initial stage of endometritis
slow closing of cervix.
117.
A.
B. *
C.
D.
E.
118.
A.
B. *
C.
D.
E.
119.
A.
B.
C.
D.
E. *
120.
A.
B. *
C.
D.
E.
121.
A.
B. *
C.
D.
E.
122.
A.
B. *
C.
D.
E.
123.
A.
B.
C. *
D.
E.
124.
A.
B.
Uterine involution is:
decreasing of uterine contractions
reverse uterine development
delay of lochia in the uterine cavity
initial stage of endometritis
slow closing of cervix
Female milk becomes mature in postpartum period:
on 2-3day
on 5-6day
on 8-10day
on 10-12day
on 15-16day
Which statement about cervix just after delivery is correct?
cervix is closed
cervix is dilated for 2cm
cervix is dilated for 4cm
cervix is formed
cervix is dilated for 10cm
Which statement about cervix on the 9 day of postpartum period is correct?
the cervix is closed
cervix is dilated for 2cm
cervix is dilated for 4cm
cervix is formed
cervix is dilated for 10cm
Routine postpartum care should include searching for all of the following EXCEPT:
Fever
Diabetes
Depression
Anemia
Thrombophlebitis
In treatment of hypertonic uterine dysfunction you would apply:
Oxytocin
Tokolytics
Misoprostol
Miphepristone
Enzaprost
In the case of ineffective pushing efforts you would do:
Tokolysis
Spasmolytic prescription
Vacuum extraction
Therapeutic rest
Amniotomy
Precipitious labor last:
More than 5 hours
Less than 4 hours
C.
D.
E. *
125.
A.
B.
C.
D.
E. *
126.
A.
B.
C.
D.
E. *
127.
A.
B. *
C.
D.
E.
128.
A. *
B.
C.
D.
E.
129.
A.
B.
C.
D.
E. *
130.
A.
B.
C.
D.
E. *
131.
A.
B. *
C.
D.
E.
Less than 6 hours
Less than 5 hours
Less than 3 hours
Uterine inertia means:
Presipitious labor
Excessive uterine activity
Discoordinative uterine activity
Hypertonic uterine dysfunction
Hypotonic uterine dysfunction
Augmentation of labor starts with:
Ultrasonography
Cordocentesis
Fetoscopy
Amnioscopy
Amniotomy
Braxton Hicks contractions are typical for:
Spontaneous abortion
False labor
Preterm labor
Molar pregnancy
Uterine inertia
The first line contractile drug for uterine inertia treatment is:
Oxytocin
Ginipral
Misoprostol
Miphepristone
Labetolol
All of the below are the contraindications to contractile drugs prescriptions in uterine inertia EXEPT:
Fetal distress
Cephalo-pelvic disproportion
Placenta abruption
Placenta previa
Gestational pyelonephritis
What is the maximal rate for oxytocin dropping in uterine inertia?
11-12 drops per minute
25-26 drops per minute
30-32 drops per minute
32-34 drops per minute
40 drops per minute
What is the initial rate for oxytocin dropping in uterine inertia?
1-2 drops per minute
5-6 drops per minute
10-12 drops per minute
15-18 drops per minute
20-28 drops per minute
132.
A. *
B.
C.
D.
E.
133.
A.
B.
C.
D.
E. *
134.
A.
B.
C.
D.
E. *
135.
A.
B. *
C.
D.
E.
136.
A.
B.
C. *
D.
E.
137.
A. *
B.
C.
D.
E.
138.
A.
B.
C.
D. *
E.
139.
A.
B. *
The anatomically contracted pelvis is associated with:
true conjugate 9 cm
internal conjugate 11.5 cm
external conjugate 20.5 cm
diagonal conjugate 13.5 cm
cephalopelvic disproportion
The clinically contracted pelvis is associated with:
true conjugate 9 cm
true conjugate 11.5 cm
true conjugate 12.5 cm
true conjugate 13.5 cm
cephalopelvic disproportion
In a nullipara at term the diagonal conjugate is10.5 cm. What is the true conjugate?
5cm
6cm
7cm
8cm
9cm
What is the main cause of cephalo-pelvic disproportion?
rachitis
fetal macrosomia
preterm labor
twins
fetal distress
Excessive compression of birth canal‘ soft tissues would provoke:
uterine rupture
cervical rupture
vesicovaginal fistulas
perineal rupture
vaginal rupture
The complication of cephalopelvic disproportion is:
uterine rupture
cervical rupture
vesicovaginal fistules
perineal rupture
vaginal rupture
The pathological contractile ring is a sign of:
anatomically contracted pelvis
fetal distress
fetal macrosomia
danger of uterine rupture
fetal distress
Management of the clinically contracted pelvis is:
normal vaginal delivery
cesarean section
C.
D.
E.
140.
A. *
B.
C.
D.
E.
141.
A.
B.
C.
D.
E. *
142.
A.
B. *
C.
D.
E.
143.
A.
B.
C. *
D.
E.
144.
A.
B.
C.
D. *
E.
145.
A. *
B.
C.
D.
E.
146.
A.
B. *
C.
D.
E.
obstetrical version
fetal destroying operation
external cephalic version
Female pelvic sizes are: 25 – 28 – 31 – 20 cm. What is the pelvic type?
normal pelvis
generally contracted pelvis
flat pelvis
flat rachitic pelvis
transverse contracted flat pelvis
Female pelvic sizes are: 23 – 26 – 29 – 17 cm. What is the pelvic type?
normal pelvis
transverse contracted pelvis
flat pelvis
flat rachitic pelvis
generally contracted pelvis
Female pelvic sizes are: 23 – 26 – 29 – 18 cm. What is the pelvic type?
normal pelvis
generally contracted pelvis
flat pelvis
flat rachitic pelvis
transverse contracted pelvis
Female pelvic sizes are: 25 – 28 – 31 – 18 cm. What is the pelvic type?
normal pelvis
generally contracted pelvis
simple flat pelvis
flat rachitic pelvis
transverse contracted pelvis
Female pelvic sizes are: 26 – 26 – 31 – 17 cm. What is the pelvic type?
normal pelvis
generally contracted pelvis
flat pelvis
flat rachitic pelvis
transverse contracted flat pelvis
Generally contracted pelvis is characterized by:
Decreasing of all pelvic diameters
Decreasing of all pelvic anteroposterior diameters
Decreasing of all pelvic transverse diameters
Decreasing of true conjugate and increasing of the pelvic outlet
Combination of generally contracted and flat pelvis
Simple flat pelvis is characterized by:
Decreasing of all pelvic diameters
Decreasing of all pelvic anteroposterior diameters
Decreasing of all pelvic transverse diameters
Decreasing of true conjugate and increasing of the pelvic outlet
Combination of generally contracted and flat pelvis
147.
A.
B.
C.
D. *
E.
148.
A. *
B.
C.
D.
E.
149.
A.
B.
C. *
D.
E.
150.
A. *
B.
C.
D.
E.
151.
A.
B. *
C.
D.
E.
152.
A.
B. *
C.
D.
E.
153.
A.
B.
C. *
D.
E.
154.
Flat rachitic pelvis is characterized by:
Decreasing of all pelvic diameters
Decreasing of all pelvic anteroposterior diameters
Decreasing of all pelvic transversal diameters
Decreasing of true conjugate and increasing of the pelvic outlet
Combination of generally contracted and flat pelvis
What is the cause of cephalo-pelvic disproportion?
Face presentation anterior
Face presentation posterior
Preterm labor
Twins
Fetal distress
Transverse contracted pelvis is characterized by:
Decreasing of all pelvic diameters
Decreasing of all pelvic anteroposterior diameters
Decreasing of all pelvic transverse diameters
Decreasing of true conjugate and increasing of the pelvic outlet
Combination of generally contracted and flat pelvis
The true conjugate of the flat pelvis is 9.5 cm. What is the degree of pelvic contraction?
I degree
II degree
III degree
IV degree
V degree
The true conjugate of the flat pelvis is 8.5 cm. What is the degree of pelvic contraction?
I degree
II degree
III degree
IV degree
V degree
The true conjugate of the flat pelvis is 8.0 cm. What is the degree of pelvic contraction?
I degree
II degree
III degree
IV degree
V degree
The true conjugate of the generally contracted pelvis is 7.0 cm. What is the degree of pelvic
contraction?
I degree
II degree
III degree
IV degree
V degree
The true conjugate of the generally contracted pelvis is 6.5 cm. What is the degree of pelvic
contraction?
A.
B.
C. *
D.
E.
155.
A.
B.
C.
D. *
E.
156.
A. *
B.
C.
D.
E.
157.
A. *
B.
C.
D.
E.
158.
A. *
B.
C.
D.
E.
159.
A.
B. *
C.
D.
E.
160.
A.
B. *
C.
D.
E.
161.
A. *
B.
I degree
II degree
III degree
IV degree
V degree
The true conjugate of the generally contracted pelvis is 5.0 cm. What is the degree of pelvic
contraction?
I degree
II degree
III degree
IV degree
V degree
Indicate “rare occurred” type of contracted pelvis:
osteomalatic pelvis
generally contracted pelvis
flat pelvis
flat rachitic pelvis
generally contracted pelvis
Management of the patients with I degree of pelvic contraction and probable fetal weight 2900g:
vaginal delivery
cesarean section only
vaginal delivery or cesarean section
fetal destroying operation
labor preparing operation
Management of the patients with II degree of pelvic contraction and probable fetal weight 2800g:
vaginal delivery
cesarean section only
vaginal delivery or cesarean section
fetal destroying operation
labor preparing operation
Management of the patients with III degree of pelvic contraction:
vaginal delivery
cesarean section only
vaginal delivery or cesarean section
fetal destroying operation
labor preparing operation
Management of the patients with IV degree of pelvic contraction:
vaginal delivery
cesarean section only
vaginal delivery or cesarean section
fetal destroying operation
labor preparing operations
What is the cause of cephalo-pelvic disproportion?
sinciput vertex presentation and large fetus
face presentation posterior
C.
D.
E.
162.
A.
B. *
C.
D.
E.
163.
A.
B.
C.
D.
E. *
164.
A.
B.
C. *
D.
E.
165.
A.
B.
C.
D. *
E.
166.
A.
B.
C.
D. *
E.
167.
A.
B.
C.
D. *
E.
168.
A.
B.
C.
D. *
E.
occiput presentation
foot-link presentation
knee-link presentation
What is the cause of cephalo-pelvic disproportion?
frank breech presentation
sinciput vertex presentation and III degree of pelvic contraction
occiput presentation
foot-link presentation
knee-link presentation
Which of the following is associated with meconium-stained amniotic fluid?
fetal macrosomia
vaginal delivery
cesarean section
chorioamnionitis
fetal distress
What is the normal average baseline fetal heart rate at term?
100 to 140 bpm
110 to 150 bpm
110 to 170 bpm
120 to 140 bpm
160-179 bpm
What is bradycardia?
baseline fetal heart rate < 130 for > 5 min
baseline fetal heart rate < 140 for > 15 min
baseline fetal heart rate < 120 for > 5 min
baseline fetal heart rate < 110 for > 15 min
baseline fetal heart rate < 120 for > 3 min
Which of the following is NOT associated with fetal bradycardia?
head compression
congenital heart block
fetal distress
gestational pyelonephritis
placental abruption
Acceleration defines as:
increasing of fetal heart rate for 10 bpm for 10 sec
increasing of fetal heart rate for 15 bpm for 10 sec
increasing of fetal heart rate for 10 bpm for 15 sec
increase of fetal heart rate for 15 bpm for 15 sec
increasing of fetal heart rate for 5 bpm for 15 sec
Fetal heart rate monitoring includes evaluation all of the below parameters EXEPT:
baseline rhythm
fetal heart rate variability
presence of accelerations
ratio between amplitude and rhythm of oscillations
presence of decelerations
169.
A.
B.
C.
D. *
E.
170.
A.
B.
C. *
D.
E.
171.
A.
B. *
C.
D.
E.
172.
A. *
B.
C.
D.
E.
173.
A.
B.
C.
D.
E. *
174.
A.
B.
C.
D. *
E.
175.
A.
B.
C.
D. *
E.
176.
A.
B. *
Which method is the best for evaluation of fetal well-being:
amnioscopy
ultrasonography
fetal heart rate monitoring
biophysical profile
determination of a-fetoprotein in amniotic fluid
How many minutes do you need for fetal heart rate monitoring?
10
20
30
40
50
Nonstress test – is:
amount of amniotic fluid
response of the fetal heart rate to the fetal movement
response of the fetal heart rate to physical irritation
response of the fetal heart rate to contractile drugs
response of the fetal heart rate to spasmolytics
Reactive nonstress test is:
increasing of fetal heart rate at least 15 bpm over a period 15 seconds following a fetal movement
increasing of fetal heart rate at least 1 bpm over a period 1 seconds following a fetal movement
decreasing of fetal heart rate at least 15 bpm over a period 15 seconds following a fetal movement
decreasing of fetal heart rate at least 15 bpm over a period 15 seconds following a fetal movement
absence of accelerations in response of fetal movement
Nonreactive nonstress test is:
increasing of fetal heart rate at least 15 bpm over a period 15 seconds following a fetal movement
increasing of fetal heart rate at least 1 bpm over a period 1 seconds following a fetal movement
decreasing of fetal heart rate at least 15 bpm over a period 15 seconds following a fetal movement
decreasing of fetal heart rate at least 15 bpm over a period 15 seconds following a fetal movement
absence of accelerations in response of fetal movement
How many parameters of fetal wellbeing are presented in determination of biophysical profile?
2
3
4
5
6
All of the below are the parameters of biophysical profile EXCEPT:
amount of amniotic fluid
fetal tone
reactive nonstress test
fetal urine output
fetal breathing movements
Biophysical profile determines:
during fetal heart rate monitoring
in ultrasonography
C.
D.
E.
177.
A.
B.
C.
D. *
E.
178.
A.
B. *
C.
D.
E.
179.
A.
B.
C. *
D.
E.
180.
A.
B.
C.
D.
E. *
181.
A.
B.
C.
D. *
E.
182.
A.
B. *
C.
D.
E.
183.
A.
B.
C.
D.
E. *
in cordocentesis
in amnioscopy
in amniocentesis
How many points of biophysical profile is considered to be normal?
1-2
3-4
5-6
7- 10
12-14
Two points for normal fetal breathing movements (FBM) in biophysical profile mean:
at least 5 FBM for 5 seconds in 10 minutes
at least 1 FBM for 60 seconds during 30 minutes observation
at least 1 FBM for 20 seconds during 30 minutes
at least 1 FBM for15 seconds during 15 minutes
at least 2 FBM for 30 seconds during 30 minutes
Two points for normal fetal tone in biophysical profile mean:
at least 2 episodes of active extension with return to flexion of fetal limbs/trunk during 30 minutes
at least 3 episode of active extension with return to flexion of fetal limbs/trunk in 15 minutes
at least 1 episode of active extension with return to flexion of fetal limbs/trunk in 30 minutes
at least 2 episodes of active extension with return to flexion of fetal limbs/trunk during 10 minutes
at least 1 episode of active extension without return to flexion of fetal limbs/trunk during 10 minutes
All of the below complications should be presented during amniocentesis EXCEPT:
maternal trauma
fetal trauma
infection
abortion
placenta previa
All of below are the main indications for cordocentesis EXCEPT:
fetal distress
fetal isoimmunization
metabolic fetal disorders
maternal pregnancy induced hypertension
fetal karyotyping
Cordocentesis – is:
puncture of amniotic sac
percutaneous umbilical blood sampling
skin sample
chorionic villus sampling
fetoscopy
Decreasing of fetal heart rate below baseline is called as:
feceleration
acceleration
doceleration
perceleration
deceleration
184.
A. *
B.
C.
D.
E.
185.
A. *
B.
C.
D.
E.
186.
A. *
B.
C.
D.
E.
187.
A. *
B.
C.
D.
E.
188.
A.
B.
C. *
D.
E.
189.
A. *
B.
C.
D.
E.
190.
A. *
B.
C.
D.
E.
Variable decelerations are closely connected with:
umbilical cord occlusion
placental abruption
placental previa
diabetes mellitus
pregnancy induced hypertension
What is the normal perception of fetal movement by pregnant woman?
more than 10 movements during 12 hours
2 movements for 2 hours
3 movements in 1 hour
5 movements in 30 minutes
1 movement for 24 hours
Normal amount of amniotic fluid volume in the biophysical profile mean:
at least 1 pocket of amniotic fluid that measures at least 2 cm in two perpendicular planes during 30
minutes
at least 2 pockets of amniotic fluid at least 1 cm in two perpendicular planes during 30 minutes
at least 1 pocket of amniotic fluid at least 1 cm in two perpendicular planes during 15 minutes
at least 3 pockets of amniotic fluid at least 1 cm in two perpendicular planes during 20 minutes
at least 1 pocket of amniotic fluid at least 1 cm in two perpendicular planes during 50 minutes
During cordocentesis all of the below complications should be presented EXCEPT:
oligohydramnios
fetal trauma
fever
abortion
placenta abruption
How many points does the woman receive at biophysical profile for one fetal breath movement by 60
seconds duration during 30 minutes observation?
0
1
2
3
4
How many points does the woman receive at biophysical profile for absence of active extension with
return to flexion of fetal limb/trunk during 30 minutes observation?
0
1
2
3
4
Biophysical profile of the fetus determines from:
30 week of gestation
16 week of gestation
12 week of gestation
40 week of gestation
34 week of gestation
191.
A.
B. *
C.
D.
E.
192.
A. *
B.
C.
D.
E.
193.
A. *
B.
C.
D.
E.
194.
A.
B.
C.
D.
E. *
195.
A. *
B.
C.
D.
E.
196.
A.
B. *
C.
D.
E.
197.
A.
B. *
C.
D.
E.
198.
A. *
B.
Equivocal biophysical fetal profile has:
4 points and lower
5-6 points
7-10 points
3-6 points
5-10 points
Abnormal biophysical fetal profile has:
4 points and lower
5-6 points
7-10 points
3-6 points
5-10 points
What you should do in case of abnormal biophysical fetal profile:
Emergent delivery
To continue observation
To stop delivery stimulation
To perform ultrasonography
To change maternal position
In case of fetal distress in labor we undergo all below prescriptions EXEPT:
Avoid supine position of the patient
Stop oxytocin dropping
Vacuum extraction
Forceps delivery
Continue oxytocin dropping
In case of fetal distress in the first period of labor we:
Perform Cesarean section immediately
Continue observation
Continue oxytocin dropping
Perform vacuum extraction
Prescribe tokolytics
In case of fetal distress in the second period of labor in breach presentation we:
Perform Cesarean section immediately
Perform breech extraction
Continue oxytocin dropping
Prescribe intravenous metabolic drugs
Perform vacuum extraction
How many degrees of fetal growth retardation have been distinguished during ultrasonography?
2
3
4
5
6
The first degree of fetal growth retardation during ultrasonography corresponds with:
2 weeks retardation
3 weeks retardation
C.
D.
E.
199.
A.
B.
C. *
D.
E.
200.
A.
B.
C.
D.
E. *
201.
A.
B.
C. *
D.
E.
202.
A.
B.
C. *
D.
E.
203.
A. *
B.
C.
D.
E.
204.
A. *
B.
C.
D.
E.
205.
A.
B.
C. *
D.
E.
4 weeks retardation
5 weeks retardation
1 week retardation
The second degree of fetal growth retardation corresponds with:
2 weeks retardation
6 weeks retardation
3-4 weeks retardation
5 weeks retardation
1 week retardation
The third degree of fetal growth retardation corresponds with:
2 weeks retardation
3 weeks retardation
4 weeks retardation
1 week retardation
more than 4 weeks retardation
Fetal heart rate auscultation by obstetric stethoscope auscultation is performed from:
20th week of pregnancy
15th week of pregnancy
23-24th week of pregnancy
28th week of pregnancy
30th week of pregnancy
Puncture of the fetal cord vessels is called as:
Amnioscopy
Fetoscopy
Cordocentesis
Amniocentesis
Culdocentesis
How is macrosomia defined?
Birthweight > 4000 g
Birthweight > 4100 g
Birthweight > 4500 g
Birthweight > 5000 g
Birthweight > 5100 g
Which of the following is a risk factor for macrosomia?
Diabetes
Pregnancy induced hypertension
Maternal anemia
Gestational age > 42 weeks
Preterm labor
Cesarean section undergo all types of multiple pregnancies EXCEPT:
Breech – breech presentation
Breech – transverse presentation
Cephalic – cephalic presentation
Breech– cephalic presentation
Transverse – transverse
206.
A.
B.
C.
D. *
E.
207.
A. *
B.
C.
D.
E.
208.
A.
B.
C. *
D.
E.
209.
A.
B.
C. *
D.
E.
210.
A.
B.
C.
D.
E. *
211.
A.
B.
C. *
D.
E.
212.
A.
B. *
C.
D.
E.
213.
A.
B. *
Which fetus is called as “giant”?
Birthweight > 4000 g
Birthweight > 4100 g
Birthweight > 4500 g
Birthweight > 5000 g
Birthweight > 5100 g
Which of the following is NOT a complication of macrosomia?
Placenta abruption
Brachial plexus injury
Shoulder dystocia
Cephalopelvic disproportion
Uterine rupture
The most common sign for dichorionic diamnionic twin pregnancy is:
Discordance
Sonographic measurement of the dividing membranes thinner than 1 mm
Two separate placentae
Fetal growth retardation
Placenta presentation
With twins, which of the following is NOT true?
Pregnancy hypervolemia approximates 50 to 60%
Cardiac output is increased
Pulse rate is decreased
Stroke volume is increased
The body weight increased
Which of the following is NOT a specific complication of monoamnionic twins?
Cord entanglement
Discordancy
Conjoined twins
Preterm labor
Postdate labor
Spontaneous vaginal delivery undergoes all types of clinical situations EXCEPT:
Cephalic –cephalic presentation
Cephalic –breech presentation
Breech – cephalic presentation
Cephalic – transverse presentation
All of the above
What is the best management of labor in breech – breech presentation?
vaginal delivery
cesarean section
vacuum extraction
forceps application
breech extraction
What is the best management of labor in breech –cephalic presentation?
vaginal delivery
cesarean section
C.
D.
E.
214.
A. *
B.
C.
D.
E.
215.
A. *
B.
C.
D.
E.
216.
A.
B. *
C.
D.
E.
217.
A.
B.
C. *
D.
E.
218.
A.
B. *
C.
D.
E.
219.
A.
B. *
C.
D.
E.
220.
A.
B.
C. *
D.
E.
vacuum extraction
forceps application
breech extraction
What is the best management of labor in cephalic – breech presentation?
vaginal delivery
cesarean section
vacuum extraction
forceps application
breech extraction
What is the best management of labor in cephalic – cephalic presentation?
vaginal delivery
cesarean section
vacuum extraction
forceps application
breech extraction
What is the best management of labor in breech – transverse presentation?
vaginal delivery
cesarean section
vacuum extraction
forceps application
breech extraction
A twin fetus is at risk for all of the below complications EXCEPT:
Stillbirth
Abnormal fetal development
Macrosomia
Malpresentation
Umbilical cord entanglement
All of the below are patients at risk for macrosomic fetus EXCEPT:
endocrine disorders
multiple pregnancy
obesity
diabetes mellitus
excessive nutrition
What congenital anomaly is associated with polyhydramnion?
ventral septal defect
spina bifida
omphalocele
hypoplastic kidneys
fetal anemia
At which gestational age amniotic fluid volume reach approximately 1-1,5 mL?
16 weeks
28 weeks
36 weeks
40 weeks
42 weeks
221.
A.
B.
C.
D.
E. *
222.
A.
B.
C.
D. *
E.
223.
A. *
B.
C.
D.
E.
224.
A.
B.
C.
D.
E. *
225.
A.
B.
C.
D.
E. *
226.
A.
B.
C. *
D.
E.
227.
A. *
B.
C.
D.
E.
228.
A.
B.
Polyhydramnios defines as increasing of amniotic fluid more than:
1000 mL
1400 mL
1600 mL
1800 mL
2000 mL
Which of the following anomalies are not associated with polyhydramnios?
central nervous system abnormalities
duodenal atresia
esophageal atresia
renal agenesis
immune hydrops
What is the major source of amniotic fluid?
amniotic epithelium
fetal urination
fetal swallowing
fetal inspiration
placental production
What is the most likely cause of polyhydramnion?
maternal anemia
maternal cardiac diseases
decreasing of maternal urination
increased blood pressure
maternal infections
Which of the following maternal symptom is NOT associated with acute polyhydramnios?
edema
respiratory distress
enlarged abdomen
preterm labor
normal maternal condition
What is a frequent maternal complication of polyhydramnios?
preeclampsia
hypertonic uterine activity
placental abruption
postterm pregnancy
anemia
What are the main compounds of the amniotic fluid?
vernix and ectodermal fetal cells
mononuclear cells and macrophages
lymphocytes
eosinophils and vernix
erythrocytes
What is the most common cause of oligohydramnios?
renal anomalies
fetal growth retardation
C.
D. *
E.
229.
A.
B.
C.
D. *
E.
230.
A.
B. *
C.
D.
E.
231.
A.
B.
C.
D.
E. *
232.
A.
B. *
C.
D.
E.
233.
A. *
B.
C.
D.
E.
234.
A. *
B.
C.
D.
E.
235.
A. *
B.
C.
D.
E.
twin–twin transfusion
premature rupture of fetal membranes
Diabetus mellitus
What is recommended for labor’ induction in patients with polyhydramnion?
stimulation of uterine contractions
episiotomy
cesarean section
early amniotomy
obstetrics forceps
Polyhydramnios is a risk factor of :
postpartum infections
early postpartum bleeding
fetal macrosomia
fetal malformations
Pregnancy induced hypertension
Which complication is typical for I stage of labor in patients with polyhydramnios?
placenta Previa
bleeding
maternal infection
fetal distress
hypotonic uterine contractions
What is the minimal physiologic blood loss in labor?
100 ml
250 ml
300 ml
350 ml
450 ml
What is the management of the total placenta percreta?
total hysterectomy
manual separation and removal of the placenta
hysterotomy
subtotal hysterectomy
ligation of the vessels
What is the management of the partial placenta percreta?
total hysterectomy
manual separation and removal of the placenta
hysterotomy
subtotal hysterectomy
ligation of the vessels
What is the management of the focal placenta percreta?
total hysterectomy
manual separation and removal of the placenta
hysterotomy
subtotal hysterectomy
ligation of the vessels
236.
B.
Which highest dose of oxytocin is prescribed in the uterine atony?
5 units
10 units
15 units
20 units
25 units
Which dose of misoprostol is prescribed in the uterine atony?
800 mkg
600 mkg
400 mkg
200 mkg
100 mkg
Couvelaire uterus is the complication of :
placental abruption
placental adherence
placental accreta
placental percreta
uterine atony
What is the best method of genital tract trauma diagnosis?
vaginal examination
speculum inspection
patients complaints
female history
ultrasonography
Which of the following is the most ideal method of delivery for severe abruption in the second stage
of labor in breech presentation?
forceps delivery
immediate cesarean section
cesarean section after blood replacement
breech extraction
vacuum application
What is the best management in the mild form of placental abruption?
forceps delivery
immediate cesarean section
C.
D. *
E.
242.
A.
B.
C.
D. *
E.
243.
A.
cesarean section after blood replacement
observation
vacuum application
Which of the following is NOT characteristic of early hypovolemic shock?
decreased mean arterial pressure
decreased stroke volume
increased arteriovenous oxygen content difference
increased central venous pressure
there is no correct answer
Which of the following is characteristic of the secondary phase of amniotic fluid embolism?
pulmonary hypertension
A.
B.
C.
D. *
E.
237.
A. *
B.
C.
D.
E.
238.
A. *
B.
C.
D.
E.
239.
A.
B. *
C.
D.
E.
240.
A.
B.
C.
D. *
E.
241.
A.
B.
C.
D. *
E.
244.
A.
B.
C.
D. *
E.
245.
A. *
B.
C.
D.
E.
246.
A.
B.
C. *
D.
E.
247.
A.
B.
C. *
D.
E.
248.
A.
B.
C.
D.
E. *
249.
A.
B.
C. *
D.
E.
250.
A.
B.
C.
decreased systemic vascular resistance
decreased left ventricular stroke index
lung injury and coagulopathy
there is no correct answer
How many degrees of hemorrhagic shock severity do you know?
1
2
3
4
5
What is the blood loss in the first degree of hemorrhagic shock?
750-1000ml
1000-1500ml
1500-2500ml
500-750ml
>2500ml
What is the blood loss in the second degree of hemorrhagic shock?
500-750ml
750-1000ml
1000-1500ml
1500-1800ml
>1800ml
What is the blood loss in the third degree of hemorrhagic shock?
500-750ml
750-1000ml
1500-2500ml
1000-1200ml
1200-1300ml
What is the blood loss in the fourth degree of hemorrhagic shock?
500-750ml
750-1000ml
1500-2000ml
2000-2200ml
>2500ml
All of the above are the main causes of disseminated intravascular clotting (DIC) syndrome
EXCEPT:
Placenta abruption
Embolic fluid embolism
Chronic bronchitis
Pregnancy induced hypertension
Hypotonic bleeding
What is the volume of infusion therapy in the mild degree of hemorrhagic shock ?
500 ml
1000 ml
1500 ml
D.
A. *
B.
2000 ml
2500 ml
Which dose of colloids is recommended in the mild degree of hemorrhagic shock?
5 ml / kg
10 ml / kg
15 ml / kg
20 ml / kg
25 ml/kg
All of the below belong to the widely used colloids in obstetrics EXCEPT:
Refortan
Gelofusin
Ringer-Lokka
Stabisol
Fresh-frozen plasma
What is the volume of infusion therapy in the moderate degree of hemorrhagic shock?
1000 ml
1500 ml
2000 ml
2500 ml
3000 ml
What is the volume of infusion therapy in the severe degree of hemorrhagic shock?
1500 ml
2000 ml
2500 ml
3000 ml
4000 ml
What is the first stage of Disseminated Intravascular Clotting syndrome?
hypocoagulation without generalizing fibrinolysis
hypercoagulation
hypocoagulation with generalizing fibrinolysis
total fibrinolysis
local fibrinolysis
What is the second stage of Disseminated Intravascular Clotting syndrome?
hypocoagulation without generalizing fibrinolysis
hypercoagulation
C.
D.
E.
257.
A.
B.
C. *
D.
E.
258.
hypocoagulation with generalizing fibrinolysis
total fibrinolysis
local fibrinolysis
What is the third stage of Disseminated Intravascular Clotting syndrome?
hypocoagulation without generalizing fibrinolysis activation
hypercoagulation
hypocoagulation with generalizing fibrinolysis activation
total fibrinolysis
local fibrinolysis
What is the fourth stage of Disseminated Intravascular Clotting syndrome?
E. *
251.
A.
B. *
C.
D.
E.
252.
A.
B.
C. *
D.
E.
253.
A.
B.
C.
D.
E. *
254.
A.
B.
C.
D.
E. *
255.
A.
B. *
C.
D.
E.
256.
A.
E. *
hypocoagulation without generalizing fibrinolysis activation
hypercoagulation
hypocoagulation with generalizing fibrinolysis activation
total fibrinolysis
Local fibrynolysis
All of the below are the main signs of Disseminated Intravascular Clotting syndrome EXCEPT:
Hemorrhages into skin and mucous membranes
Hemorrhages from the places of injections, incisions, uterus
Necrosis of some areas of skin and mucous membranes
Hypertension
Central nervous system impairment, acute renal, liver, pulmonary insufficiency.
Which drug is contraindicated in all stages of Disseminated Intravascular Clotting syndrome?
Heparin
Fresh frozen plasma
Contrical
Transamacha acid
Gordox
Which drug is contraindicated in all stage of Disseminated Intravascular Clotting syndrome?
Fresh frozen plasma
Fibrinogen
Aminocapronic acid
Tranexamic acid
Proteolytic enzymes inhibitors
All of the below are the main signs of Cardiorespiratory collapse in amniotic fluid embolism
EXCEPT:
Severe pain in the chest
Cough
Feeling of the death, cyanosis
Hypertension
Sudden dyspnea, hypotension
In which level of hemoglobin blood transfusion in hemorrhagic shock is indicated?
< 120 g/l
< 110 g/l
< 100 g/l
< 80 g/l
< 70 g/l
264.
A. *
B.
C.
D.
E.
265.
A.
B.
Shock index is 0.8-1. What is the blood loss?
750-1000ml
1000-1200
1200-1500
1500-1700
1800-2000
Shock index is 1.0-1.5. What is the blood loss?
400-600ml
750-900ml
B.
C.
D. *
E.
259.
A.
B.
C.
D. *
E.
260.
A. *
B.
C.
D.
E.
261.
A.
B. *
C.
D.
E.
262.
A.
B.
C.
D. *
E.
263.
A.
B.
C.
D.
C. *
B.
C.
1000-1500ml
200-400ml
900-1000ml
Shock index is 1.5 – 2.0. What is the blood loss?
400-600ml
750-900ml
1000-1500ml
1500-2500ml
900-1000ml
Shock index is >2.0. What is the blood loss?
750-1000ml
1000-1200
1200-1500
1500-1700
>2500
All of the below are risk factors for amniotic fluid embolism EXCEPT:
excessive labor contractions
manual removal of placenta
placenta abruption
chronic pyelonephritis
hemorrhagic shock
All of the below are risk factors for septic shock EXCEPT:
Placenta abruption
Septic abortion
Chorionamnionitis
Pyelonephritis
Endometritis
Which dose of colloids is recommended in the moderate degree of hemorrhagic shock?
5 ml / kg
10 ml / kg
15 ml / kg
20 ml / kg
25 ml/kg
Which dose of fresh-frozen plasma is recommended in the moderate degree of hemorrhagic shock?
5 - 10 ml / kg
10 - 15 ml / kg
15 - 20 ml / kg
D.
E.
272.
A.
B. *
C.
D.
E.
20 - 25ml / kg
25 - 30ml/kg
Which dose of blood transfusion is recommended in the severe degree of hemorrhagic shock?
5 ml / kg
10-20 ml / kg
30 ml / kg
40 ml / kg
3ml/kg
D.
E.
266.
A.
B.
C.
D.
E.
267.
A.
B.
C.
D.
E.
268.
A.
B.
C.
D. *
E.
269.
A. *
B.
C.
D.
E.
270.
A.
B. *
C.
D.
E.
271.
A. *
273.
279.
Which dose of crystalloids is recommended in the severe degree of hemorrhagic shock?
7 ml / kg
10 ml / kg
15 - 20 ml / kg
25ml / kg
25 - 30ml/kg
Which dose of fresh-frozen plasma is recommended in the severe degree of hemorrhagic shock?
5 - 10 ml / kg
10 - 15 ml / kg
15 - 20 ml / kg
20 - 25ml / kg
25 - 30ml/kg
All of the below are indicated in the infusion therapy in the hemorrhagic shock EXCEPT:
Reopolyglycin
Isotonic solution
Refortan
Gelofusin
Blood transfusion
All of the above are indicated in the infusion therapy in the hemorrhagic shock EXCEPT:
Isotonic solution
5 % glucose
Stabisol
Gelofusin
Blood transfusion
What is the initial rate of infusion therapy in the case of hemorrhagic shock and low arterial blood
pressure?
50 ml per minute
100 ml per minute
200 ml per minute
150 ml per minute
250 ml per minute
What is the female heart rate in the mild degree of hemorrhagic shock?
70-80 beats per min
90 -100 beats per min
100-110 beats per min
110-120beats per min
120-130 beats per min
What is the female heart rate in the moderate degree of hemorrhagic shock?
A.
B.
C. *
D.
E.
280.
A.
70-80 beats per min
90 -100 beats per min
110-120 beats per min
120 -140beats per min
160 beats per min
What is the female heart rate in the severe degree of hemorrhagic shock?
70-80 beats per min
A. *
B.
C.
D.
E.
274.
A.
B. *
C.
D.
E.
275.
A. *
B.
C.
D.
E.
276.
A.
B. *
C.
D.
E.
277.
A.
B.
C. *
D.
E.
278.
A.
B.
C. *
D.
E.
B.
C.
D.
E. *
281.
A.
B. *
C.
D.
E.
282.
A.
B.
C. *
D.
E.
283.
A.
B.
C.
D. *
E.
284.
A.
B.
C.
D.
E. *
285.
A.
B. *
C.
D.
E.
286.
A.
B.
C.
D.
E. *
287.
A.
80 -90 beats per min
90-100 beats per min
100 -110beats per min
120-140 beats per min
What is the level of systolic blood pressure in the mild degree of hemorrhagic shock?
120 mm Hg
90-100 mm Hg
70 – 90 mm Hg
50- 70 mm Hg
< 50 mm Hg
What is the level of systolic blood pressure in the moderate degree of hemorrhagic shock?
120 mm Hg
90-100 mm Hg
70 – 90 mm Hg
50- 70 mm Hg
< 50 mm Hg
What is the level of systolic blood pressure in the severe degree of hemorrhagic shock?
20 mm Hg
90-100 mm Hg
70 – 90 mm Hg
50- 70 mm Hg
< 50 mm Hg
What is the level of systolic blood pressure in the considerable degree of hemorrhagic shock ?
120 mm Hg
90-100 mm Hg
70 – 90 mm Hg
50- 70 mm Hg
< 50 mm Hg
Predomination of amniotic pressure over venous is presented in Amniotic fluid embolism in all
below situations EXCEPT:
excessive labor contractions
preterm labor
placenta abruption
uterine cervix dystocia
multiple pregnancy
Trauma of venous uterine vessels is presented in Amniotic fluid embolism in all below situations
EXCEPT:
placenta abruption
puerperal hypotonic hemorrhage
cesarean section
manual removal of placenta
postdate pregnancy
Differential diagnosis of Amniotic fluid embolism is performed with all of the below diseases
EXCEPT:
Myocardial infarction
B.
E.
294.
Pulmonary artery thrombembolism
Pneumonia
Air’ embolism
Mendelson’ syndrome
When does hypotonic uterine bleeding start:
at cervical stage
at the expulsive stage
after the delivery of the fetus
after the placental separation
At pelvic stage
All of the below are the main reasons for postpartum hemorrhages EXEPT:
Birth canal trauma
Violation of the uterine contractile activity
DIC syndrome
Hypertonic disease
Lacerations of birth canal
In the early postpartum bleeding you should perform firstly:
Inspection and suturing of birth canal lacerations
Colposcopy
Hysterotocography
Laparoscopy
Ultrasonography
First aid in case of early postpartum bleeding includes:
Contractile drugs prescription
Diuretics administration
Vessels ligation
Using of mezaton because of low blood pressure
Hysterectomy
Retained placenta in uterine cavity is diagnosed firstly by:
Abnormal shape of the placenta
Delay of amniotic membranes
Broken vessels in the placenta
Thin placenta
Hypertension
Retained placenta in uterus in late postpartum period is diagnosed by:
Uterine palpation
Ultrasound examination
X ray examination
Vaginal examination
Colposcopy
Management of bleeding on 6 day of postpartum period:
A.
B. *
C.
D.
Manual exploration of the uterine cavity
Uterine curettage
Pudendal block
Puncture of the Douglas space
C. *
D.
E.
288.
A.
B.
C.
D. *
E.
289.
A.
B.
C.
D. *
E.
290.
A. *
B.
C.
D.
E.
291.
A. *
B.
C.
D.
E.
292.
A.
B.
C. *
D.
E.
293.
A.
B. *
C.
D.
E.
C.
Nothing above
The next step after prescription 2-3 line contractile drugs for atonic postpartum bleeding treatment is:
External massage of the uterus
Oxytocin prescription
Bimanual uterine compression
Tranexamic acid prescription
Balloon tamponade of the uterus
The next step after bimanual uterine compression for atonic postpartum bleeding treatment is:
External massage of the uterus
Oxytocin prescription
Manual exploration of uterine cavity
Tranexamic acid prescription
Balloon tamponade of the uterus
Which blood loss in uterine atony is indication for laparotomy?
1, 5% and more from body weight
more than 250 ml
more than 400 ml
more than 100 ml
0,5 % from body weight
Methods of surgical hemostasis for uterine devascularization?
bilateral ligation of uterine vessels
bilateral ligation of ovarian vessels
compressive sutures
bilateral ligation of a.iliaca interna
all of the above
Indications for hysterectomy in the case of postpartum bleeding?
Placenta accreta
Placenta increta
Placenta percreta
Uterine rupture
All of the above
Management of uterine inversion in postpartum period:
Reposition of the uterus
Total uterine hysterectomy
Subtotal uterine hysterectomy
Tamponade of the uterus
Ligation of uterine vessels
What is the most characteristic sign of amniotic fluid embolism during cesarean section in general
anesthesia?
Cough
Bradycardia
Hypertension
D.
E. *
Hypothermia
Unexplained decreasing of saturation to 70-85%
295.
A.
B.
C. *
D.
E.
296.
A.
B.
C.
D.
E. *
297.
A. *
B.
C.
D.
E.
298.
A.
B.
C.
D.
E. *
299.
A.
B.
C.
D.
E. *
300.
A. *
B.
C.
D.
E.
301.
A.
B.
302.
D.
E.
309.
What is the most characteristic sign of amniotic fluid embolism during cesarean section in general
anesthesia?
Cough
Bradycardia
Hypertension
Hypothermia
Wet wheezing in the lungs
Which of the following could be risk factor for ectopic pregnancy?
Previous pelvic/tubal surgery- PID (Pelvic Inflammatory Disease)
Ovarian torsion
HIV
Maternal obesity
Maternal trauma, such as a car accident
Pregnancy induced hypertension is hypertension which
Detected before pregnancy
Detected after 20th week
Detected before 20th week
Detected 45 days after delivery
Detected during pregnancy
Indications for drug therapy in woman with chronic hypertension include
Diastolic BP>110
Systolic BP >140
Diastolic BP>130
Systolic BP >160
Elevated BP
Which drug is contraindicated for woman with chronic hypertension?
Peripheral vasodilatators
Angiotensin-converting enzyme inhibitors
β-blockers
Ca-channel blockers
α 2-receptor agonists
Which drug is contraindicated for woman with chronic hypertension?
Peripheral vasodilatators
Diuretics
?-blockers
Ca-channel blockers
?2-receptor agonists
What is the first sign of fluid retention suggestive of pregnancy-induced hypertension?
Abdominal enlargement
Facial swelling
Sudden weight gain
Swelling of the feet and ankles
General edema
At the result of the internal rotation of the fetal head the sagittal suture is
A.
in the transversal size of pelvic inlet
A.
B.
C.
D.
E. *
303.
A. *
B.
C.
D.
E.
304.
A.
B. *
C.
D.
E.
305.
A. *
B.
C.
D.
E.
306.
A.
B. *
C.
D.
E.
307.
A.
B. *
C.
D.
E.
308.
A.
B.
C. *
B.
C.
D.
E. *
310.
A.
B.
C. *
D.
E.
311.
A. *
B.
C.
D.
E.
312.
A. *
B.
C.
D.
E.
313.
A. *
B.
C.
D.
E.
314.
A.
B.
C. *
D.
E.
315.
A.
B.
C. *
D.
E.
in the oblique size of the greatest pelvic dimension
in the anterior-posterior size of the greatest pelvic dimension
in the anterior-posterior size of the least pelvic dimension
in the anterior-posterior size of the pelvic outlet
The patient with gestational hypertension has all the signs below. The most dangerous symptom is:
Diarrhea
Decreased urine output
Blurred vision
Backache
Facial swelling
What is the main recommendation for pregnant with chronic hypertension during routine check up?
Activity restriction
Balanced nutrition
Increased fluid intake to ensure adequate hydration
Instruction about the effect of diuretics
Increased nutrition
The objective of magnesium sulfate therapy for the patient with preeclampsia is to:
Prevent convulsions
Promote diaphoresis
Increase reflex irritability
Act as a saline cathartic
Increase peripheral circulation
Which assessment should be performed during intravenous magnesium sulfate infusion therapy for
management of severe preeclampsia?
Count respirations and report a rate of less than 12 breaths per minute.
Count respirations and report a rate of more than 20 breaths per minute.
Check blood pressure and report a rate of less than 100/60.
Monitor urinary output and report a rate of less than 100 ml per hour.
Monitor reflexes and report increased reflexes
Which drug should be available for immediate IV administration when magnesium sulfate toxity is
developed:
Ergonovine maleate
Oxytocin
Calcium gluconate
Hydralazine
?2-receptor agonists
Several pregnant clients are waiting to be seen in the triage area of the obstetrical unit. Which client
is the highest priority?
A client at 13 weeks' gestation experiencing nausea and vomiting three times a day with + 1 ketones
in her urine.
A client at 37 weeks' gestation who is an insulin-dependent diabetic and experiencing 3 to 4 fetal
movements per day.
A client at 32 weeks' gestation who has preeclampsia and + 3 proteinuria who is returning for
evaluation of epigastric pain.
A primigravida at 17 weeks' gestation complaining of not feeling fetal movement at this point in her
pregnancy.
A multigravida at 38 weeks’ gestation with mild irregular abdominal pain
316.
A.
B.
C. *
D.
E.
317.
A. *
B.
C.
D.
E.
318.
A.
B.
C. *
D.
E.
319.
A.
B. *
C.
D.
E.
320.
A.
B.
C. *
D.
E.
321.
A. *
B.
C.
D.
E.
322.
A.
B.
C.
D. *
E.
What is the most appropriate client centered recommendation for a primigravid client at 30 weeks'
gestation diagnosed with mild preeclampsia
Return visit to the prenatal clinic in approximately 4 weeks.
Decreased edema after 1 week of a low-protein, low-fiber diet.
Bed rest on the left side during the day, with bath-room privileges.
Immediate reporting of adverse reactions to magnesium sulfate therapy.
Call physician immediately after development of swelling of the feet and ankles
What is NOT the typical complication of preeclampsia?
Hydrocephalic infant.
Abruptio placentae.
Intrauterine growth retardation.
Poor placental perfusion.
Preterm labor
During which cardinal movement of labor the anterior shoulder appears under the symphysis?
extension
expulsion
external head rotation
descent
internal head rotation
Which of them is shown on ultrasound in case of ovarian torsion?
Cylindric features
Adnexal mass with absent doppler flow to ovary
Bilateral ovarian masses
Multiple spots on ovaries
excessive intra-ovarian venous flow
Which of the following types of diet should be physician discussed with a multigravid client
diagnosed with mild preeclampsia?
High-residue diet.
Low-sodium diet.
Regular diet.
High-protein diet.
Low-protein diet.
Which of the following assessment findings would alert the physician to suspect magnesium sulfate
toxity?
Decreased deep tendon reflexes.
Cool skin temperature.
Rapid pulse rate
Tingling in the toes.
Decrease of ankle edema
What is the aim of magnesium sulfate therapy prescribed for treatment of severe preeclampsia
Decreased generalized edema within 8 hours.
Decreased urinary output during the first 24 hours
Sedation and decreased reflex excitability within 48 hours.
Absence of any seizure activity during the first 48 hours.
Decreased breath movement less than 12 per minute
323.
A.
B.
C. *
D.
E.
324.
A. *
B.
C.
D.
E.
325.
A. *
B.
C.
D.
E.
326.
A.
B.
C. *
D.
E.
327.
A.
B.
C. *
D.
E.
328.
A. *
B.
C.
D.
E.
329.
A.
B.
C. *
D.
E.
Which group of drug does magnesium sulfate used for treatment of severe preeclampsia belongs to?
Peripheral vasodilator
Antihypertensive.
Central nervous system depressant.
Sedative-hypnotic.
Diuretic
Which of the following assessment findings should be report immediately during a continuous
intravenous infusion of 4 g of magnesium sulfate in Ringer's solution?
Respiratory rate of 12 breaths /minute
Patellar reflex of+2.
Blood pressure of 160/88 mm Hg.
Urinary output exceeding intake.
Increase of deep tendon reflexes
Choose the cardinal movement of labor when the base of the occiput is brought into contact with the
inferior margin of the symphysis :
extension
expulsion
descent
flexion
external rotation
How do you explain the ovarian apoplexy?
Cancer of ovary
Shrinken ovaries
Sudden rupture in the ovary
Female organ prolapse
Benign tumor on ovary
What is the first action at the beginning of a seizure in client diagnosed with severe preeclampsia?
Insert an airway to improve oxygenation.
Note the time when the seizure begins and ends.
Call for immediate assistance.
Turn the client to her left side.
Catheterize central vein
What complication of labour can be suspected after eclampsia?
Abruptio placentae.
Transverse lie.
Placenta accreta.
Uterine atony.
Placenta previa
Which of the following assessments should the physician prescribe during intravenous magnesium
sulfate infusion for treatment of severe preeclampsia?
Urinary output even'8 hours.
Deep tendon reflexes even' 4 hours.
Respiratory rate every hour.
Blood pressure every 6 hours.
Uterine contraction every 4 hours
330.
A.
B.
C.
D. *
E.
331.
A.
B.
C.
D.
E. *
332.
A.
B. *
C.
D.
E.
333.
A. *
B.
C.
D.
E.
334.
A. *
B.
C.
D.
E.
335.
A.
B. *
C.
D.
E.
336.
A.
B.
C. *
D.
E.
Which of the following actions should the physician do first in case of seizure developed in woman
with severe preeclampsia?
Pad the side rails of the client's bed.
Turn the client to the right side.
Insert a padded tongue blade into the client's mouth.
Call for immediate assistance in the client's room.
Catheterize central vein
What is the leading point at the anterior occiput presentation?
fossa occipitalis
tuber occipitalis
the area of the border of the hair part
the midpoint of sagittal suture
small fontanel
Healing of true erosion is going with:
connective tissue
single-layered cylindrical epithelium
multilayer pavement epithelium
growth of secretory glands
metaplasia
What is immediate action in case of seizure
Turn the client's head to the side
Place an airway into the client's mouth
Check the client for a spontaneous birth
Assess the fetal heart rate for decelerations
Monitor uterine contraction
The physician should teach the pregnant client has been diagnosed with gestational hypertension that
her pregnancy diet now requires:
No changes
Limited proteins
Restricted sodium
Increased carbohydrates
Increased liquid
What is the next step of assessment after obtaining the vital signs in a client with preeclampsia:
Call the nurse
Check the client's reflexes
Determine the client's blood type
Administer intravenous normal saline
Catheterize urinary bladder
Before administering IV magnesium sulfate therapy to a client with preeclampsia, the physician
should assess the client's:
Temperature and respirations
Urinary glucose and specific gravity
Urinary output and patellar reflexes
Level of consciousness and funduscopic appearance
Fetal heart rate and cervical dilatation
337.
A.
B.
C.
D. *
E.
338.
A.
B.
C.
D. *
E.
339.
A.
B.
C. *
D.
E.
340.
A. *
B.
C.
D.
E.
341.
A. *
B.
C.
D.
E.
342.
A.
B. *
C.
D.
E.
343.
A. *
B.
C.
D.
E.
Magnesium sulfate is being given for treatment of severe preeclampsia primarily because it is a:
Hypotensive that relaxes smooth muscles
Cholinergic that increases the release of acetylcholine
Muscle relaxant that decreases the severity of uterine contractions
Central nervous system depressant that blocks neuromuscular transmissions
Source of microelements
What is the leading point in the posterior occiput presentation?
fossa occipitalis
tuber occipitalis
the area of the border of the hair part
the midpoint of sagittal suture
small fontanel
Which of the following sign or symptom would most likely indicate the potential for a seizure in
client with severe preeclampsia?
Audible crackles
Blurring of vision
Epigastric discomfort
Generalized facial edema
Uterine contraction
When measuring the blood pressure to ensure consistency and to facilitate early detection of blood
pressure changes consistent with preeclampsia, the physician should:
Place the woman in a seated or a left lateral position
Allow the woman to rest for 15 minutes after positioning before measuring her blood pressure
Use the woman's right arm if she is lying on her left side.
Use a proper sized cuff that covers at least 50% of her upper arm
there are no any rules for measuring blood pressure in pregnant women
Which one of the following assessment findings would be indicated by progress mild preeclampsia to
severe preeclampsia?
Proteinuria greater than 4+, in two specimens collected 6 hours apart
Dependent edema in the ankles and feet at bedtime
Deep tendon reflexes 2+, ankle clonus is absent
Blood pressure of 154/94 and 156/100, 6 hours apart
Urinary output more than 100 ml per hour
How many centimeters does the suboccipito-bregmatic diameter have?
14 cm
9,5 cm
12 cm
11 cm
10 cm
True erosion is diagnosed with:
Colposkopy
Bimanual assessment
Ultrasonography
Smear bacterioskopy
cytology
344.
A.
B. *
C.
D.
E.
345.
A.
B.
C. *
D.
E.
346.
A.
B.
C. *
D.
E.
347.
A.
B.
C. *
D.
E.
348.
A.
B.
C.
D. *
E.
349.
A.
B. *
C.
D.
E.
350.
A.
B. *
C.
D.
E.
The primary expected outcome for care associated with the administration of magnesium sulfate
would be met if the woman:
Exhibits a decrease in both systolic and diastolic blood pressure
Experiences no seizures
States that she feels more relaxed and calm
Urinates more frequently resulting in a decrease in pathologic edema
Feel fetal movement well
The patient with gestational hypertension has all the signs below. Which sign should be alert because
of development complication:
Diarrhea
Decreased urine output
Blurred vision
Backache
Frequent urination
What is the first fixing point in the posterior occiput presentation?
small fontanel
tuber occipitalis
the area of the border of the hair part
the midpoint of sagittal suture
fossa suboccipitalis
Which of the following should concern physician that monitoring primigravida in prenatal clinic for
preeclampsia?
Blood pressure increase to 138/86 mm Hg
Weight gain of 0.5 kg during the past 2 weeks
A dipstick value of 3+ for protein in her urine
Pitting pedal edema at the end of the day
Increased urinary output to 2000 ml per 24 hours
The physician's primary duty during the seizure in a woman with preeclampsia is to:
Insert an oral airway
Suction the mouth to prevent aspiration
Administer oxygen by mask
Call for help
Catheterize central vein
Which diameter of the fetal head presents in the anterior occiput presentation?
fronto-occipitalis
suboccipito-bregmatic
biparietal
sagittal suture
bitemporal
Which of the following symptom alert about development of magnesium sulfate toxity?
A sleepy, sedated affect
A respiratory rate of 10 breaths per minute
Deep tendon reflexes of +2
Absent ankle clonus
Facial edema
351.
A. *
B.
C.
D.
E.
352.
A.
B.
C. *
D.
E.
353.
A.
B.
C.
D. *
E.
354.
A.
B.
C. *
D.
E.
355.
A.
B.
C.
D. *
E.
356.
A.
B.
C. *
D.
E.
357.
A.
B. *
C.
D.
E.
HELLP syndrome is associated with an increased risk for adverse perinatal outcomes including
which of the following?
Placental abruption
Placenta previa
Hepato-splenomegalia
Cirrhosis
Preterm rupture of membranes
HELLP syndrome is associated with an increased risk for adverse perinatal outcomes including
which of the following?
Glomerulonephritis
Placenta previa
Renal failure
Cirrhosis
Cystitis
HELLP syndrome is associated with an increased risk for adverse perinatal outcomes including
which of the following?
Macrosomia
Placenta previa
Cirrhosis
Maternal and fetal death
Constipation
What are the cardinal movements of labor in anterior occiput presentation (in order)?
descent, flexion, internal rotation, extension, expulsion
flexion, engagement, internal rotation, external rotation
flexion, internal rotation, extension, external rotation of the head, internal rotation of the body
flexion, descent, internal rotation, extension, expulsion
internal rotation, extension, external rotation, flexion
What changes of multilayer squamosus epithelium is common for true erosion?
Proliferation
desquamation
Ectopia
Metaplasia
Regeneration
The antidote administered to reverse magnesium toxicity is
calcium phosphate
calcium succinat
calcium gluconate
calcium chloridum
calcium sulfate
Which effect of magnesium sulfate which used for treatment of preeclampsia is suspected?
tocolytic.
anticonvulsant.
antihypertensive.
diuretic.
spasmolytic
358.
A.
B.
C.
D. *
E.
359.
A.
B.
C. *
D.
E.
360.
A.
B. *
C.
D.
E.
361.
A.
B. *
C.
D.
E.
362.
A.
B.
C. *
D.
E.
363.
A. *
B.
C.
D.
E.
364.
A.
B.
C.
D. *
E.
365.
What are the cardinal movements of labor in posterior occiput presentation (in order)?
descent, flexion, internal rotation, extension, expulsion
flexion, engagement, internal rotation, external rotation
flexion, internal rotation, extension, external rotation
flexion, internal rotation, additional flexion. extension, expulsion
additional flexion, internal rotation, extension, additional extension, external rotation
What is the only known cure for preeclampsia?
Magnesium sulfate
Antihypertensive medications
Delivery of the fetus
Administration of aspirin every day of the pregnancy
Diuretics
Which intrapartal assessment should be avoided when caring for a woman with HELLP syndrome?
Auscultation of the heart and lungs
Abdominal palpation
Checking deep tendon reflexes
Venous sample of blood
Sonographyc examination of liver
Which of the following assessments in a client diagnosed with pregnancy-induced hypertension who
is taking magnesium sulfate would indicate a therapeutic level of medication?
Urinary output of 20 ml/hr
Normal deep tendon reflexes
Respiratory rate of 10 to 12 breaths/minute
Drowsiness
Blurred vision
A woman taking magnesium sulfate has respiratory rate of 10 breaths/minute. In addition to
discontinuing the medication, the physician should:
vigorously stimulate the woman.
instruct her to take deep breaths.
administer calcium gluconate.
increase her IV fluids.
auscultate fetal heart rate
Which of the following is a classic sign of preeclampsia?
proteinuria
fever
glycosuria
vomiting
constipation
What is the most appropriate tactic in incomplete abortion?
Hemostatic drugs
Blood transfusion
Spasmolytic
A dilatation and curettage (D&C)
Bed rest and Vitamin supplements
Which circumference the fetal head is delivered in anterior occiput presentation?
A. *
B.
C.
D.
E.
366.
A. *
B.
C.
D.
E.
367.
A.
B.
C. *
D.
E.
368.
A.
B. *
C.
D.
E.
369.
A.
B. *
C.
D.
E.
370.
A.
B.
C. *
D.
E.
371.
A.
B.
C. *
D.
E.
372.
32 cm
33 cm
34 cm
36 cm
38 cm
What is the most common site of implantation of fertilized egg outside the uterus?
Fallopian tube.
Intestine.
Interstitial lining.
Ovary.
Uterine cervix
Before surgery to remove an ectopic pregnancy and the fallopian tube, which of the following would
alert to the possibility of tubal rupture?
Amount of vaginal bleeding and discharge.
Falling hematocrit and hemoglobin levels.
Slow, bounding pulse rate of 80 bpm.
Marked abdominal edema.
Abdominal cramping
Which circumference the fetal head is delivered in posterior occiput presentation?
32 cm
33 cm
34 cm
36 cm
38 cm
Which process represents the IIIa type of smear at oncocytological examination?
the unchanged epithelium
mild or moderate dysplasia
cancer
inflammatory process
suspicion on malignisation
Which of the following would assess in addition to monitoring the client's blood pressure before
surgery in case of ruptured ectopic pregnancy?
Uterine cramping.
Abdominal distention.
Hemoglobin and hematocrit.
Pulse rate.
Vaginal discharge
What is the predisposing factor for development of ectopic pregnancy?
Urinary tract infection.
Marijuana use during pregnancy.
Episodes of pelvic inflammatory disease.
Use of estrogen-progestin contraceptives.
Constipation
Which of the following may be ordered for treatment ectopic pregnancy if fallopian tube has not
ruptured yet?
A.
B.
C. *
D.
E.
373.
A. *
B.
C.
D.
E.
374.
A.
B.
C.
D.
E. *
375.
A.
B. *
C.
D.
E.
376.
A.
B. *
C.
D.
E.
377.
A.
B.
C.
D.
E. *
378.
A.
B. *
C.
D.
E.
379.
Progestin contraceptives
Medroxyprogesterone (Depo-Provera).
Methotrexate.
Betamethasone
Oxytocin
True erosion is diagnosed with
colposcopy
smear bacterioskopy
ultrasound
bimanual assessment
cytology
Which of the following is essential for the generation of uterine contractions?
prostaglandins
calcium
estrogen
oxytocin
all of the mentioned
Which of the following signs and symptoms would be most important for early detection after a
dilatation and curettage (D&C) to evacuate a molar pregnancy?
Urinary tract infection.
Hemorrhage.
Abdominal distention.
Chorioamnionitis.
Vaginal infection
After evacuation of a hydatidiform mole the patient is at risk of development of
Ectopic pregnancy.
Choriocarcinoma.
Multifetal pregnancies.
Infertility.
Septic abortion
Where is oxytocin primarily synthesized?
adrenal gland
placenta
anterior pituitary
ovary
posterior pituitary
Which time spans the client should avoid pregnancy after suction and evacuation of a complete
hydatidiform mole?
6 months.
12 months.
18 months.
24 months.
30 months
Which of the following signs and symptoms will most likely make the physician suspect that the
patient is having hydatidiform mole?
A.
B. *
C.
D.
E.
380.
A. *
B.
C.
D.
E.
381.
A.
B. *
C.
D.
E.
382.
A.
B. *
C.
D.
E.
383.
A.
B.
C. *
D.
E.
384.
A. *
B.
C.
D.
E.
385.
A.
B.
C.
D.
E. *
386.
Slight bleeding
Passage of clear vesicular mass per vagina
Absence of fetal heart beat
Enlargement of the uterus
Purulent vaginal discharge
All processes play the part in the labor initialization EXEPT
progesterone increases
prostaglandins increase
oxytocin increases
estrogens increases
serotonin increases
Which of the following signs will distinguish threatened abortion from inevitable abortion?
Severity of bleeding
Dilation of the cervix
Nature and location of pain
Presence of uterine contraction
Gestational age
Discharge recommendations after placement of cerclage because of a history of recurrent pregnancy
should emphasize that
Any vaginal discharge should be reported immediately to her care provider.
The presence of any uterine cramping or low backache may indicate preterm labor and should be
reported.
She will need to make arrangements for care at home because her activity level will be restricted.
She will be scheduled for a cesarean birth.
She have a risk for development of placenta previa
Methotrexate is recommended as part of the treatment plan for which of the following obstetric
complications?
Complete hydatidiform mole
Missed abortion
Unruptured ectopic pregnancy
Abruptio placentae
Cervical incompetence
Spontaneous termination of a pregnancy is considered to be an abortion if:
the pregnancy is less than 20 weeks.
the fetus weighs less than 1000 g.
the products of conception are passed intact.
there is no evidence of intrauterine infection.
the fetus length less than 20 cm
All of the bllow are the basic elements of the uterine contractile system EXСEPT:
actin
myosin
adenosine triphospate
calcium
estrogens
An abortion in which the fetus dies but is retained in the uterus is called:
A.
B. *
C.
D.
E.
387.
A.
B.
C.
D. *
E.
388.
A. *
B.
C.
D.
E.
389.
A.
B. *
C.
D.
E.
390.
A.
B.
C. *
D.
E.
391.
A.
B.
C.
D. *
E.
392.
A.
B. *
C.
D.
E.
393.
A.
inevitable abortion.
missed abortion.
incomplete abortion.
threatened abortion.
recurrent abortion
In which of the following situations would a D&C be indicated?
Complete abortion at 8 weeks
Incomplete abortion at 16 weeks
Threatened abortion at 6 weeks
Incomplete abortion at 10 weeks
Recurrent abortion
Which of the following orders should the physician prescribe for a client admitted with a threatened
abortion?
Pad count
Ritodrine IV
Nothing per os
Metotrexate 50 mg every 3 hours im
Oxitocin
Which of the following pieces of data found on a client’s health history would place her at risk for an
ectopic pregnancy?
Use of oral contraceptives for 5 years
Recurrent pelvic infections
Ovarian cyst 2 years ago
Heavy menstrual flow of 4 days’ duration
Use of condom for last year
Which of the following findings might suggest a hydatidiform mole at 10 weeks of gestation?
Complaint of frequent mild nausea
Blood pressure of 120/80
Fundal height measurement of 18 cm
History of bright red spotting for 1 day weeks ago
Low abdominal cramping
What is the main principle of care for primigravida with ectopic pregnancy?
bed rest and analgesics are the recommended treatment.
she will be unable to conceive in the future.
a D&C will be performed to remove the products of conception.
hemorrhage is the major concern.
urinary tract infection is the main predisposing factor for development of this problem
Sharon Baker's history reveals recurrent abortions. What does this mean?
She has never carried a pregnancy to term.
At least three of her pregnancies terminated before age of viability.
She has experienced at least one early abortions.
She has experienced at least two late abortions.
She has experienced at least one preterm labour
What is the most important in the characteristic of the uterine contractions?
strong
B. *
C.
D.
E.
394.
A.
B.
C. *
D.
E.
395.
A.
B. *
C.
D.
E.
396.
A. *
B.
C.
D.
E.
397.
A.
B.
C.
D. *
E.
398.
A.
B. *
C.
D.
E.
399.
A.
B.
C. *
D.
E.
400.
A.
B. *
C.
D.
regular
moderate
painful
strength
Etiological factors of psedoerosin is all EXCEPT:
Dyshormonal disturbances
Autoimmune process
Alimentary factor
Changes of humoral immunity
Inflammatory process
What is the aim of prescription of contractile drug (Oxytocin) after incomplete abortion?
to prevent intrauterine infection
to avoid placental fragment retention
to reduce the risk of hypertension
to allow hormone levels to return to normal
to avoid future infertility
What is the risk factor for an ectopic pregnancy?
history of pelvic inflammatory disease
grand multiparity (five or more births)
use of an intrauterine device for 1 year
use of an oral contraceptive for 5 years
use of an condoms for 3 years
Which three tests typically are ordered to identify ectopic pregnancy?
serum test for beta-hCG, ultrasonography, and amniocentesis
serum test for progesterone, laparoscopy, and culdocentesis
serum test for estrogen, ultrasonography, and nitrazine paper test
serum test for beta-hCG, ultrasonography, and laparoscopy
serum test for beta-hCG, nitrazine paper test, and colposcopy
Which labor forces are presented in I stage of labor?
false uterine contractions
true uterine contractions
uterine contractions and pushing
pushing
all of the above
Cancer prevention program for women include all of the following except:
Smoking cessation
Periodic screening
Bone density index measurement
Elimination of unopposed estrogen use for menopause
Human papillomavirus (HPV) tests.
What ultrasonography findings are typical for gestational trophoblastic disease
empty gestational sac
grapelike clusters
severely malformed fetus
ectopic pregnancy
E.
401.
A. *
B.
C.
D.
E.
402.
A. *
B.
C.
D.
E.
403.
A.
B.
C. *
D.
E.
404.
A.
B. *
C.
D.
E.
405.
A.
B. *
C.
D.
E.
406.
A.
B. *
C.
D.
E.
407.
A.
B.
C. *
D.
E.
408.
A.
two babies
Which of the following is a common adverse effect of ritodrine?
tachycardia
pohuria
hypertension
hyporeflexia
hypotermia
Which of these is a hormone needed to produce an egg?
Follicle stimulating hormone (FSH)
Follicle producing hormone (FPH)
Egg producing hormone (EPH)
None of these
Follicle realizing hormone (FRH)
Which labor forces are presented in II stage of labor?
false uterine contractions
true uterine contractions
uterine contractions and pushing
pushing
all of the above
For polyp treatment we use all except:
cryodestruction
conization of cervix
endocervical curettage
Coagulation
polyp twisting
What does the Basal Body Temperature (BBT) chart tell you?
Problems with ovulation
When you ovulated
When is your next ovulation
None of these
When previous ovulation was
During the menstrual cycle, progesterone is produced by
the secondary oocyt
the corpus luteum.
the stroma of the ovary.
primary follicles.
pituitary gland
Which labor forces are presented in III stage of labor?
false uterine contractions
true uterine contractions
uterine contractions and pushing
pushing
all of the above
During the menstrual cycle, progesterone would be at its highest levels
during the menstrual phase
B.
C.
D. *
E.
409.
A. *
B.
C.
D.
E.
410.
A. *
B.
C.
D.
E.
411.
A.
B.
C. *
D.
E.
412.
A.
B.
C.
D.
E. *
413.
A.
B.
C. *
D.
E.
414.
A.
B.
C. *
D.
E.
415.
A.
B. *
C.
D.
just prior to ovulation
just after ovulation
late in the postovulatory phase
before period
Which moment is the beginning of I stage of labor?
onset of regular uterine contractions
complete dilatation of cervix
rupture of amniotic sac
onset of pushing
delivery of the fetus
To the risk factors for dysplasia belong all EXCEPT:
hyperprogesteronemia
hyperestrogenemia
cervical trauma during delivery and abortion
A lot of sexual partner
Early sexual activity
The main function of progesterone during the menstrual cycle is to
initiate ovulation
initiate menstruation
thicken the endometrium
repair the surface of the ovary after ovulation
repair the surface of the uterus after menstruation
Which moment is the end of II stage of labor?
onset of uterine contractions
complete dilatation of cervix
rupture of amniotic sac
complete cervical effacement
delivery of the fetus
If fertilization does not occur, the corpus luteum
is expelled into the pelvic cavity.
begins to secrete low levels of FSH.
degenerates into the corpus albicans.
continues to secrete progesterone until the next ovulation.
start to secrete estrogen
About the time of ovulation, the anterior pituitary gland releases a relatively large quantity of
estrogen
progesterone
LH
androgen
oxytocin
Secondary contraceptive effects of the gestaginic component of the combination oral agents include:
Endometrial alterations, decrease in cervical mucus viscosity
Endometrial alteration, increase in cervical mucus viscosity
Stimulation of endogenous estrogen production
Increase in cervical mucus viscosity, stimulation of endogenous estrogen production
E.
416.
A.
B.
C.
D. *
E.
417.
A.
B.
C.
D.
E. *
418.
A. *
B.
C.
D.
E.
419.
A.
B. *
C.
D.
E.
420.
A.
B.
C.
D. *
E.
421.
A. *
B.
C.
D.
E.
422.
A. *
B.
C.
Suppression of endogenous estrogen production
All of the following contraceptive methods have theoretical effectiveness (lowest expected) failure
rates of < 1% EXCEPT:
Oral contraceptives
Progestin implant
Male sterilization
Condoms
Intrauterine device
What sign is not typical for proliferative myoma?
increased mitotic activity
fast growth
plenty of lymphoid cells
plenty of plasmatic cells
Atypical growth
Which moment is the beginning of III stage of labor?
separation of placenta
complete dilatation of cervix
rupture of amniotic sac
complete cervical effacement
delivery of the fetus.
Which of the following instructing should be given for client about basal body temperature method
for family planning?
Check the cervical mucus to see if it is thick and spars
Take her temperature at the same time every morning before getting out of be
Document ovulation when her temperature decreases at least 1°F.
Avoid coitus for 10 days after a slight rise in temperature
you still infertile before rising temperature
Which moment is the end of 3 stage of labor?
onset of pushing
complete dilatation of cervix
separation of placenta
expulsion of placenta
delivery of the fetus
When instructing a client about the proper use of condoms for pregnancy prevention, which of the
following instructions would be included to ensure maximum effectiveness?
Place the condom over the erect penis before coitus.
Withdraw the condom after coitus when the penis is flacci
Ensure that the condom is pulled tightly over the penis before coitus.
Obtain a prescription for a condom with nonoxynol 9.
All recommendations are correct
The most common technique used for the medical termination of a pregnancy in the second trimester
would be:
Administration of prostaglandins
Instillation of hypertonic saline into the uterine cavity
Intravenous administration of Pitocin
D.
E.
423.
A. *
B.
C.
D.
E.
424.
A.
B.
C. *
D.
E.
425.
A.
B. *
C.
D.
E.
426.
A.
B. *
C.
D.
E.
427.
A. *
B.
C.
D.
E.
428.
A.
B.
C.
D.
E. *
429.
A. *
B.
C.
D.
E.
430.
Vacuum aspiration
Dilatation and curettage
Besides the condom, which is another barrier method of birth control?
Diaphragm
Intrauterine Device (IUD)
Withdrawal
Sterilization
Pill
How long is the vaginal ring left in place?
1 week
2 weeks
3 weeks
3 months
4 weeks
Which of the following is NOT associated with II stage of labor?
uterine contractions
placental separation
fetal expulsion
pushing
fetal internal rotation
In diagnostic of cervical dysplasia we use all EXCEPT:
colposcopy
metrosalpingography
cytogenetic examination
histochemical examination
cytological examination
How long is the hormonal patch left in place?
1 week
2 weeks
3 weeks
3 months
4 weeks
Which of the following is NOT associated with III stage of labor?
uterine contractions
placental expulsion
placental separation
pushing
fetal internal rotation
The woman starts taking the birth control pills on about day ________ of the cycle
1
7
10
14
28
Use of the pill is associated with an increased risk of:
A. *
B.
C.
D.
E.
431.
A.
B.
C. *
D.
E.
432.
A.
B. *
C.
D.
E.
433.
A.
B.
C.
D.
E. *
434.
A. *
B.
C.
D.
E.
435.
A.
B.
C. *
D.
E.
436.
A.
B.
C.
D. *
E.
437.
A. *
heart attack and stroke
endometrial cancer
ovarian cancer
all of the above
varicose vein
In what type of ovarion tumour do we have an endometrium hyperplasia?
papillary cystoma
paraovarian cyst
follicle cyst
ovarian cancer
yellow body cyst
Oral contraception in the form of a combination of low-dose estrogen and progesterone:
Reduces the pH of cervical mucus, thereby destroying sperm
Protects against iron deficiency anemia by reducing blood loss with menses
Prevents the transmission of sexually transmitted diseases
Is 90% effective in preventing pregnancy when used correctly
Increase peristaltic of uterine tube, thereby prevent conception
Which of the following characterizes I stage of labor?
myometrial relaxation
uterine awakening
fetal expulsion
pushing
cervical dilatation
The most common, and for some women the most distressing side effect of Norplant (progestin only
implant), is
Irregular menstrual bleeding
Headache
Nervousness
Nausea
Constipation
A woman with an Intrauterine Device (IUD) should confirm its placement by checking the IUD’s
string:
Before each menstrual period
After intercourse
At the time of ovulation
During menstrual bleeding
During routine checkup one time a year
When teaching women about the effective use of chemical barriers, the physician should tell them to:
Insert foams at least 1 hour prior to coitus
Insert suppositories just prior to penile contact with the vagina
Douche immediately after last intercourse
Reapply before each act of coitus
Insert foams not later 12 hours after intercourse
In diagnostic of cervical leucoplacia we use all EXCEPT:
culdoscopy
B.
C.
D.
E.
438.
A.
B.
C. *
D.
E.
439.
A.
B. *
C.
D.
E.
440.
A.
B.
C.
D. *
E.
441.
A. *
B.
C.
D.
E.
442.
A. *
B.
C.
D.
E.
443.
A.
B.
C. *
D.
E.
444.
A.
B.
C.
colposcopy
biopsy
cytology
Speculum assessment
Which contraction duration (sec) characterizes active labor?
20
30
60
90
100
When using a cervical cap, the woman should:
Apply spermicide inside the cap and around the rim
Leave it in place for a minimum of 8 hours and maximum of 4g hours after the last act of coitus
Continue to use the cap during menstrual periods
Check the position of the cap and insert additional spermicide before each act of coitus
Use separate cap during each intercourse
What is the minimal dilatation during the first stage of labor in multiparous?
0,5-0,8 cm/hour
0,8-1.0 cm/hour
1.0-1.2 cm/hour
1.2-1.5 cm/hour
2.0-2.5 cm/hour
A woman has chosen the calendar method of conception control. During the assessment process, it is
most important that the physician:
Obtain a history of menstrual cycle lengths for the last 6 to 12 months.
Determine her weight gain and loss pattern for the previous year.
Examine skin pigmentation and hair texture for hormonal changes.
Explore her previous experiences with conception control.
Ask about ability to check fertile period every day
Which of the following statement is true about tubal ligation?
“It is highly unlikely that you will become pregnant following the procedure”
“This is an effective form of 100% permanent sterilization. You will not be able to get pregnant.
“Sterilization offers some form of protection against sexually transmitted infections.”
“Your menstrual cycle will greatly increase after your sterilization.”
“Your husband should sing permission for this procedure”
Injectable progestins (DMPA, Depo-Provera) are a good contraceptive choice for women who:
Desire menstrual regularity and predictability.
Have a history of thrombotic problems or breast cancer.
Have difficulty remembering to take oral contraceptives daily.
Are homeless or mobile and rarely receive health car
Have more than 1 sexual partner
What is the most important measure of labor progression?
contraction frequency
contraction intensity
contraction duration
D. *
E.
445.
A.
B.
C.
D. *
E.
446.
A.
B.
C.
D.
E. *
447.
A. *
B.
C.
D.
E.
448.
A. *
B.
C.
D.
E.
449.
A. *
B.
C.
D.
E.
450.
A.
B.
C.
D. *
E.
451.
A.
B.
cervical dilatation
cervical effacement
What the major differences are between the cervical cap and diaphragm?
“No spermicide is used with the cervical cap, so it is less messy.”
“The diaphragm can be left in place longer after intercours”
“Repeated intercourse with the diaphragm is more convenient.”
“The cervical cap can safely be used for repeated acts of intercourse without adding more spermicide
later.”
“The main difference is the size of cap and diaphragm”
Node consistency of uterine fibromyoma depends on:
node size
vessels' amount
fatty tissue amount
presence of endometrioid tissues
correlation of parenchyma and stroma
Which contraceptive method should be avoided by couple if a woman was treated recently for toxic
shock syndrome?
Cervical cap
Condom
Vaginal film
Vaginal sheath
Combine contraceptive pill
Which of the following characterizes phase 2 of labor?
fetal expulsion
uterine awakening
cervical effacement
cervical dilatation
placental separation
Postcoital contraception with Postinor:
Requires that the first dose be taken within 72 hours of unprotected intercourse
Requires that the woman take second and third doses at 24 and 36 hours after the first dos
Has an effectiveness rate in preventing pregnancy of approximately 50%.
Is commonly associated with the side effect of menorrhagia
Will be more effective if takes 1 hour before intercourse
Which of the following statements is most appropriate for the physician to make for a married couple
is discussing male and female sterilization?
“Male and female sterilization methods are 100% effective”
“A vasectomy may have a slight effect on sexual performance”
“Tubal ligation can be easily reversed if you change your mind in the future”
“Major complications after sterilization are rar”
“A vasectomy is more preferable than tubal ligation”
A woman will be taking oral contraceptives using a 28-day pack. To be protected from pregnancy,
the physician should advise this woman to:
Limit sexual contact for one cycle after starting the pill.
Use condoms and foam instead of the pill for as long as she takes an antibiotic
C. *
D.
E.
452.
A. *
B.
C.
D.
E.
453.
A.
B.
C.
D.
E. *
454.
A.
B.
C.
D.
E. *
455.
A.
B. *
C.
D.
E.
456.
A.
B.
C.
D.
E. *
457.
A. *
B.
C.
D.
E.
Take one pill at the same time every day.
Throw away the pack and use a backup method if she misses two pills during week one of her cycle
Use barrier method during fertile period
Although reported in small numbers, toxic shock syndrome (TSS) can occur with the use of the
contraceptive diaphragm. The physician should instruct the woman about ways to reduce her risk
for toxic shock syndrome. This would include:
“You should always remove your diaphragm 6-8 hours after intercourse, not use the diaphragm
during menses, and watch for dangers signs of toxic shock syndrome which include a sudden onset
fever of greater than 38.4TРC, hypotension, and a rash.
“You should remove your diaphragm right after intercourse to prevent TSS.”
“It’s okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly
first to avoid toxic shock syndrom”
“Make sure that you don’t leave your diaphragm in for more than 24 hours or you may get toxic
shock syndrome”
“Modern diaphragms are not related to development of toxic shock syndrome”
Which of the following characterizes III stage of labor?
myometrial tranquility
fetal expulsion
cervical effacement
cervical dilatation
placental separation
What is typical for proliferative myoma?
presence of atypia
atypical localization
multiple nodes
node calcification
increased mitotic activity
When assessing the timing for ovulation and possible fertilization, the physician understands that the
client with a 30-day menstrual cycle would probably ovulate on which day?
Day 30
Day 15
Day 10
Day 13
Day 11
Indicate the place for prostaglandins synthesis:
adrenal gland
placenta
posterior pituitary
ovary
decidua
The female client indicates understanding of teaching when she says that the cause of menses is:
Declining progesterone levels
Rising estrogen levels
Increasing LH levels
Declining FSH levels
Estrogen/progesterone imbalance
458.
A.
B.
C. *
D.
E.
459.
A. *
B.
C.
D.
E.
460.
A.
B.
C. *
D.
E.
461.
A.
B.
C.
D.
E. *
462.
A.
B.
C. *
D.
E.
463.
A.
B.
C.
D.
E. *
464.
A.
B.
C.
D.
E. *
465.
Which method of birth control is most suitable for the client with diabetes?
Vaginal ring
Oral contraceptives
Diaphragm
Contraceptive sponge
Progestine only pill
How many eggs does a normal healthy ovary produce every month?
One
Two
Three
Four
Five
In the menstrual cycle, estrogen functions to stimulate uterine wall development, whereas
progesterone functions to
stimulate erection of the clitoris
cause ejection of milk from the mammary glands
stimulate the uterine lining to become more glandular
inhibit the release of FSH;
stimulate the release of FSH
What sign is not typical for proliferative myoma?
increased mitotic activity
fast growth
plenty of lymphoid cells
plenty of plasmatic cells
Atypical growth
In the menstrual cycle, estrogen functions to _____, whereas progesterone functions to stimulate the
uterine lining to become more glandular
stimulate erection of the clitoris
cause the formation of milk
stimulate uterine wall development;
inhibit the release of FSH
stimulate the release of FSH
Subserouse fibromyoma node is localizes in:
between broad ligament layers
behind cervix
in myometrium
under uterine mucous layer
under peritoneum
How often should the fetal heart rate be auscultated during the second stage of labor?
5 min
10 min
15 min
30 min
after every uterine contraction
During the menstrual cycle, LH is at its highest levels
A.
D. *
during the menstrual phase
just prior to ovulation
just after ovulation
just before menstruation begins
in the middle of proliferative
During the menstrual cycle, the endometrium would be at its thickest
during the menstrual phase
just prior to ovulation
just after ovulation
late in the postovulatory phase
during proliferative phase
The part of the female reproductive system that is shed during menstruation is the
myometrium
Vaginal mucus
tunica albuginea
stratum functionalis of the endometrium
Basal lay of endometrium
What is the maximal duration of the second stage of labor in primaparas?
5 min
20 min
50 min
100 min
120 min
Which sexual practices as high-risk factors for contracting HIV?
Heterosexual intercourse
Absent of intercourse
A monogamous relationship
French kissing
Hugs
Submucous myoma node is localized:
between broad ligament layers
behind cervix
in myometrium
under uterine mucous layer
E.
471.
A.
B.
C. *
D.
E.
472.
A.
B.
C. *
under peritoneum
The success of the rhythm method depends on the:
Age of the client
Frequency of intercourse
Regularity of the menses
Range of the client’s temperature
Quantity of partners
When the cervix and vagina should be inspected for lacerations?
after first signs of placental separation
after fetal delivery
after placental delivery
B. *
C.
D.
E.
466.
A.
B.
C.
D. *
E.
467.
A.
B.
C.
D. *
E.
468.
A.
B.
C.
D.
E. *
469.
A. *
B.
C.
D.
E.
470.
A.
B.
C.
D.
E.
473.
A.
B.
C.
D. *
E.
474.
A. *
B.
C.
D.
E.
475.
A.
B.
C.
D.
E. *
476.
A.
B.
C. *
D.
E.
477.
A.
B.
C.
D. *
E.
478.
A.
B.
C.
D.
E. *
479.
A.
B.
C. *
after suturing of the lacerations of vagina
2 hours after delivery
Intramural myoma node is localized:
between broad ligament layers
under uterine mucous layer
behind cervix
in myometrium
under peritoneum
Which statement made by the client who has just had a mammogram indicates a need for clarification
regarding the importance or purpose of this procedure?
“Now that I have had a mammogram, my risk for getting breast cancer is reduced.”
“Even though I have had a mammogram, I should still perform a breast self-examination monthly.”
“Yearly mammograms can reduce my risk of dying from breast cancer.”
“The amount of radiation exposure from a mammogram is low.”
“Sonography does not rule out need of mammography”
What is the most reliable indicator of rupture of the fetal membranes?
fluid per cervical os
positive nitrazine test
positive ferning test
membranes are not palpated
all of the above
Which characteristic of a breast lump or mass is more associated with breast cancer than with
benign breast disease?
Lump or mass present in same area of both breasts
Pain or discomfort caused by palpation
Attached firmly to the chest wall
Appeared suddenly
Skin is not changed above the lump
The reservoirs for storing milk in the breast are:
Lobules
Alveoli
Montgomery’s glands
Lactiferous sinuses
Nipples
Which moment of the fetal membranes rupture is considered as a normal?
before the beginning of uterine contraction
at the beginning of I stage of labor
at the end of I stage of labor
at the beginning of II stage of labor
all of the above
When teaching the breast self-examination, you would inform the woman that the best time to
conduct breast self-examination is:
at the onset of the menstrual period
on the 14th day of the menstrual cycle
on the 4h to 7th day of the cycle
D.
B. *
just before the menstrual period
any time during the cycle
The examiner is going to inspect the breast for retardation. The best position for this part of the exam
is:
lying supine with arms at the sides
leaning forward with hands outstretched
Sitting with hand pushing onto hips
One arm at the side, the other arm elevated
All position is available for examination
A bimanual technique of Clinical Breast Examination may be the preferred approach for a woman:
who is pregnant
who is having the first breast exam by a health care provider
with pendulous breasts
who has felt a change in the breast during self examination
for teenagers
What is the maximal duration of the third stage of labor?
5 min
20 min
30 min
50 min
120 min
Interstitial myoma node is localized:
between broad ligament layers
in myometrium
under uterine mucous layer
under peritoneum
behind cervix
During the breast examination, you detect a mass. Identify the description that is most consistent
with cancer rather than benign breast disease
round firm, well demarcated
irregular poorly defined, fixed
rubbery, mobile, tender
lobular, clear margins, negative skin retraction
mobile, well demarcated, negative skin retraction
How often during the first stage of labor should the fetal heart rate be auscultated in a low-risk
pregnancy?
every 5 min before a contraction
every 15 min after a contraction
C.
D.
E.
486.
A.
B.
C.
every 40 min before a contraction
every 45 min after a contraction
after every uterine contraction
During the examination of the breast of pregnant woman, you would expect to find:
peau d’orange
nipple retraction
a unilateral, obvious venous pattern
E.
480.
A.
B.
C. *
D.
E.
481.
A.
B.
C. *
D.
E.
482.
A.
B.
C. *
D.
E.
483.
A.
B. *
C.
D.
E.
484.
A.
B. *
C.
D.
E.
485.
A.
D. *
B. *
a blue vascular pattern over both breasts
decrease size of breast
Intraligamentary myoma node is localized:
between broad ligament layers
in myometrium
behind cervix
under uterine mucous layer
under peritoneum
Which of the following women should not be referred for further evaluation?
a 26-year-old with multiple nodules palpated in each breast
a 48-year-old who has a 6-month history of reddened and sore left nipple and areolar area
a 25-year-old with asymmetrical breasts and inversion of the nipples since adolescence
a 64-year-old with unclear area at tip of right nipple, no masses, tenderness, or lymph nodes palpated
a 34-year-old with enlarged breast to size 7
What factor is determining the forming of pain intensity during labor?
level of oxytocin in the organism;
level of pain sensitiveness;
force of cerebral impulses;
force of uterine contractions;
patient’s behavior.
Breast asymmetry:
increases with age and parity
may be normal
indicates a neoplasm
is accompanied by enlargement axillary lymph nodes
inquired abnormalities
At what age does the American Cancer Society recommend that women perform monthly breast
self-examination?
At menarche
At onset of sexual activity
Starting at age 20
Starting at age 35
At onset of menopause
Which client should the physician encourage to seek genetic counseling regarding her risk for
BRCA1 or BCRA2 gene mutation–related breast cancer?
55-year-old woman whose father had lung cancer and mother had leukemia, and whose two siblings
have had malignant melanoma
45-year-old woman whose brother and sister have breast cancer and whose mother has ovarian cancer
C.
65-year-old woman whose fraternal twin sister has breast cancer
D.
E.
493.
A.
B.
25-year-old woman who has bilateral benign breast disease
35-year-old woman who has endometriosis, irregular bleeding
Fibrocystic change in breasts is:
A disease of the milk ducts and glands in the breasts.
A premalignant disorder characterized by lumps found in the breast tissue.
E.
487.
A. *
B.
C.
D.
E.
488.
A.
B.
C. *
D.
E.
489.
A.
B. *
C.
D.
E.
490.
A.
B. *
C.
D.
E.
491.
A.
B.
C. *
D.
E.
492.
A.
C. *
E.
500.
Lumpiness with pain and tenderness found in varying degrees in breast tissue of healthy women
during menstrual cycles.
Lumpiness accompanied by tenderness after menses.
Breast cancer
The physician who is teaching a group of women about breast cancer would tell the women that:
Risk factors identify more than 50% of women who will develop breast cancer.
One in ten women in the United States will develop breast cancer in her lifetime.
Nearly 90% of lumps found by women are malignant.
The exact cause of breast cancer is unknown.
Women who breastfeed baby have higher risk of breast cancer than if not
What is an obligatory condition for the beginning of the medicinal anaesthetizing of labor?
the fluid gash;
normal feto-pelvic proportions;
physiology duration of labor;
presence of regular uterine contractions and opening of uterine cervix on 3-4 cm;
primapara.
Retrocervical myoma node is localized:
between broad ligament layers
under peritoneum
under uterine mucous layer
behind cervix
in myometrium
Which of the following diagnostic tests is used to confirm a suspected diagnosis of breast cancer?
Mammogram
Ultrasound
Fine-needle aspiration (FNA)
CA 15-3
MRI
What condition is obligatory for the beginning of the medicinal anaesthetizing of labor?
opening of uterine cervix on 3-4 cm;
normal feto-pelvic proportions;
physiology duration of labor;
the fluid gash;
primapara.
Which recommendation is the American Cancer Society guideline for early detection of BC?
Beginning at 18 y.o. have a biannual clinical breast exam
Beginning at 30 y.o. perform monthly breast self exams.
Beginning at 40 y.o., receive a yearly mammogram.
Beginning at 50 y.o. have a breast sonogram every 5 yrs
Beginning after completion of breastfeeding
What is typical for hormonal status of patient with fibromyoma?
A. *
B.
C.
D.
high level of estrogens
high level of progesteron
high level of androgens
high level of chorionic gonadotropin
D.
E.
494.
A.
B.
C.
D. *
E.
495.
A.
B.
C.
D. *
E.
496.
A.
B.
C.
D. *
E.
497.
A.
B.
C. *
D.
E.
498.
A. *
B.
C.
D.
E.
499.
A.
B.
C. *
D.
E.
C.
high level of pituitary gland hormons
Which side effect of promedol limits the term of its introduction in labor?
depresses the respiratory center of fetus;
causes bradicardia at a mother;
causes a somnolence;
causes tachicardia at a mother;
causes the allergic reactions.
When teaching a 22-year-old patient about breast self-examination (BSE), the physician will instruct
the patient that
BSE will reduce the risk of dying from breast cancer.
performing BSE right after the menstrual period will improve comfort.
BSE should be done daily while taking a bath or shower.
annual mammograms should be scheduled in addition to BSE.
You should start to do BSE when become pregnant
How many lobes does the breast contain?
15-20
20-25
25-30
5-10
10-15
What is the peculiarity of introduction of promedol for anaesthetizing of labor?
should be given at least 2 hours to the birth of fetus;
should be given only in the ІІ period of labor;
should be given only one time;
should be given only intravenously;
should be given in combination with spasmolytics.
Each lobe of breast contains
lobules
Glands
Cells
Sinuses
Alveoli
What requirement is obligatory for medicines, which are used for the medicinal anaesthetizing?
to decrease the uterine contractions;
to improve the state of fetus;
do not depress the contractive activity of uterus;
not to cause a somnolence;
to have short time of action.
How do the estrogens effect on breast?
increased breast size in puberty
cyclic decrease in breast size due to ovarian cycle
decrease in size in pregnancy
D.
E.
508.
is not influence on breast
stimulate milk production
How do the estrogens effect on breast?
501.
A. *
B.
C.
D.
E.
502.
A.
B. *
C.
D.
E.
503.
A. *
B.
C.
D.
E.
504.
A. *
B.
C.
D.
E.
505.
A. *
B.
C.
D.
E.
506.
A.
B.
C. *
D.
E.
507.
A. *
B.
A. *
E.
515.
cyclic increase in breast size due to ovarian cycle
decrease milk production
stimulate development of breast cancer
responsible for development of fibroadenoma
increase sensation to prolactin
How do the estrogens effect on breast?
increase in size in pregnancy
increase sensation to prolactin
is not influence on breast
cyclic decrease in breast size due to ovarian cycle
stimulate development of breast cancer
Which hormone causes growth in lobules
Progesterone
Prolactin
Testosterone
Estrogen
insulin
How does the progesterone effect on breast?
Causes growth in lobules
Stimulate milk production
Suppress proliferation of epithelium
Do not influence on the breast
Stimulate growth of breast
What is the diagnosis for fibrocystic changes?
Palpation, biopsy, ultrasonography
Breast self examination, mammography, MRI
CT, X-ray, MRI
Palpation, mammography, X-ray
Biopsy, breast self examination, palpation
What part of the body is normally involved in fibrocystic changes?
upper/outer breast quadrant is more frequent segment involved
upper/inner breast quadrant is more frequent segment involved
lower/outer breast quadrant is more frequent segment involved
lower /inner breast quadrant is more frequent segment involved
nipple
The second stage of labor at patient is finished by obstetric forceps applying. What method of
anesthesia is the best?
inhalation anesthesia;
epidural anesthesia;
intravenous anesthesia;
local anesthesia;
it is possible to perform without any anesthesia.
What is the etiology of fibrocystic changes?
A. *
B.
unknown but thought to be related to hormones
unknown but thought to be related to infections
B.
C.
D.
E.
509.
A. *
B.
C.
D.
E.
510.
A. *
B.
C.
D.
E.
511.
A. *
B.
C.
D.
E.
512.
A. *
B.
C.
D.
E.
513.
A. *
B.
C.
D.
E.
514.
A.
B.
C. *
D.
C.
D.
E.
516.
A. *
B.
C.
D.
E.
517.
A. *
B.
C.
D.
E.
518.
A.
B.
C.
D. *
E.
519.
A. *
B.
C.
D.
E.
520.
A. *
B.
C.
D.
E.
521.
A.
B.
C. *
D.
E.
522.
A.
B.
C.
unknown but thought to be related to trauma
unknown but thought to be related to level of physical activity
unknown but thought to be related to food
What sign is typical for submucous myoma?
hyperpolymenorrhea
amenorrhea
foamy vaginal discharge
symptomless
tumour destruction
Benign, slow-growing breast tumor with epithelial and stromal components in women elder than 30
y.o. is:
Fibroadenoma
Breast cancer
fibrocystic breast disease
mastitis
Lactostasis
Which of the follows is the most effective for cervical dilation in the I stage of labor?
analgin in pills;
no-shpa in pills;
novocaine 0,25%;
baralgin 5 ml intravenously;
papaverin 2% 2 ml i/m.
What is Fibroadenoma’s claim to fame?
women < 30 years
Postmenopausal women
women < 40 years
women > 30 years
girls in puberty
What method of anaesthesia is used in I and ІІ stage of preterm labor?
epidural anesthesia;
inhalation anesthesia;
intravenous anesthesia;
local anaesthesia;
spasmolitics.
"Orange peel" appearance caused by edema from blocked lymphatic drainage in advanced cancer
Colostrum
Gynecomastia
Peau d'orange
Galactorrhea
Mastitis
Thick, yellow discharge that may leak from breasts in the month prior to birth in preparation for
lactation
Peau d'orange
Galactorrhea
Gynecomastia
D. *
E.
523.
A.
B.
C.
D.
E. *
524.
A.
B.
C. *
D.
E.
525.
A.
B.
C.
D.
E. *
526.
A.
B.
C.
D. *
E.
527.
A. *
B.
C.
D.
E.
528.
A.
B. *
C.
D.
E.
529.
A. *
B.
C.
D.
E.
Colostrum
Mastitis
Mobile, Firm, Well-Delineated Lumps 1-5 cm in diameter, Freely movable, Asymptomatic, Single
tumor near the nipple or in the upper outer quadrant is
Carcinoma
Intraductal Papilloma
Benign Breast Disease
Gynecomastia
Fibroadenoma
Which disease manifesting with Dimpling of the skin, Deviation of the nipple, Nipple retraction,
Change in the shape of one breast, Edema, Discharge?
Benign Breast Disease
Fibroadenoma
Carcinoma of the Breast
Mammary Duct Ectasia
Intraductal Papilloma
The sebaceous glands on the areola, which enlarge and produce a secretion that protects and
lubricates the nipples is
Suspensory ligaments
Acini cells
Areola
Mammary ridge
Montgomery's glands (tubercles)
What affirmation in relation to the state of cervix just after labor is correct?
the cervix is closed;
the cervix admits a 1 transversal finger;
the cervix admits 3-4 transversal fingers;
the cervix is formed.
the cervix admits a hand;
What sign is typical for retrocervical myoma?
rectum dysfunction
infertility
amenorrhea
foamy vaginal discharge
hyperpolymenorrhea
Lactation not associated with childbearing or breast-feeding is
Colostrum
Galactorrhea
Peau d'orange
Gynecomastia
Lactostasis
What complications can develop due to the incorrect suturing of cervical rupture in a future?
cervical ectropion;
violation of function of pelvic muscles;
prolaps of uterus;
endometritis;
bleeding
530.
A.
B. *
C.
D.
E.
531.
A. *
B.
C.
D.
E.
532.
A.
B.
C.
D. *
E.
533.
A.
B. *
C.
D.
E.
534.
A.
B.
C.
D.
E. *
535.
A.
B.
C. *
D.
E.
536.
A.
B.
C.
D. *
E.
Which of the following positions accentuates the presence of dimpling during the inspection phase of
breast assessment?
Sitting with arms relaxed at the sides
Sitting with arms raised over the head
Supine with arm elevated
Leaning forward with arms in front of the client
All positions are available for performing the inspection phase breast assessment
Which disease characterized by Lumps, Pain or Tenderness, and Nipple Discharge as a Result of
Thickening of the Breast Tissue
Benign Breast Disease
Carcinoma of the Breast
Mammary Duct Ectasia
Fibroadenoma
Intraductal Papilloma
Which of the following hormones is predominantly essential for maintaining pregnancy?
Estrogen
hCG
Oxytocin
Progesterone
Testosteron
Physiological blood loss of puerperal woman with 76 kg mass is:
260 ml;
380 ml;
320 ml;
240 ml;
450 ml.
What method should be used for diagnostic of subserous myoma?
curettage of uterine cavity
hysterography
uterine probing
hysterosalpingography
ultrasound
All of the following are normal gastrointestinal changes in pregnancy EXCEPT:
Ptyalism
Pyrosis
Pica
Decreased peristalsis
Constipation
What hormone is produced by a pituitary gland under the act of nipple compression at feeding of
child?
oxythocin;
vasopressin;
progesteron;
prolactin;
estradiol.
537.
A. *
B.
C.
D.
E.
538.
A.
B. *
C.
D.
E.
539.
A.
B.
C. *
D.
E.
540.
A.
B. *
C.
D.
E.
541.
A.
B. *
C.
D.
E.
542.
A.
B.
C. *
D.
E.
543.
A.
B.
C.
D.
E. *
544.
A. *
Appendicitis may be difficult to diagnose in pregnancy because the appendix is:
Displaced upward and laterally, high and to the right.
Displace upward and laterally, high and to the left.
Deep at McBurney’s point.
Displaced downward and laterally, low and to the right.
Displaced posteriorly and covered by the uterus
What are probable signs of pregnancy?
Determined by ultrasound.
Observed by the health care provider.
Reported by the client.
Diagnostic tests.
Determined by X-ray
The diagnosis of pregnancy is based on the following positive signs of pregnancy.
Quickening
Verification of fetal sex
Verification of fetal movement by examiner
Positive hCG test.
Delay of the period
When is the fetus begins to descend and drop into the pelvis:
Attitude
Lightening
Presentation
Chloasma
Station
Which of the following include signs and symptoms that a woman should report immediately to her
health care provider?
Fetal movement
Heartburn accompanied by severe headache
Decreased libido
Urinary frequency
Morning sickness
Whant is the maximal physiologycal blood lost in labor?
0,1 % of body weight
0,3 % of body weight
0,5 % of body weight
0,7 % of body weight
1 % of body weight
What method should be used for diagnostic submucous myoma?
puncture of abdominal cavity through posterior vaginal fornix
laparoscopy
biopsy
Doppler assessment
hysteroscopy
Prenatal care should ideally begin:
Before the first missed menstrual period.
B.
C.
D.
E.
545.
A.
B.
C.
D. *
E.
546.
A. *
B.
C.
D.
E.
547.
A.
B.
C. *
D.
E.
548.
A.
B.
C.
D. *
E.
549.
A.
B. *
C.
D.
E.
550.
A.
B.
C. *
D.
E.
551.
A.
B. *
After the first missed menstrual period.
After the second missed menstrual period.
After the third missed menstrual period.
After the birth
Physiologycal blood loss of puerperal woman with body weight 68 kg is:
260 ml;
380 ml;
360 ml;
340 ml;
420 ml.
For which of the following women is recommended HIV prenatal testing?
All women, regardless of risk factors
A woman who has had more than one sexual partner
A woman who has had a sexually transmitted infection
A woman who is monogamous with her partner
This test is not indicated for pregnant woman
Which of the following is characteristic of true labor?
Irregular contractions
Discomfort in lower abdomen
Cervical dilatation
Discomfort relieved by sedation
Passage of the blood-tinged
Which of the following symptoms would be considered a first trimester warning sign and should be
reported immediately by the pregnant woman to her health care provider?
Nausea with occasional vomiting
Fatigue
Urinary frequency
Vaginal bleeding
Fetal movement
Condoms should be used in pregnancy by:
Unmarried pregnant women
Women at risk for acquiring or transmitting sexually transmitted infections
All pregnant women
Women at risk for candidiasis
Using of condoms is not recommended for pregnant woman
When should the fetal heart rate be auscultated during observation for labor in the II stage?
Before the contraction
During the contraction
At the end and immediately after a contraction
Any time
After delivery
Which of the following blood pressure (BP) assessment findings during the second trimester
indicates a risk for pregnancy-induced hypertension?
Baseline BP 120/80, current BP 126/85
Baseline BP 100/70, current BP 130/85
C.
D.
E.
552.
A. *
B.
C.
D.
E.
553.
A.
B. *
C.
D.
E.
554.
A.
B.
C.
D. *
E.
555.
A. *
B.
C.
D.
E.
556.
A.
B.
C.
D.
E.
557.
A.
B.
C. *
D.
E.
558.
A.
Baseline BP 140/85, current BP 130/80
Baseline BP 110/60, current BP 110/60
Baseline BP 120/80, current BP 116/75
The triple marker test is used to assess the fetus for which condition?
Down syndrome
Diaphragmatic hernia
Congenital cardiac abnormality
Anencephaly
Cleft lips
A woman who is 32 weeks pregnant is informed by the physician that a danger sign of pregnancy
could be:
Constipation
Alteration in the pattern of fetal movement
Heart palpitations
Edema in ankles and feet at the end of the day
Braxton Hicks contractions
For which of the following reasons would breastfeeding be contraindicated?
Hepatitis B
Everted nipples
History of breast cancer 3 years ago
Hepatitis C
Herpes simplex type I
Which of the following include signs and symptoms that a woman should report immediately to her
health care provider?
Vaginal bleeding
Fetal movement
Decreased libido
Urinary frequency
Constipation
A woman is 3 months pregnant. At her prenatal visit, she tells the physician that she doesn’t know
what is happening; one minute she is happy that she is pregnant, and the next minute she cries for no
reason. Which of the following responses by the physician is most appropriate?
“Don’t worry about it; you’ll feel better in a month or so.”
“Have you talked to your husband about how you feel?”
“Perhaps you really don’t want to be pregnant.”
“Hormone changes during pregnancy commonly result in mood swings.”
“It is abnormal situation, you should be examined by psychiatrist”
Which of the following is the partner’s main role in pregnancy?
Provide financial support.
Protect the pregnant woman from “old wives’ tales”.
Support and nurture the pregnant woman.
Ensure that the pregnant woman keeps prenatal appointments.
Pregnant woman do not need any partner
What is the station where the fetal head is visible at the introitus?
+2
B. *
C.
D.
E.
559.
A.
B. *
C.
D.
E.
560.
A.
B. *
C.
D.
E.
561.
A.
B.
C. *
D.
E.
562.
A. *
B.
C.
D.
E.
563.
A.
B.
C.
D. *
E.
564.
A.
B. *
C.
D.
E.
565.
A.
+3
+4
+5
0
What method should be used for diagnostic interstitial myoma?
hysterosalpingography
ultrasound
hysteroscopy
curettage of uterine cavity
uterine probing
During the first trimester of pregnancy, a woman can expect which of the following changes in her
sexual desire?
An increase because of enlarging breasts
A decrease because of nausea and fatigue
No change in the first trimester
An increase because of increased levels of female hormones
A decrease because of decreased levels of female hormones
What is the most reliable indicator of rupture of the fetal membranes?
Fluid per cervical os
Positive nitrazine test
Positive ferning
Positive oncofetal fibronectin
Bloody discharge
Which of the following behaviors indicates that a woman is “seeking safe passage” for herself and
her infant?
She keeps all prenatal appointments.
She “eats for two.”
She drives her car slowly.
She wears only low-heeled shoes.
She stops driving to avoid stressful situation
In what form of uterine fibromyoma we have such complication as node twisting?
retrocervical
interstitial
submucosal
subserosal
intraligamentous
Which of the following include signs and symptoms that a woman should report immediately to her
health care provider?
Fetal movement
Rupture of membranes
Decreased libido
Urinary frequency
Braxton Hicks contractions
What is the station where the presenting part is at the level of the ischial spines?
-2
B.
C. *
D.
E.
566.
A.
B.
C. *
D.
E.
567.
A.
B.
C.
D. *
E.
568.
A. *
B.
C.
D.
E.
569.
A.
B. *
C.
D.
E.
570.
A.
B. *
C.
D.
E.
571.
A.
B. *
C.
D.
E.
572.
A.
B.
-1
0
+1
+2
Which meal would provide the most absorbable iron?
Toasted cheese sandwich, celery sticks, tomato slices, and a grape drink
Oatmeal, whole wheat toast, jelly, and low-fat milk
Black bean soup, wheat crackers, ambrosia (orange sections, coconut, and pecans), and prunes
Red beans and rice, cornbread, mixed greens, and decaffeinated tea
Burgers, pizza, Cola
During the third stage of labor, which of the following is NOT a sign of placenta separation?
A gush of blood
Uterus rises in the abdomen
Umbilical cord protrudes out of the vagina
A sudden, sharp, unrelenting contraction
Nothing above
Which nutrient’s recommended dietary allowance (RDA) is higher during lactation than during
pregnancy?
Energy (kcal)
Iron
Vitamin A
Folic acid
Weight (grams)
Pregnant woman experiencing nausea and vomiting should:
Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning
Eat small, frequent meals (every 2 to 3 hours)
Increase the intake of high-fat foods to keep the stomach full and coated
Limit fluid intake throughout the day
Be hospitalized for additional assessment
To prevent GI upset, clients should take iron supplements:
On a full stomach
At bedtime
After eating a meal
With milk
One hour before eating a meal
Women with an inadequate weight gain during pregnancy are at higher risk for giving birth to an
infant with:
Spina bifida
Intrauterine growth retardation
Diabetes mellitus
Down syndrome
Pregnancy induced hypertension
For what are pregnants adolescents at high risk due to lower BMIs and “fad” dieting?
Obesity
Diabetes
C. *
D.
E.
573.
A.
B.
C.
D. *
E.
574.
A.
B.
C. *
D.
E.
575.
A.
B.
C. *
D.
E.
576.
A.
B.
C.
D. *
E.
577.
A. *
B.
C.
D.
E.
578.
A. *
B.
C.
D.
E.
579.
A. *
B.
C.
D.
Low birth weight babies
High birth weight babies
Postpartum hemorrhage
Which of the following assessments are not included in fetal biophysical profile (BPP)?
Fetal movement
Fetal tone
Fetal heart rate
Placental grade
Amount of amniotic fluid
In pregnancy maternal serum alpha-fetoprotein (MSAFP) levels have been used as a screening tool
for:
abdominal wall defects
intestinal defects
neural tube defects
palate defects
heart defects
Intrauterine growth restriction is associated with what pregnancy related risk factors?
Ovarian cyst
Premature rupture of membranes
Poor nutrition
Neural tube defects
Polyhydramnios
Intrauterine growth restriction is associated with what pregnancy related risk factors?
Premature rupture of membranes
Ovarian cyst
neural tube defects
Pregnancy-induced hypertension
Preterm labor
Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?
Multiple-marker screening
Lecithin-sphingomyelin ratio
Biophysical profile
Blood type and crossmatch of maternal and fetal serum
Doppler velocimetry
Which of the following is an indication for fetal diagnostic procedures?
Maternal diabetes
Maternal age older than 30 y.o.
Previous infant more than 3000 g at birth
Weight gain of 11,500 kg
Father’s age alder than 35 y.o.
When is the most accurate time to determine gestational age through ultrasound?
First trimester
Second trimester
Third trimester
There is no difference in accuracy between the trimesters.
E.
580.
A.
B. *
C.
D.
E.
581.
A.
B.
C. *
D.
E.
582.
A. *
B.
C.
D.
E.
583.
A.
B.
C.
D.
E. *
584.
A.
B. *
C.
D.
E.
585.
A.
B.
C.
D. *
E.
586.
A.
B. *
C.
D.
Before delivery
The primary reason for evaluating alpha-fetoprotein levels in maternal serum is to determine whether
the fetus has:
hemophilia
a neural tube defect.
sickle cell anemia
a normal lecithin-sphingomyelin ratio
diabetes
Chorionic villus sampling can be performed during pregnancy as early as:
4 weeks.
8 weeks.
10 weeks.
12 weeks.
16 weeks
On which of the following aspects of fetal diagnostic testing do parents usually place the most
importance?
Safety of the fetus
Duration of the test
Cost of the procedure
Physical discomfort caused by the procedure
Maternal’s desire
The physician’s role in diagnostic testing is to provide:
advice to the couple.
assistance with decision making.
information about the tests.
reassurance about fetal safety.
prescription of the test
Which of the following would be considered a contraindication for transcervical chorionic villus
sampling?
Rh-negative mother
Positive for group B streptococcus
Maternal age less than 35 years
Gestation less than 15 weeks
Agent placenta
Which diagnostic test evaluates the effect of fetal movement on fetal heart activity?
Contraction stress test
Sonography
Biophysical profile
Nonstress test
Doppler velocimetry
Which physician’s intervention is necessary prior to a second trimester transabdominal utrasound?
Ensure the client is NPO for 12 hours.
Instruct the client to drink 1 to 2 quarts of water.
Administer a soap suds enema
Perform an abdominal prep.
E.
587.
A.
B.
C.
D. *
E.
588.
A.
B.
C. *
D.
E.
589.
A. *
B.
C.
D.
E.
590.
A.
B.
C.
D. *
E.
591.
A.
B. *
C.
D.
E.
592.
A.
B.
C. *
D.
E.
593.
A.
B.
C.
D. *
There no any recommendation how to prepare to this procedure
The major advantage of chorionic villus sampling over amniocentesis is that it:
is not an invasive procedure.
does not require hospitalization.
has less risk of spontaneous abortion.
requires less time to obtain results.
Increase risk of gestational diabetes development
What is the purpose of amniocentesis for a client hospitalized at 34 weeks of gestation with
pregnancy-induced hypertension?
To identify abnormal fetal cells
To detect metabolic disorders
To determine fetal lung maturity
To identify the sex of the fetus
To detect quantity of amniotic fluid
Post-surgery care after amniocentesis includes:
monitoring uterine activity.
placing the client in a supine position for 2 hours.
applying a pressure dressing to the puncture site.
forcing fluids by mouth.
bed rest during next 3 days
A nonstress test in which there are two or more fetal heart rate accelerations of 15 or more beats per
minute with fetal movement in a 20-minute period is termed:
nonreactive.
positive.
negative.
reactive.
normal
The purpose of initiating contractions in a contraction stress test is:
to determine the degree of fetal activity.
to apply a stressful stimulus to the fetus.
to identify fetal acceleration patterns.
to increase placental blood flow.
to evaluate quantity of amniotic fluid
A score of 9 on a biophysical profile is considered:
abnormal.
equivocal.
normal.
negative
positive
Which diagnostic test would be the most important to have for a primigravid client in the second
trimester of her pregnancy?
Culdocentesis to detect abnormalities.
Chorionic villus sampling.
Ultrasound testing.
a-fetoprotcin (AFP) testing.
E.
594.
A.
B. *
C.
D.
E.
595.
A.
B. *
C.
D.
E.
596.
A.
B.
C. *
D.
E.
597.
A.
B.
C. *
D.
E.
598.
A.
B.
C. *
D.
E.
599.
A. *
B.
C.
D.
E.
600.
A.
B.
C.
Doppler velocymetry
After reviewing the physician's explanation of amniocentesis with a multigravid client, which of the
following, if reported by the client as a primary risk of the procedure, would indicate successful
teaching?
Premature rupture of the membranes.
Possible premature labor.
Fetal limb malformations.
Fetal organ malformations.
polyhydramnios
Which of the following statements about a fetal biophysical profile would be incorporated into the
teaching plan for a primigravid client with insulin-dependent diabetes?
It determines fetal lung maturity.
It is noninvasive using real-time ultrasound
It will correlate with the newborn's Apgar score.
It requires the client to have an empty bladder.
Has increased risk of preterm labour
As part of preparing a 24-year-old woman at 42 week’s gestation for a nonstress test, the physician
would:
Tell the woman to fast for 8 hours prior to the test
Explain that the test will evaluate how well her baby is moving inside her uterus
Show her how to indicate when her baby moves
attach a spiral electrode to the presenting part to determine FHR patterns
show the baby’s sex
In what form of uterine fibromyoma we have such complication as node delivering?
retrocervical
interstitial
submucous
subserous
intraligamentous
What endometrium conditions belong to the premalignant disease?
glandular-cystic hyperplasia
endometritis
polyposis of endometrium
endometriosis
glandular hyperplasia
What is typical for hormonal status of patient with hyperplasia of endometrium?
high level of estrogens
high level of pituitary gland hormons
high level of androgens
high level of progesteron
high level of chorionic gonadotropin
How pregnancy does influence on fibromyoma’s growth?
doesn’t effect at all
promote fibromyoma’s elimination
promote fibromyoma’s malignization
D.
E. *
601.
A. *
B.
C.
D.
E.
602.
A.
B.
C. *
D.
E.
603.
A.
B.
C.
D.
E. *
604.
A.
B. *
C.
D.
E.
605.
A.
B.
C. *
D.
E.
606.
A.
B.
C. *
D.
E.
607.
A. *
B.
C.
D.
E.
608.
promote necrosis of node
promote fast growth of fibromyoma
What substance is in IUD for fibromyoma treatment?
levonorgestrel
synestrol
17-oxiprogesteroni capronat
Zoladex
Etinilestradiol
At what type of ovarian tumour does endometrium hyperpasia develop?
papillary cystoma
paraovarian cyst
follicular cyst
ovarian cancer
yellow body cyst
What tumour of external genitalia develops from connective tissue?
papilloma
hemangioma
myxoma
lipoma
fibroma
What tumour of external genitalia develops from fatty and connective tissue?
fibroma
lipoma
myxoma
hemangioma
papilloma
What treatment should be prescribes for patient with dermoid cyst?
antibacterial therapy
Zoladex
cystectomy
substitutive hormonal therapy
combined oral contraceptives
Bilateral ovarian cyst on ultrasound, associated with molar pregnancy and multiple gestation is?
Metastasis
Endometriosis
Theca luteum cyst
PID (Pelvic inflammatory disease)
lipoma
Bilateral solid ovarian masses on ultrasound, metastases from primary GIT cancer is suggestive for?
Krukenberg tumor
Luteoma
Fibrosis
Endometriosis
Theca luteum cyst
Cervical pap smear test is recommended to this age group with the timing of:
A.
B.
C.
D. *
E.
609.
A.
B.
C. *
D.
E.
610.
A.
B.
C. *
D.
E.
611.
A.
B.
C.
D. *
E.
612.
A.
B.
C.
D.
E. *
613.
A.
B.
C.
D.
E. *
614.
A.
B.
C.
D.
E. *
615.
A.
B. *
Twice in a lifetime- <25 years old
Once a lifetime- all ages
Every 10 years- >65 years
Every 3 years- 21 to 65 years
Every year- 5 to 18 years
Name the ovarian cyst with thick sebaceous yellow fluid in and ectodermal (hair) component.
Hydatid mole
Trauma-related cyst
Mature cystic teratoma (dermoid cyst)
Cancerous cyst
Adenocarcinoma
Call the benign uterine fibroids, causing enlarged uterus with an irregular contour:
Adenocarcinoma
Fibroma
Leiomyoma uteri
Carcinoma
Mole
Yellow or yellow-brown masses, solid ovarian mass on ultrasound, 50% bilateral, regress after
delivery is?
Bartholian
Cancer
Krukenberg tumor
Luteoma
Theca luteum cyst
Diagnostic method to diagnose uterine Leiomyomas (fibroids):
Normal observation
MRI of pelvis
Bimanual exam
Pelvic x-ray
Ultrasound of pelvic
Which of them is NOT an indication for endometrial biopsy?
Lynch syndrome in patient <45 years
Atypical glandular cells on pap test
Postmenopausal bleeding
Obesity/anovulation
Sheehan syndrome
Soft mobile mass, normally asymptomatic, commonly on the base of the labium major (vulva) is:
Syphilis related mass
Malignancy
HSV related cyst
HPV (wart)
Bartholin duct cyst
Cyst resulting from incomplete regression of the wolffian duct during fetal development?
Vaginal cancer
Gartner duct cyst
C.
D.
E.
616.
A. *
B.
C.
D.
E.
617.
A.
B. *
C.
D.
E.
618.
A.
B.
C.
D.
E. *
619.
A.
B.
C.
D. *
E.
620.
A. *
B.
C.
D.
E.
621.
A. *
B.
C.
D.
E.
622.
A.
B.
C. *
D.
E.
Fibroid
Fissure/ Fistula
Bartholin cyst
Theca lutein cyst is an ovarian hyperstimulation due to?
Gestational trophoblastic disease
X-linked related
Autoimmunity
Anatomically malformation
Krukenberg tumor
Leiomyomata uteri (fibroids) are a common cause of?
Vaginal itching
Heavy menstrual bleeding
Ectopic pregnancy
Severe pelvic and leg pain
Vaginal discharge (yellowish)
Which of the following is correct regarding polyps?
Polyps are the most common cysts in the fallopian tubes
Polyps are similar to the fistula
Polyps causing secondary amenorrhea but only age after 52y
Polyps are always associated with pain
Polyps are not associated with pain
Choose the most common benign neoplasm of the female genital tract:
Endometrial cancer
Cervical cancer
Vagina cancer
Uterine leiomyoma (fibroids)
Polyps
Which of the following describes the uterine leiomyoma?
Discrete/ round ,firm
Attached, triangle-like, dense
Single, huge, full of pus, dense
Cuboid-shaped, pinkish-color, firm
Cylendric-chain looking, irregular borders
Indicate the key words about uterine myomas and their effects on body:
On physical exam uterus is irregular and mobile
On physical exam uterus is innervated and shrinky
There is lots of yellowish-brownish discharge
Heavy bleeding, leading to anemia (only at age <35.y.)
None of them
If a uterine mass continue to grow after menopausa, suspect……?
PID (Pelvic inflammatory disease)
Chronic abscess
Malignancy
Fistula
Normal, will be self-limited
623.
A.
B.
C.
D. *
E.
624.
A. *
B.
C.
D.
E.
625.
A. *
B.
C.
D.
E.
626.
A.
B.
C.
D.
E. *
627.
A.
B.
C. *
D.
E.
628.
A. *
B.
C.
D.
E.
629.
A.
B. *
C.
D.
E.
630.
A.
B. *
What for the Gardasil vaccine may be used?
Endometrial cancer
Types of breast cancer
For protecting the recurrent miscarriage
Genital warts and cervical cancer
Reduces the development of ovarian cancer in young women
Choose a symptom of uterine prolapsed:
all of them
vaginal pressure sensation
vaginal fullness
problems with sexual intercourse
the uterus or cervix protruding out of the vagina.
Indicate the explanation for the cystocele:
Bladder prolapse into the vagina
Bladder prolapse under the diaphragm
Bladder rupture
Fistula in the vaginal canal
Partially rupture of the bladder
Indicate the types of incontinence:
Stress-mechanical
Stress-physiological
Urge-mechanical
Urge-neurological
Stress-urge
Indicate testing for stress incontinence:
Muscle strength + sphincter test
Needle biopsy + nerve study
Pelvic exam + Q-tip test
Inguinal canal exam
Schiller's test
Choose example of anatomically caused incontinence
Vesicovaginal fistula
Vaginal canal fistula
Uterine tumor
Ovarian tumor
Uterine cancer
Which process represents the IIIa type of smear at oncocytological examination?
the unchanged epithelium
mild or moderate dysplasia
cancer
inflammatory process
suspicion on malignisation
For polyp treatment we use all except:
cryodestruction
conization of cervix
C.
D.
E.
631.
A. *
B.
C.
D.
E.
632.
A.
B.
C.
D.
E. *
633.
A.
B. *
C.
D.
E.
634.
A.
B.
C. *
D.
E.
635.
A. *
B.
C.
D.
E.
636.
A.
B.
C.
D.
E. *
637.
A.
B.
C.
D.
E. *
endocervical curettage
Coagulation
polyp twisting
To the risk factors for cervical dysplasia belong all EXCEPT:
hyperprogesteronemia
hyperestrogenemia
cervical trauma during delivery and abortion
A lot of sexual partner
Early sexual activity
What sign is not typical for proliferative myoma?
increased mitotic activity
fast growth
plenty of lymphoid cells
plenty of plasmatic cells
Atypical growth
In diagnostic of cervical dysplasia we use all EXCEPT:
colposcopy
metrosalpingography
cytogenetic examination
histochemical examination
cytological examination
In what type of ovarion tumour do we have an endometrium hyperplasia?
papillary cystoma
paraovarian cyst
follicle cyst
ovarian cancer
yellow body cyst
In diagnostic of cervical leucoplacia we use all EXCEPT:
culdoscopy
colposcopy
biopsy
cytology
Speculum assessment
Node consistency of uterine fibromyoma depends on:
node size
vessels' amount
fatty tissue amount
presence of endometrioid tissues
correlation of parenchyma and stroma
What is typical for proliferative myoma?
presence of atypia
atypical localization
multiple nodes
node calcification
increased mitotic activity
638.
A.
B.
C.
D.
E. *
639.
A. *
B.
C.
D.
E.
640.
A. *
B.
C.
D.
E.
641.
A.
B.
C. *
D.
E.
642.
A. *
B.
C.
D.
E.
643.
A.
B.
C.
D.
E. *
644.
A. *
B.
C.
D.
E.
645.
A.
B.
What sign is not typical for proliferative myoma?
increased mitotic activity
fast growth
plenty of lymphoid cells
plenty of plasmatic cells
Atypical growth
What sign is typical for submucous myoma?
hyperpolymenorrhea
amenorrhea
foamy vaginal discharge
symptomless
tumour destruction
What sign is typical for retrocervical myoma?
rectum dysfunction
infertility
amenorrhea
foamy vaginal discharge
hyperpolymenorrhea
What endometrium conditions belong to the premalignant disease?
glandular-cystic hyperplasia
endometritis
polyposis of endometrium
endometriosis
glandular hyperplasia
What is typical for hormonal status of patient with hyperplasia of endometrium?
high level of estrogens
high level of pituitary gland hormons
high level of androgens
high level of progesteron
high level of chorionic gonadotropin
How pregnancy does influence on fibromyoma’s growth?
doesn’t effect at all
promote fibromyoma’s elimination
promote fibromyoma’s malignization
promote necrosis of node
promote fast growth of fibromyoma
What substance is in IUD for fibromyoma treatment?
levonorgestrel
synestrol
17-oxiprogesteroni capronat
Zoladex
Etinilestradiol
At what type of ovarian tumour does endometrium hyperpasia develop?
papillary cystoma
paraovarian cyst
C. *
D.
E.
646.
A.
B.
C. *
D.
E.
647.
A.
B.
C.
D. *
E.
648.
A.
B.
C. *
D.
E.
649.
A.
B.
C.
D. *
E.
650.
A.
B.
C.
D.
E. *
651.
A.
B.
C.
D.
E. *
652.
A.
B.
C.
D.
follicular cyst
ovarian cancer
yellow body cyst
What treatment should be prescribes for patient with dermoid cyst?
antibacterial therapy
Zoladex
cystectomy
substitutive hormonal therapy
combined oral contraceptives
Cervical pap smear test is recommended to this age group with the timing of:
Twice in a lifetime- <25 years old
Once a lifetime- all ages
Every 10 years- >65 years
Every 3 years- 21 to 65 years
Every year- 5 to 18 years
Call the benign uterine fibroids, causing enlarged uterus with an irregular contour:
Adenocarcinoma
Fibroma
Leiomyoma uteri
Carcinoma
Mole
Yellow or yellow-brown masses, solid ovarian mass on ultrasound, 50% bilateral, regress after
delivery is?
Bartholian
Cancer
Krukenberg tumor
Luteoma
Theca luteum cyst
Diagnostic method to diagnose uterine Leiomyomas (fibroids):
Normal observation
MRI of pelvis
Bimanual exam
Pelvic x-ray
Ultrasound of pelvic
Which of them is NOT an indication for endometrial biopsy?
Lynch syndrome in patient <45 years
Atypical glandular cells on pap test
Postmenopausal bleeding
Obesity/anovulation
Sheehan syndrome
Soft mobile mass, normally asymptomatic, commonly on the base of the labium major (vulva) is:
Syphilis related mass
Malignancy
HSV related cyst
HPV (wart)
E. *
653.
A.
B. *
C.
D.
E.
654.
A.
B. *
C.
D.
E.
655.
A.
B.
C.
D.
E. *
656.
A.
B.
C.
D. *
E.
657.
A. *
B.
C.
D.
E.
658.
A. *
B.
C.
D.
E.
659.
A.
B.
C. *
D.
E.
660.
A.
Bartholin duct cyst
Cyst resulting from incomplete regression of the wolffian duct during fetal development?
Vaginal cancer
Gartner duct cyst
Fibroid
Fissure/ Fistula
Bartholin cyst
Leiomyomata uteri (fibroids) are a common cause of?
Vaginal itching
Heavy menstrual bleeding
Ectopic pregnancy
Severe pelvic and leg pain
Vaginal discharge (yellowish)
Which of the following is correct regarding polyps?
Polyps are the most common cysts in the fallopian tubes
Polyps are similar to the fistula
Polyps causing secondary amenorrhea but only age after 52y
Polyps are always associated with pain
Polyps are not associated with pain
Choose the most common benign neoplasm of the female genital tract:
Endometrial cancer
Cervical cancer
Vagina cancer
Uterine leiomyoma (fibroids)
Polyps
Which of the following describes the uterine leiomyoma?
Discrete/ round ,firm
Attached, triangle-like, dense
Single, huge, full of pus, dense
Cuboid-shaped, pinkish-color, firm
Cylendric-chain looking, irregular borders
Indicate the key words about uterine myomas and their effects on body:
On physical exam uterus is irregular and mobile
On physical exam uterus is innervated and shrinky
There is lots of yellowish-brownish discharge
Heavy bleeding, leading to anemia (only at age <35.y.)
None of them
If a uterine mass continue to grow after menopausa, suspect……?
PID (Pelvic inflammatory disease)
Chronic abscess
Malignancy
Fistula
Normal, will be self-limited
What for the Gardasil vaccine may be used?
Endometrial cancer
B.
C.
D. *
E.
661.
A. *
B.
C.
D.
E.
662.
A.
B.
C.
D.
E. *
663.
A.
B.
C. *
D.
E.
664.
A.
B. *
C.
D.
E.
665.
A.
B. *
C.
D.
E.
666.
A.
B.
C.
D. *
E.
667.
A.
B.
C.
D.
Types of breast cancer
For protecting the recurrent miscarriage
Genital warts and cervical cancer
Reduces the development of ovarian cancer in young women
Indicate the explanation for the cystocele:
Bladder prolapse into the vagina
Bladder prolapse under the diaphragm
Bladder rupture
Fistula in the vaginal canal
Partially rupture of the bladder
Indicate the types of incontinence:
Stress-mechanical
Stress-physiological
Urge-mechanical
Urge-neurological
Stress-urge
What kind of endometriosis belongs to internal?
endometriosis of uterine cervix
endometriosis of vagine
endometriosis of uterus
endometriosis of perineum
endometriosis of Umbilicus
Commonest site of endometriosis:
vagina
uterus.
urinary bladder
peritoneal cavity.
umbilicus
Which of medicines should NOT BE USED for treatment of endometriosis?
danasol
sinestrol
dufaston
zoladex
danogen
To the benign cervical condition belong all EXCEPT:
Endometriosis
dysplasia
leukoplakia
adenomatosis
erythroplasia
Why does endometriosis cause pain in some women?
Endometriosis tissues cannot leave the body
Endometriosis areas make chemicals that irritate pelvic tissues
Endometriosis produces chemicals that are known to cause pain
Developing adhesions
E. *
668.
A.
B.
C.
D. *
E.
669.
A.
B.
C.
D.
E. *
670.
A.
B. *
C.
D.
E.
671.
A.
B.
C. *
D.
E.
672.
A.
B. *
C.
D.
E.
673.
A. *
B.
C.
D.
E.
674.
A.
B.
C. *
D.
E.
675.
All of the above
What is one of the most common symptoms of endometriosis?
Bloating
Pelvic muscle spasm
Diarrhea
Infertility
Heavy Bleeding
The main symptom of endometriosis is
uterine abscess formation
Heavy Bleeding
Hormonal imbalance
Fever
dysmenorrhea
The main symptom of endometriosis is
Uterine abscess formation
Pain
Heavy Bleeding
Hormonal imbalance
Fever
Endometriosis affects women of reproductive age and is characterized by:
Squamous cells over producing
White spots in the vaginal canal
Ectopic implantation of endometrial glands
Uterus enlargement and unilateral severe pelvic pain
Abdominal bloating, vomiting
Which one is the pathogenesis of endometriosis?
Epithelial hypoplasia
Ectopic implantation of endometrial glands
Endometrial glands overgrowth
Over producing of epithelial cells
Squamous cells over producing
All of them are clinical findings of endometriosis except:
Fatigue/muscle ache
Dyschezia
Chronic pelvic pain
Dysmenorrhea
Dyspareunia
Immobile uterus, cervical motion tenderness, adnexal mass and posterior cul-de-sac are suggestive
for?
Mole presentation
Ovarian cancer
Endometriosis
Vaginal cancer
Metastasis breast cancer
Which of the following is true about endometriosis?
A.
B.
C.
D.
E. *
676.
A.
B.
C.
D. *
E.
677.
A.
B.
C.
D.
E. *
678.
A.
B.
C.
D.
E. *
679.
A.
B.
C. *
D.
E.
680.
A. *
B.
C.
D.
E.
681.
A.
B.
C. *
D.
E.
682.
A.
B. *
C.
Affects approximately 50% of women
Affects mostly the age 5-25 years
Rarely causes infertility
Risk increased in menopause
extremely painful (or disabling) menstrual cramps
The most common symptom of a vaginal yeast infection is:
Bleeding
Discharge
Fever
Itching
Infertility
Which of the following is a possible symptom of sexually transmitted diseases (STD), EXCEPT?
Bumps, sores, or warts near the mouth, anus, or vagina
Painful urination
Painful sex
Infertility
Ovarian apoplexy
The bacterium Chlamydia trachomatis can cause all EXCEPT:
Lymphogranuloma venereum (LGV)
Cervicitis
Urethritis
Infertility
Female organ prolapse
Name a complication of Pelvic inflammatory disease (PID), EXCEPT:
Infertility
Ectopic pregnancy
Menopause
Abscesses
Long-term (chronic) pain
Excretions from a vagina “cheese-like” arise up at:
Vaginal candidosis
Genital trichomoniasis
Malignant tumors
Menopause
Puberty age
Which localization of pain is typical for the inflammatory diseases of adnexa?
in lower part of abdomen above a pubis
in a right hypogastric area
in lateral quadrants of lower part of abdomen
in epigastrium
in sacrum and lumbal region
Thin-white discharge with fishy odor, no inflammation is suggestive for?
Hormonal imbalance
Bacterial vaginitis
Candida vaginitis
D.
E.
683.
A.
B.
C.
D.
E. *
684.
A.
B.
C. *
D.
E.
685.
A.
B.
C. *
D.
E.
686.
A. *
B.
C.
D.
E.
687.
A.
B. *
C.
D.
E.
688.
A.
B.
C. *
D.
E.
689.
A.
B.
C. *
D.
E.
690.
Trichomoniasis
Syphilis
Thin-yellow/ green malodorous discharge with vaginal inflammation mostly indicates?
Hormonal changes
Candida vaginitis
Cervicitis
Bacterial vaginitis
Trichomoniasis
Genital warts (condylomata acuminata), is cause by?
Candida
Bacterial vaginitis
Human papillomavirus (HPV) 6 and 11
Syphilis
Trichomoniasis
Choose the diagnostic testing method for chlamydia and gonorrhea in women:
Skin testing
Pap smear
Nucleic-acid amplification testing
Cytology
Human papillomavirus (HPV)
Choose the treatment of choice for the Pelvic inflammatory disease (PID):
Parenteral (iv) clindamycin + Gentamicin
Hormone replacement therapy (HRT)
thyroxine
Birth control pills
Clomiphene citrate
Why chlamydia does not show organisms on culturing?
It is weakly motile
It is an obligate intracellular pathogen
It has no color
It is highly mobile
It is strongly motile
Choose criteria for the clinical diagnosis of bacterial vaginosis:
Abnormal whitish-gray discharge
Vaginal pH > 4.5
All of them
Positive amine (whiff) test
Clue cells comprise > 20% of epithelial cells on wet mount
Choose best describe for Pelvic inflammatory disease (PID):
Inflammation of genital
Inflammation of uterus and urethra
Polymicrobial infection of the upper genital tract
It is always caused by trachomatis
Never causes lower abdominal pain
If there are many WBCs and no organism on saline smear, then suspect:
A.
B. *
C.
D.
E.
691.
A.
B.
C.
D. *
E.
692.
A.
B. *
C.
D.
E.
693.
A.
B.
C.
D. *
E.
694.
A.
B.
C. *
D.
E.
695.
A. *
B.
C.
D.
E.
696.
A.
B. *
C.
D.
E.
697.
A.
B.
C.
Candida
Chlamydia
Aerobes rods
HSV
Streptococcus B group
Choose treatment of candida vaginitis:
Azithromycin
Amoxicillin
Ceftriaxone
Topical azole or fluconazole
Low pH soap
Choose the right treatment of Pelvic inflammatory disease (PID):
Methotrexate
Ofloxacin or levofloxacin 14 days or metronidazole 14 days
Estrogen
Clomiphene citrate
Progestin
Choose the complication caused from Pelvic inflammatory disease (PID):
Infertility
Fitz-Hugh-Curtis syndrome
Repeated episodes of infection
All of them
Chronic pelvic pain
Pelvic inflammatory disease (PID) presents with all of the following, EXCEPT?
Lower abdominal pain
Fever/ chills
Night sweats
Menstrual disturbances
Purulent cervical discharge
Choose the similar name for the “cervical motion tenderness”:
Chandelier sign
Cul-de-sac
Poor negative reflect
Fitz-Hugh-curtis
Cervical os over-opening
Which organism is responsible for toxic shock syndrome within 5 days after tampons use?
Streptococcus B
Staphylococcus aureus
Chlamydia
N. Gonorrhea
Candida
Pelvic inflammatory disease (PID) is causing chronic pelvic pain due to…….?
Producing ulcers
Hard nodules
Tearing of ligaments
D. *
E.
698.
A. *
B.
C.
D.
E.
699.
A.
B. *
C.
D.
E.
700.
A.
B.
C. *
D.
E.
701.
A.
B.
C.
D.
E. *
702.
A.
B. *
C.
D.
E.
703.
A.
B.
C.
D. *
E.
704.
A.
B. *
C.
D.
E.
705.
Pelvic scarring
Abscess rupture
Which of the following is true about vaginitis?
The most common presenting symptom is discharge
Night sweats
Headaches
Mood changes
Anxiety
Which of the following is NOT the side effect of the combination oral contraceptives?
Hypertension
Diarrhea
Nausea
Bloating
Breaking through bleeding
Combined oral contraceptive can __________ risk of ovarian/ endometrial cancer.
Unchanged
Increase
Decrease
Rapidly increase
Strongly increase
Which of the following is an advantage of Combined oral contraceptive’s use, EXCEPT:
Reliable with failure rate of <1%
Decreases incidence of Pelvic inflammatory disease (PID) and ectopic pregnancy
Makes menses more predictable and less painful
Protective against ovarian and endometrial cancer
sexually transmitted diseases (STD) protection
Choose a disadvantage of Combined oral contraceptive’s use:
Makes menses more predictable
No sexually transmitted diseases (STD) protection
Weight loss
Anorexia
Makes menses less painful
Choose an alternative to Combined oral contraceptive’s:
Withdrawal intercource
Ovariectomy
Hysterectomy
Intrauterine device
Sexual abstinence
Contraceptive oral pills help in birth control by
Killing of ova
Preventing ovulation
Killing of sperms
Forming barrier between sperms and ova
Decreasing libido
Most important component of oral contraceptive agents is
A.
B.
C. *
D.
E.
706.
A.
B. *
C.
D.
E.
707.
A.
B. *
C.
D.
E.
708.
A.
B. *
C.
D.
E.
709.
A.
B.
C. *
D.
E.
710.
A.
B.
C. *
D.
E.
711.
A.
B.
C. *
D.
E.
712.
A.
B.
C.
Thyroxine
Luteinizing hormone(LH)
Progestrone
Follicle-stimulating hormone (FSH)
Gonadotrophin-releasing hormone (GnRH)
Copper-T/ loop prevents
Ovulation
Fertilization
Zygote formation
Cleavage
Reproduction
Which of the following is a mechanical barrier used in birth control?
Copper-T
Diaphragm
Loop
Dalcon shield
Combined oral contraceptive
Oral contraceptive pills function by inhibiting
Fertilization
Ovulation
Reproduction
Implantation
Libido
Menopause is defined as:
2 or more irregular periods after age 40
The start of hot flashes
No menstrual period for 12 consecutive months
No menstrual period for 6 consecutive months
An increase in mood swings
The average age of menopause is:
60
55
51
45
40
The first step in the workup of primary or secondary amenorrhea is:
Bimanual examination
Ultrasound of abdomen/pelvic
Pregnancy test
Nucleic amplification test
Mammography
Choose the right period for menstruation/follicular phase
Days 7-14
Days 14-21
Days 5-10
D. *
E.
713.
A.
B.
C.
D.
E. *
714.
A.
B. *
C.
D.
E.
715.
A.
B. *
C.
D.
E.
716.
A.
B.
C. *
D.
E.
717.
A.
B. *
C.
D.
E.
718.
A.
B. *
C.
D.
E.
719.
A.
B.
C.
D. *
E.
720.
Days 1-13
Days 14-21
Choose the right period for ovulation:
Day 5
Day 21
Day 28
Day 7
Day 14
Choose the right period for luteal phase:
Days 3-14
Days 15-28
Days 5-10
Days 7-14
Days 10-14
Duration of proliferation phase in uterine cycle is:
from 1 to 5 day
from 5 to 14 day
from 14 to 28day
from 10 to 14 day
from 15 to 20 day
Duration of secretion phase in uterine cycle is:
from 1 to 5 day
from 5 to 14 day
from 14 to 28day
from 10 to 14 day
from 15 to 20 day
What is spaniomenorrhea?
menstruations come in 6-8 weeks
menstruations come 1 time per 4-6 monthes
menstruations are absent
quantity of menstrual blood less than 50ml
duration of menstruation 1-2 days
In climacteric age the medical treatment of dysfunctional uterine bleeding begin with:
setting of estrogens
diagnostic curettage of uterine cavity
colposcopy
setting of androgens
setting of gestagens
What appearance of the first menstruation in 17 years can testify about?
About the presence of inflammatory disease of uterus
About the presence of inflammatory disease of adnexa
About the presence of abnormal position of uterus
About the presence of genital infantilism
About normal development of organism of girl
Hypomenstrual syndrome includes:
A.
B. *
C.
D.
E.
721.
A.
B.
C.
D. *
E.
722.
A.
B. *
C.
D.
E.
723.
A.
B. *
C.
D.
E.
724.
A.
B. *
C.
D.
E.
725.
A.
B.
C.
D. *
E.
726.
A.
B. *
C.
D.
E.
727.
A.
B.
C. *
Opsomenorrhea, polimenorrhea
Oligomenorrhea, opsomenorrhea, hypomenorrhea
Proyomenorrhea, hypomenorrhea
Oligomenorrhea, hypermenorrhea
Spaniomenorrhea, hypermenorrhea
What appearance of the first menstruation in 14 years can testify about?
about the presence of inflammatory disease of uterus
about the presence of inflammatory disease of adnexa
about the presence of abnormal position of uterus
about normal development of organism of girl
about the presence of of genius infantilism
To hypothalamic amenorrhea does not belong:
psychogenic amenorrhea
amenorrhea at a syndrome Shikhane
amenorrhea at false pregnancy
amenorrhea at adipozogenital dystrophy
amenorrhea at a syndrome Kiary-Frommel
Menorrhagia is:
acyclic uterine bleeding
cyclic uterine bleeding in connection with menstruation cycle
painfull and abundant menstruation
pre- & post menstruation bloody allocation
short period of menstruation cycle
What is spaniomenorrhea?
menstruations come in 6-8 weeks
menstruations come 1 time per 4-6 monthes
menstruations are absent
quantity of menstrual blood less than 50ml
duration of menstruation 1-2 days
How is the state named, when less than 2 days proceed to menstruation?
spaniomenorrhea
hypomenorrhea
proyomenorrhea
oligomenorrhea
opsomenorrhea
What is the initial evaluation in case of secondary amenorrhea?
Prolactin, TSH and FSH followed by B-hcG to exclude pregnancy
B-hcG
Prolactin level only
Patient's BMI and level of cortisol
Patient's age and level of gonadotropine
Mean age for menopause is?
40 years
45 years
51 years
D.
E.
728.
A.
B.
C. *
D.
E.
729.
A.
B.
C.
D.
E. *
730.
A.
B. *
C.
D.
E.
731.
A.
B. *
C.
D.
E.
732.
A.
B.
C. *
D.
E.
733.
A. *
B.
C.
D.
E.
734.
A.
B. *
C.
D.
E.
735.
48 years
39 years
Which of the following is NOT a risk factor for the cervical cancer?
Multiple or high risk sexual partners
Tobacco use
Being at menopausal age
History of Sexual Transmitted Disease
Hpv 16.18
Which of the following is true about granulosa cell tumor?
Cells in rosette pattern
Complex ovarian mass
High estradiol and high inhibin
Sex cord-stromal tumor
All of them
Which among these gynecologic neoplasms has the highest mortality rate?
Uterine
Ovarian
Cervical
Endometrial
Vulvar
Indicate the types of endometrial cancer:
Benign endometroid – atypical endometrial
Type 1, endometroid - Type 2, serous
Type 1 serous – Type 2, endometroid
Columnar - squamous
Type A, fibroid, Type B, serous
Indicate the risk factor of vulvar cancer:
Alcoholism-down syndrome
Sjogren syndrome
HPV (16,18,31), lichen sclerosis, smoking
Diabetes, allergy, high protein diet
Stress(anxiety), anorexia nervosa
Choose the frequency of female genital tract cancers:
Endometrial>ovarian>cervical
Ovarian>endometrial>cervical
Cervical>ovarian>endometrial
Endometrial>cervical>ovarian
Ovarian>cervical>endometrial
Choose the number of death rate with female genital tract cancers:
Endometrial>ovarian>cervical
Ovarian>endometrial>cervical
Cervical>endometrial>ovarian
Ovarian>cervical>endometrial
Endometrial>cervical>ovarian
Indicate which of the following best explains teratoma:
A.
B.
C.
D.
E. *
736.
A. *
B.
C.
D.
E.
737.
A. *
B.
C.
D.
E.
738.
A.
B.
C.
D. *
E.
739.
A.
B.
C.
D. *
E.
740.
A.
B.
C. *
D.
E.
741.
A.
B. *
C.
D.
E.
742.
A.
B.
C. *
A tumor very soft, round, filled with clean pus
A tumor very large, firm, filled in with blood
An abscess with a pinkish surface
An abscess covering the os of cervix
A tumor made up of hair, muscle, bone
Explain the term called, serous cystadenoma:
Most common ovarian neoplasm, and is benign
Most common ovarian neoplasm, highly aggressive
Most common uterus neoplasm
Cervical hyperplasia
Large cyst under the one ovary
What is a Brenner tumor?
Group of ovarian neoplasm, majority benign
Group of ovarian neoplasm, causing rapid metastasis
This tumor is very common in young women
The tumor is made up of muscle, hair and bone
The tumor is firm-small in size <1cm
Explain correctly the krukenberg tumor:
Benign tumor of ovaries
Benign tumor of uterus
Benign tumor on labia major
Malignancy in the ovary that metastasized from other site
Malignancy in the cervix that metastasized from primary site
Explain what the sertoli-leydig cell tumor is:
A small tumor on labia minor
A small tumor on posterior wall of vagina
A tumor on the opening of the cervix
Is an ovarian tumor that secrets testosterone
Is an ovarian tumor with LH overproducing
Thick cottage-cheese-like discharge and vaginal inflammation is suggestive of?
Cancer
Hormonal changes
Candida vaginitis
Bacterial vaginitis
Trichomoniasis
Fitz-Hugh-Curtis syndrome (perihepatitis) mostly caused by:
HBV
Chlamydia and gonorrhea
E.coli
Candida
Streptococci
How can the Tanner Stages be defined?
Emotional changes of the aging woman
Thelarche
Stages of adolescent physical development
D.
748.
Menarche
Menopause
What is correct about test tube baby?
Fertilization inside female genital tract and grown in test tube
Rearing of prematuraly born in incubator
Fertilization outside and gestation inside womb of mother
Both fertilization and development are effected outside the genital tract.
Fertilization of only donation egg
Which of the following represents a condition where the motility of sperms is highly reduced?
Azospermia
Polyspermy
Oligospermia
Asthenospermia
Hyperspermy
Oral contraceptive pills function by inhibiting:
Fertilization
Ovulation
Reproduction
Implantation
Libido
Which test is found positive during fertlity period of menstrual cycle, in which cervical mucus is
slippery and can be drawn into a thread when stretched between two fingers:
Spinnbarkeit test
Shick test
Ballottement test
Pyroglobulin test
Schiller's test
Failure of testis to descend into the scrotum is called:
Paedogenesis
Castration
Cryptorchidism
Impotency
Infertility
After a sperm has entered on ovum, entry of other sperm is prevented by:
A.
B.
C.
D. *
E.
749.
A.
B.
C.
D. *
E.
Condensation of the yolk
Formation of pigment coat
Development of viteline membrane
Development of fertilization membrane
Formation of chorion
The site of fertilization in human is:
Ovary
Uterus
Vagina
Fallopian tube
Cervix
E.
743.
A.
B.
C. *
D.
E.
744.
A.
B.
C.
D. *
E.
745.
A.
B. *
C.
D.
E.
746.
A. *
B.
C.
D.
E.
747.
A.
B.
C. *
D.
E.
750.
C.
D. *
Gonads develop from embryonic:
Ectoderm
Endoderm
Mesoderm
Both mesoderm and endoderm
Both ectoderm and endoderm
Location and secretion of Leydig cells are:
Liver-cholestrol
Ovary-estrogen
Testis-testosterone
Pancreas-glucogen
Ovary-progesteron
Freshly released human egg has:
One Y-chromosome
One X-chromosome
Two X-chromosome
One X-chromosome and one Y-chromosome
Two Y-chromosome
In 28 day human ovarian cycle, ovulation occures on:
Day 1
Day 5
Day 14
Day 28
Two days before mensis
Part of sperm involved in penetrating egg membrane is:
Tail
Acrosome
Allosome
Autosome
Plasma membrane
Preparation of sperm before penetrating ovum is:
Spermation
Coition
Insemination
Capacitation
E.
756.
A. *
B.
C.
D.
E.
757.
A.
B. *
Implantation
Spermatozoa are nourished by:
Sertoli cells
Interstitial cells
Connective tissue cells
Adiposal tissue cells
Hyaluronic acid
Fertilized ovum is implanted in uterus after:
1 day
7 days
A.
B.
C. *
D.
E.
751.
A.
B.
C. *
D.
E.
752.
A.
B. *
C.
D.
E.
753.
A.
B.
C. *
D.
E.
754.
A.
B. *
C.
D.
E.
755.
A.
B.
C.
B.
8 days
10 days
1 month
Middle piece of human sperm contains:
Nucleus
Vacuoles
Mitochondria
Centriole
Chorion
Immediately after ovulation, the egg is covered by a membrane called:
Chorion
Zona pellucida
Corona radiata
Vitelline membarane
Placenta
Ovulation or release of ovum occures on the day of menstrual cycle:
8-10
12-14
14-18
Last two days of mensrtual cycle
Mensis
Sperms produce an enzymatic substance for dissolving egg coverings. It is called:
Hyaluronic acid
Hyaluronidase
Androgamone
Diastase
Estogen
Testes descent into scrotum for:
Spermatogenesis
Fertilization
Development of sex organs
Development of visceral organs
Sexual life
Choose the indications for cervical conization
Cervicitis
Uterine masses
C. *
D.
E.
764.
A.
B. *
C.
D.
E.
Cervical intraepithelial neoplasia grades 2 and 3
Ovarian torsion
Vaginitis
Indicate the risk factors for the pelvic organ prolapse:
Lack of vitamins, obesity, Nulliparity
Obesity, multiparity, hysterectomy, postmenopausal age
Nulliparity, obesity, young age
Alcohol abuse, aspirin intake
Young age, diabetes, drug abuse
D.
E.
758.
A.
B.
C. *
D.
E.
759.
A.
B. *
C.
D.
E.
760.
A.
B. *
C.
D.
E.
761.
A.
B. *
C.
D.
E.
762.
A. *
B.
C.
D.
E.
763.
A.
765.
D.
E. *
Choose the treatment of stress incontinence:
Kegel exercises, surgery
Fitness, diet
Walking exercises, Nonsteroidal anti-inflammatory drugs (NSAIDs)
Warm compress
Hot patches
Choose the treatment of urge incontinence:
Kegel exercises
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Anti-spasmotics, anti-cholinergics
Beta blockers
Muscle relaxants
The two main anatomic divisions of the uterus are:
corpus and fundus.
cornu and fundus.
cervix and isthmus .
cervix and fundus .
corpus and cervix.
Which of the following doesn’t supply the uterus?
uterine artery.
ovarian artery.
all above.
nothing above.
vaginal artery.
Before puberty, the ratio of the length of the body of the uterus to the length of the cervix is
approximately:
3:1.
4:1.
nothing above.
1:1.
2:1.
What part of the ovary comes to contain the developing follicles?
medulla.
inner par .
membrane.
nothing above.
cortex.
771.
A.
B.
C.
D.
E. *
772.
A.
What portions does the uterus tube consist of?
isthmus.
ampulla.
infundibulum.
ampulla and infundibulum
all above.
The wall of the uterus consists of:
serous membrane and myometrium.
A. *
B.
C.
D.
E.
766.
A.
B.
C. *
D.
E.
767.
A.
B.
C.
D.
E. *
768.
A.
B.
C.
D.
E. *
769.
A.
B.
C.
D. *
E.
770.
A.
B.
C.
B.
C. *
endometrium and myometrium
endometrium and perimetrium
perimetrium and myometrium
perimetrium, myometrium, endometrium.
What is the narrowest part of uterine tube?
ampulla.
infundibulum.
all above
ampulla and infundibulum
isthmus.
Duration of secretion phase in uterine cycle
from 1 to 5 day
from 5 to 14 day
from 10 to 14 day.
from 14 to 28day .
from 15 to 20 day
Duration of proliferation phase in uterine cycle
from 1 to 5 day
from 14 to 28day
from 10 to 14 day
from 15 to 20 day
from 5 to 14 day
The blood supply of the fallopian tubes is from
the ovarian arteries
the uterine arteries
the tubal arteries
the rectum arteries
the ovarian and uterine arteries
What quantity of blood is loss by a woman during normal menstruation?
less than 40 ml.
60-80 ml.
250-300 ml.
200-250 ml.
50-150 ml.
This is the site of fertilization
Ureters
Urethra
Uterine tubes
D.
E.
779.
A.
B. *
C.
D.
Ovaries
Vagina
This is the portion of the uterus that opens into the vagina
Urethra
Cervix
Uterine tubes
Inguinal canal
C.
D.
E. *
773.
A.
B.
C.
D.
E. *
774.
A.
B.
C.
D. *
E.
775.
A.
B.
C.
D.
E. *
776.
A.
B.
C.
D.
E. *
777.
A.
B.
C.
D.
E. *
778.
A.
B.
E.
786.
A.
Ovaries
Anterior to the vagina and urethral openings is the
Labia majora
Labia minora
Mons pubis
Cervical sphincter
Labial frenulum
Skene's glands secrete
Estrogen
Progesterone
Testosterone
Androgens
Mucus
Structures that produce estrogens?
pituitary gland
Luteal body
growing follicles
hypothalamus
Germinal epithelium
Progesteron is secreted by
Thymus
Thyroid
Testis
Corpus luteum
Corpus albicans
Bartholin’s gland of femal corresponds to gland in male
Rectal
Cowper’s
Inguanal
Prostate
Nothing above
The vagina is lined by:
pseudo-stratified squamous non keratinised epithelium
stratified cuboidal non keratinised endothelium
stratified cuboidal non keratinised epithelium
stratified squamous keratinised epithelium
stratified squamous non keratinised epithelium
What is produced by the ovaries?
Primary oocytes, insulin and estrogen
B.
C.
D. *
E.
787.
A. *
Secondary oocytes, progesterone and cortisol
Tertiary oocytes, insulin and estrogen
Secondary oocytes, estrogen and progesterone
Primary oocytes, estrogen and testosterone
What is the narrowest part of uterine tube?
isthmus .
780.
A.
B.
C.
D.
E. *
781.
A.
B.
C.
D.
E. *
782.
A.
B.
C. *
D.
E.
783.
A.
B.
C.
D. *
E.
784.
A.
B. *
C.
D.
E.
785.
A.
B.
C.
D.
E. *
B.
C.
D.
E.
788.
A.
B.
C.
D.
E. *
789.
A. *
B.
C.
D.
E.
790.
A.
B.
C.
D.
E. *
791.
A. *
B.
C.
D.
E.
792.
A.
B.
C. *
D.
E.
793.
A.
B.
C. *
D.
E.
794.
A.
B.
C.
ampulla
infundibulum
all above
ampulla and infundibulum
The uterus is supported by:
the uterosacral ligaments
the cardinal ligaments
the round ligaments
the broad ligaments
all above
Number of eggs typically produced in a 28 day menstrual cycle?
one egg
two eggs
three eggs
some eggs
ten eggs
What quantity of blood is lost by a woman during normal menstruation?
less than 50 ml.
50-100 ml.
150-200 ml.
200-250 ml.
50-150 ml.
Combined hormonal methods of contraception protect against:
Endometrial/ovarian cancer
Osteoporosis
Mammary Paget disease
Hypertension
Sexually transmitted diseases
Ovarian cancer is:
Early to detect with the Pap smear
Likely to carry a good prognosis once it is detected
Frequently detected late in its course
Early to detect with Human papillomavirus (HPV) tests
Early to detect with An alpha-fetoprotein (AFP) tests
Cancer prevention program for women include all of the following, EXCEPT:
Smoking cessation
Periodic screening
Bone density index measurement
Human papillomavirus (HPV) tests
Pap tests
Risk factors for uterine cancer include those factors that expose the endometrium to estrogen,
including:
Early menarche (before 12)
Never having children
Late menopause(after age 55)
D.
A.
History of failure to ovulate
All of them
Risk factors for uterine cancer include those factors that expose the endometrium to estrogen,
including:
Infertility
Diabetes
Gallbladder disease
Hypertension
All of them
Risk factors for uterine cancer include those factors that expose the endometrium to estrogen,
including:
Infertility
Gallbladder disease
Hypertension
Obesity
All of them
Which of the following symptoms is seen in granulosa cell tumor?
Thickened endometrium
Postmenopausal bleeding
Endometrial hyperplasia
Large adnexal mass
All of them
Vaginal cancer located on upper 1/3 of the posterior vaginal wall.
Squamous cell
Columnar epithelial
Multiple cells
Clear cell adenocarcinoma
Leiomyoma
Vaginal cancer located on upper 1/3 of the anterior vaginal wall.
Clear cell adenocarcinoma
Squamous cell
Multiple cells
Cuboidal cells
Columnar epithelial
Choose the management of choice for the cervical intraepithelial neoplasia:
Cervical conization
Antibiotics
Chemotherapy
Radiotherapy
Hormanal therapy
Which of the following is NOT a risk factor for the cervical cancer?
Multiple or high risk sexual partners
B.
C. *
D.
Tobacco use
Being at menopausal age
History of Sexually transmitted diseases (STDs)
E. *
795.
A.
B.
C.
D.
E. *
796.
A.
B.
C.
D.
E. *
797.
A.
B.
C.
D.
E. *
798.
A. *
B.
C.
D.
E.
799.
A. *
B.
C.
D.
E.
800.
A. *
B.
C.
D.
E.
801.
E.
D. *
E.
Hpv 16.18
Which of the following is true about granulosa cell tumor?
Cells in rosette pattern
Complex ovarian mass
High estradiol and high inhibin
Sex cord-stromal tumor
All of them
Which among these gynecologic neoplasms has the highest mortality rate?
Uterine
Ovarian
Cervical
Endometrial
Vulvar
Indicate the types of endometrial cancer:
Benign endometroid – atypical endometrial
Type 1, endometroid - Type 2, serous
Type 1 serous – Type 2, endometroid
Columnar - squamous
Type A, fibroid, Type B, serous
Indicate the risk factor of vulvar cancer:
Alcoholism-down syndrome
Sjogren syndrome
HPV (16,18,31), lichen sclerosus, smoking
Diabetes, allergy, high protein diet
Stress(anxiety), anorexia nervosa
Choose the frequency of female genital tract cancers:
Endometrial>ovarian>cervical
Ovarian>endometrial>cervical
Cervical>ovarian>endometrial
Endometrial>cervical>ovarian
Ovarian>cervical>endometrial
Choose the number of death rate with female genital tract cancers:
Endometrial>ovarian>cervical
Ovarian>endometrial>cervical
Cervical>endometrial>ovarian
Ovarian>cervical>endometrial
Endometrial>cervical>ovarian
Choose the ovarian tumor marker for epithelial tumor:
An alpha-fetoprotein (AFP)
CA-19
Lactate dehydrogenase (LDH)
CA-125
human chorionic gonadotrophin (hCG)
809.
A.
Choose the ovarian tumor marker for endometrial sinus tumor:
CA-19
802.
A.
B.
C.
D.
E. *
803.
A.
B. *
C.
D.
E.
804.
A.
B. *
C.
D.
E.
805.
A.
B.
C. *
D.
E.
806.
A. *
B.
C.
D.
E.
807.
A.
B. *
C.
D.
E.
808.
A.
B.
C.
B.
A.
B.
C.
CA-125
human chorionic gonadotrophin (hCG)
Inhibin
An alpha-fetoprotein (AFP)
Choose the ovarian tumor marker for embryonal carcinoma:
An alpha-fetoprotein (AFP)
human chorionic gonadotrophin (hCG)
CA-125
An alpha-fetoprotein (AFP), human chorionic gonadotrophin (hCG)
Inhibin
Choose the ovarian tumor marker for choriocarcinoma:
Lactate dehydrogenase (LDH)
CA-19
CA-125
Inhibin
human chorionic gonadotrophin (hCG)
Choose the ovarian tumor marker for the dysgerminoma:
Inhibin
CA-125
human chorionic gonadotrophin (hCG)
Lactate dehydrogenase (LDH)
An alpha-fetoprotein (AFP)
Indicate which of the following best explains teratoma:
A tumor very soft, round, filled with clean pus
A tumor very large, firm, filled in with blood
An abscess with a pinkish surface
An abscess covering the os of cervix
A tumor made up of hair, muscle, bone
Explain the term called, serous cystadenoma:
Most common ovarian neoplasm, and is benign
Most common ovarian neoplasm, highly aggressive
Most common uterus neoplasm
Cervical hyperplasia
Large cyst under the one ovary
What is a Brenner tumor?
Group of ovarian neoplasm, majority benign
Group of ovarian neoplasm, causing rapid metastasis
This tumor is very common in young women
The tumor is made up of muscle, hair and bone
The tumor is firm-small in size <1cm
Explain correctly the krukenberg tumor:
Benign tumor of ovaries
Benign tumor of uterus
Benign tumor on labia major
D. *
Malignancy in the ovary that metastasized from other site
C.
D.
E. *
810.
A.
B.
C.
D. *
E.
811.
A.
B.
C.
D.
E. *
812.
A.
B.
C.
D. *
E.
813.
A.
B.
C.
D.
E. *
814.
A. *
B.
C.
D.
E.
815.
A. *
B.
C.
D.
E.
816.
E.
817.
A.
B.
C.
D. *
E.
818.
A.
B. *
C.
D.
E.
819.
A.
B.
C. *
D.
E.
820.
A.
B.
C. *
D.
E.
821.
A. *
B.
C.
D.
E.
822.
A.
B.
C. *
D.
E.
823.
A. *
B.
C.
D.
E.
824.
Malignancy in the cervix that metastasized from primary site
Explain what is the sertoli-leydig cell tumor:
A small tumor on labia minor
A small tumor on posterior wall of vagina
A tumor on the opening of the cervix
Is an ovarian tumor that secrets testosterone
Is an ovarian tumor with Luteinising hormone (LH) overproducing
Indicate one of the cause of secondary amenorrhea:
Premature ovarian failure
All of them
Hypothalamus (neoplasm)
Pituitary (adenoma)
Asherman syndrome
Menopause is defined as:
2 or more irregular periods after age 40
The start of hot flashes
No menstrual period for 12 consecutive months
No menstrual period for 6 consecutive months
An increase in mood swings
The average age of menopause is:
60
55
51
45
40
Choose the treatment of choice for the primary dysmenorrhea:
Topical heat therapy, combined Oral contraceptive pills (OCPs), progestin Intrauterus device (IUD),
nonsteroidal anti-inflammatory drugs (NSAIDs)
Topical cold therapy, nonsteroidal anti-inflammatory drugs (NSAIDs, muscle relaxants
Corticosteroids
Antibiotics therapy
Non-combined Oral contraceptive pills (OCPs) and estrogen patch
The first step in the workup of primary or secondary amenorrhea is:
Bimanual examination
Ultrasound of abdomen/pelvic
Pregnancy test
Nucleic amplification test
Mammography
Which of the following can NOT cause central hypogonadism?
Hypernatremia
Undernourishment
Stress
Central nerve system (CNS) tumor
Hyperprolactinemia
Luteinizing hormone (LH) surge triggers the:
A.
B. *
C.
D.
E.
825.
A.
B.
C.
D. *
E.
826.
A.
B.
C.
D.
E. *
827.
A.
B. *
C.
D.
E.
828.
A.
B. *
C.
D.
E.
829.
A.
B.
C. *
D.
E.
830.
A.
B. *
C.
D.
E.
831.
A.
B. *
C.
D.
Ovulation and initiates production of estrogen
Ovulation and initiates production of progesterone
Direct effect on production of growth hormone
Stimulates production of estrogen
Indirectly maintains the T4/T3 levels
Choose the right period for menstruation/follicular phase
Days 7-14
Days 14-21
Days 5-10
Days 1-13
Days 14-21
Choose the right period for ovulation:
Day 5
Day 21
Day 28
Day 7
Day 14
Choose the right period for luteal phase:
Days 3-14
Days 15-28
Days 5-10
Days 7-14
Days 10-14
Duration of proliferation phase in uterine cycle is:
from 1 to 5 day
from 5 to 14 day
from 14 to 28day
from 10 to 14 day
from 15 to 20 day
Duration of secretion phase in uterine cycle is:
from 1 to 5 day
from 5 to 14 day
from 14 to 28day
from 10 to 14 day
from 15 to 20 day
What is spaniomenorrhea?
menstruations come in 6-8 weeks
menstruations come 1 time per 4-6 monthes
menstruations are absent
quantity of menstrual blood less than 50ml
duration of menstruation 1-2 days
In climacteric age the medical treatment of dysfunctional uterine bleeding begin with:
setting of estrogens
diagnostic curettage of uterine cavity
colposcopy
setting of androgens
E.
832.
A.
B. *
C.
D.
E.
833.
A.
B.
C. *
D.
E.
834.
A.
B.
C. *
D.
E.
835.
A.
B. *
C.
D.
E.
836.
A.
B.
C.
D. *
E.
837.
A.
B.
C.
D. *
E.
838.
A.
B. *
C.
D.
E.
setting of gestagens
What causes dysfunctional uterine bleeding during adolescence?
Abnormal periods
Anovulatory cycles
Poor diet
Poor grades
Social withdrawal
What is the most visible sign of puberty?
Social withdrawal
Weight gain
Enlargement of the breast bud
Anger
Increasing libido
How can the Tanner Stages be defined
Emotional changes of the aging woman
Thelarche
Stages of adolescent physical development
Menarche
Menopause
What is the second phase of the normal menstrual cycle?
Ovulation
Secretory-luteal phase
Menstruation
Proliferative phase
Follicular phase
The corpus luteum regresses with decreases in estrogen and progestin, resulting in menstruation,
when what does not occur?
Ovulation
Cysts
Menarche
Implantation
Menopause
What appearance of the first menstruation in 17 years can testify about?
About the presence of inflammatory disease of uterus
About the presence of inflammatory disease of adnexa
About the presence of abnormal position of uterus
About the presence of genital infantilism
About normal development of organism of girl
Deficiency of which hormone presents in case of dysfunctional uterine bleeding?
Estrogen
Progesterone
Thyroxin
Adrenocorticotropic hormone (ACTH)
Cortisol
Назва наукового напрямку (модуля):
Семестр: 12
Obstetrics and Gynecology КРОК
Опис:
6 course, 12 term
Перелік питань:
1.
A.
B.
C.
D.
E. *
2.
A.
B.
C. *
D.
E.
3.
A.
B.
C.
D.
E. *
4.
A. *
B.
C.
D.
E.
5.
A.
B.
C. *
D.
E.
A 52-year-old obese woman complains of bloody discharges from sexual organs during 4 days. Last
normal menses were 2 years ago. At histological investigation adenomatous hyperplasia was
revealed. What is reason of mentioned pathology ?
Supersecretion of androgens by the cortex of paranephroses
Hypersecretion of estrogens by tissues of the organism.
Poor aromatization of preandrogens due to hypothyroidism
The increased contents of follicle-stimulating hormone
Excessive transformation of preandrogens from adipose tissues.
A 40-year-old woman complains of yellow color discharges from the vagina. There are no
pathological changes in bimanual examination. Bacterioscopy reveals Trichomonas vaginalis and
mixed flora. There are two hazy fields on the front labium, with a negative Iodum probing at
colposcopy. What is your tactics?
Specific treatment of Trichomonas colpitis
Diathermocoagulation of the cervix uteri
Treatment of specific colpitis with the subsequent biopsy
Cervix ectomy
Cryolysis of cervix uteri
A woman complains of having slight dark bloody discharges and mild pains in the lower part of
abdomen for several days. Last menstrual perid were 7 weeks ago. The pregnancy test is positive.
Uterine body is enlarged to 5-6 weeks of pregnancy, soft, painless. There is a retort-like formation,
7х5 cm large, mobile, painless in the region of the adnexa. What examination is necessary for
detection of conceptus localization?
Cystoscopy
Hysteroscopy
Hromohydrotubation
Colposcopy
Ultrasound
A 24-year-old woman complains of amenorrhea at 13 month after cesarean section. Cesarian section
was performed as a result of placenta abruption. The total amount of blood loss was 2000 ml due to
coagulation disorders.Choose the most suitable investigation.
Determination of the level of gonadotropin
Ultrasound of organs of a small pelvis
Progesteron test
Computer tomography of the head
Determination of the contents of testosteron-depotum in blood serum.
27-year-old patient complained of amenorrhea after Caesarian section at 15 month. Cesarean
section was performed because of Placental Abruption. Choose the most suitable investigation:
Progesteron test
USI of small pelvis organs
Estimation of gonadotropin rate
Computer tomography of head
Estimation of testosteron rate in blood serum
6.
A. *
B.
C.
D.
E.
7.
A.
B. *
C.
D.
E.
8.
A. *
B.
C.
D.
E.
9.
A.
B.
C.
D. *
E.
10.
A. *
B.
C.
D.
E.
11.
A. *
B.
C.
D.
E.
In the woman of 24 years about earlier normal menstrual function, cycles became irregular, according
to tests of function diagnostics - anovulatory. The contents of prolactin in blood is boosted. Choose
the most suitable investigation:
Computer tomography of the head
Determination of the level of gonadotropins
USI of organs of small pelvis
Progesterone assay
Determination of the contents of testosteron-depotum in blood serum
A 29 year old patient underwent surgical treatment because of the benign serous epithelial tumour of
an ovary. The postoperative period has elapsed without complications. What is it necessary to
prescribe for the rehabilitational period:
Antibacterial therapy and adaptogens
Hormonotherapy and proteolytic enzymes
Lasertherapy and enzymotherapy
Magnitotherapy and vitamin therapy
The patient does not require further care
A 26 y.o. woman complains of sudden pains in the bottom of abdomen irradiating to the anus,
nausea, giddiness, bloody dark discharges from sexual tracts for one week, the delay of menses for 4
weeks. Signs of the peritoneum irritation are positive. Bimanual examination: borders of the uterus
body and its appendages are not determined because of sharp painfullness. The painfullness of the
back and dextral fornixes of the vagina are evident. What is the most probable diagnosis?
Ruptured tubal pregnancy
Apoplexy of the ovary
Acute right-side adnexitis
Torsion of the crus of the ovary tumour
Acute appendicitis
At the gynaecological department there is a patient of 32 years with the diagnosis: "acute
bartholinitis".Body temperature is 38,2 0C, leucocytes count 10,4*109/L, the ESR is 24 mm/hour. In
the area of big gland of the vestibulum - the dermahemia, the sign of the fluctuation, sharp
tenderness (pain). What is the most correct tactics of the doctor?
Antibiotic therapy
Antibiotics, Sulfanilamidums
Surgical dissection, drainage of the abscess of the gland
Surgical dissecting, a drainage of an abscess of the gland, antibiotics
Antibiotics, detoxication and biostimulants.
An onset of severe preeclampsia at 16 weeks gestation might be caused by:
Hydatidiform mole
Anencephaly
Twin gestation
Maternal renal disease
Interventricular defect of the fetus
Which of the methods of examination is the most informative in the diagnostics of a tubal infertility?
Laparoscopy with chromosalpingoscopy
Pertubation
Hysterosalpingography
Transvaginal echography
Bicontrast pelviography
12.
A.
B.
C.
D. *
E.
13.
A. *
B.
C.
D.
E.
14.
A. *
B.
C.
D.
E.
15.
A.
B.
C. *
D.
E.
16.
A. *
B.
C.
A 26 y.o. woman complains of a mild bloody discharge from the vagina and pain in the lower
abdomen. She has had the last menstruation 3,5 months ago. The pulse is 80 bpm. The blood pressure
(BP) is 110/60 mm Hg and body temperature is 36,6 0C. The abdomen is tender in the lower parts.
The uterus is enlarged up to 12 weeks of gestation. What is your diagnosis?
Complete abortion
Incipient abortion
Incomplete abortion
Inevitable abortion
Disfunctional bleeding
A18 y.o. woman complains of pain in the lower abdomen. Some minutes before she has suddenly
appeared unconscious at home. The patient had no menses within last 3 months.On examination: pale
skin, the pulse- 110 bpm, BP- 80/60 mm Hg. The Schyotkin's sign is positive. Hb- 76 g/L. The
vaginal examination: the uterus is a little bit enlarged, its displacement is painful. There is also any
lateral swelling of indistinct size. The posterior fornix of the vagina is tendern and overhangs inside.
What is the most probable diagnosis?
Ruptured ectopic
Ovarian apoplexy
Twist of cystoma of right uterine adnexa
Acute salpingoophoritis
Acute appendicitis
In the gynecologic office a 28 y.o. woman complains of sterility within three years. The menstrual
function is not impaired. There were one artificial abortion and chronic salpingo-oophoritis in her
case history. Oral contraceptives were not used. Her husband's analysis of semen is without
pathology. What diagnostic method will you start from the workup in this case of sterility?
Hysterosalpingography
Hormone investigation
Ultra sound investigation
Diagnostic scraping out of the uterine cavity
Hysteroscopia
A 28-year-old patient underwent endometrectomy as a result of incomplete abortion. Blood loss was
at the rate of 900 ml. It was necessary to start hemotransfusion. After transfusion of 60 ml of
erythrocytic mass the patient presented with lumbar pain and fever which resulted in hemotransfusion
stoppage. 20 minutes later the patient's condition got worse: she developed adynamia, apparent skin
pallor, acrocyanosis, profuse perspiration. t- 38,5 0C, Ps-110/min, AP- 70/40 mm Hg. What is the
most likely diagnosis?
Septic shock
Hemorrhagic shock
Hemotransfusion shock
Anaphylactic shock
DIC syndrome
A 58-year-old female patient came to the antenatal clinic with complaints of bloody light-red
discharges from the genital tracts. Menopause is 12 years. Gynaecological examination found
externalia and vagina to have age involution; uterine cervix was unchanged, there were scant bloody
discharges from uterine cervix, uterus was of normal size; uterine adnexa were not palpable;
parametria were free. What is the most likely diagnosis?
Uterine carcinoma
Atrophic colpitis
Abnormalities of menstrual cycle with climacteric character
D.
E.
17.
A.
B. *
C.
D.
E.
18.
A. *
B.
C.
D.
E.
19.
A.
B. *
C.
D.
E.
20.
A. *
B.
C.
D.
E.
21.
A.
B. *
C.
D.
E.
22.
Cervical carcinoma
Granulosa cell tumor of ovary
The results of a separate diagnostic curettage of the mucous of the uterus' cervix and body made up in
connection with bleeding in a postmenopausal period: the scrape of the mucous of the cervical
canal revealed no pathology, in endometrium - the highly differentiated adenocarcinoma was found.
Metastases are not found. What method of treatment is the most correct?
Surgical treatment and chemotherapy
Surgical treatment and hormonotherapy
Surgical treatment and radial therapy
Radial therapy
all are wrong
A 27 y.o. woman complains of having the disoders of menstrual function for 3 months, irregular
pains in abdomen. On bimanual examination: in the right adnexa of uterus there is an elastic spherical
formation, painless, 7 cm in diameter. USI: in the right ovary - a fluid formation, 4 cm in diameter,
unicameral, smooth. What method of treatment is the most preferable?
Prescription of an estrogen-gestogen complex for 3 months with repeated examination
Operative treatment
Dispensary observation of the patient
Anti-inflammatory therapy
Chemotherapeutic treatment
A 40 year old patient complains of yellowish discharges from the vagina. Bimanual examination
revealed no pathological changes. The smear contains Trichomonas vaginalis and blended flora.
Colposcopy revealed two hazy fields on the frontal labium, with a negative Iodine test. Your tactics:
Diathermocoagulation of the cervix of the uterus
Treatment of specific colpitis and subsequent biopsy
Specific treatment of Trichomonas colpitis
Cervix ectomy
Cryolysis of cervix of the uterus
A 48 year old female patient complains about contact haemorrhage. Speculum examination revealed
hypertrophy of uterus cervix. It resembles of cauliflower, it is dense and can be easily injured.
Bimanual examination revealed that fornices were shortened, uterine body was nonmobile. What is
the most probable diagnosis?
Cervical carcinoma
Metrofibroma
Endometriosis
Cervical pregnancy
Cervical papillomatosis
Laparotomy was performed to a 54 y.o. woman on account of big formation in pelvis that turned out
to be one-sided ovarian tumor along with considerable omental metastases. The most appropriate
intraoperative tactics involves:
Biopsy of omentum
Ablation of omentum, uterus and both ovaries with tubes
Biopsy of an ovary
Ablation of an ovary and omental metastases
Ablation of omentum and both ovaries with tubes
A parturient complains about pain in the mammary gland. Palpation revealed a 3х4 cm large
infiltration, soft in the centre. Body temperature is 38,5oC. What is the most probable diagnosis?
A. *
B.
C.
D.
E.
23.
A.
B.
C.
D. *
E.
24.
A. *
B.
C.
D.
E.
25.
A.
B.
C.
D.
E. *
26.
A. *
B.
C.
D.
E.
27.
A.
B.
Acute purulent mastitis
Pneumonia
Pleuritis
Retention of milk
Birth trauma
A 43 y.o. patient complains of formation and pain in the right mammary gland, rise of temperature up
to (37,20C) during the last 3 months. Condition worsens before the menstruation. On examination:
edema of the right breast, hyperemia, retracted nipple. Unclear painful infiltration is palpated in the
lower quadrants. What is the most probable diagnosis?
Premenstrual syndrome
Right-side acute mastitis
Right-side chronic mastitis
Cancer of the right mammary gland
Tuberculosis of the right mammary gland
A 14 year old girl complains of profuse bloody discharges from genital tracts during 10 days after
suppresion of menses for 1,5 month. Similiar bleedings recur since 12 years on the background of
disordered menstrual cycle. On rectal examination: no pathology of the internal genitalia. In blood:
Нb - 70 g/l, RBC- 2,3*1012 l, Ht - 20. What is the most probable diagnosis?
Juvenile bleeding, posthemorrhagic anemia
Werlholf's disease
Polycyst ovarian syndrome
Hormonoproductive ovary tumor
Incomplete spontaneous abortion
A 33-year-old woman was urgently brought to clinic with complaints of the pain in the lower part of
the abdomen, mostly on the right, irradiating to rectum, she also felt dizzy. The above mentioned
complaints developed acutely at night. Last menses were 2 weeks ago. On physical exam: the skin is
pale, Ps - 92 bpm, t- 36,6 0C, BP- 100/60 mm Hg. The abdomen is tense, slightly tender in lower
parts, peritoneal symptoms are slightly positive. Hb- 98 g/L. What is the most probable diagnosis?
Renal colic
Acute appendicitis
Intestinal obstruction
Abdominal pregnancy
Apoplexy of the ovary
A 54-year-old female patient consulted a doctor about bloody discharges from the genital tracts after
2 years of amenorrhea. USI and bimanual examination revealed no genital pathology. What is the
tactics of choice?
Fractional biopsy of lining of uterus and uterine mucous membranes
Styptic drugs
Contracting drugs
Estrogenic haemostasia
Hysterectomy
A 27 y.o. gravida with 17 weeks of gestation was admitted to the hospital. There was a history of 2
spontaneous miscarriages. On bimanual examination: uterus is enlarged to 17 weeks of gestation,
uterus cervix is shortened, isthmus allows to pass the finger tip. The diagnosis is isthmico-cervical
insufficiency. What is the doctor's tactics?
To interrupt pregnancy
To administer tocolytic therapy
C. *
D.
E.
28.
A.
B.
C.
D. *
E.
29.
A.
B.
C. *
D.
E.
30.
A. *
B.
C.
D.
E.
31.
A.
B. *
C.
D.
E.
32.
A.
B.
To place suture on the uterus cervix
To administer hormonal treatment
To perform amniocentesis
A 27 y.o. woman turns to the maternity welfare centre because of infertility. She has had sexual life
in marriage for 4 years, doesn't use contraceptives. She didn't get pregnant. On examination: genital
development is without pathology, uterus tubes are passable, basal (rectal) temperature is one-phase
during last 3 menstrual cycles. What is the infertility cause?
Immunologic infertility
Chronic adnexitis
Abnormalities in genital development
Anovular menstrual cycle
Genital endometriosis
A 43 y.o. woman complains of contact hemorrhages during the last 6 months. Bimanual examination:
cervix of the uterus is enlarged, its mobility is reduced. Mirrors showed the following: cervix of the
uterus is in the form of cauliflower. Chrobak and Schiller tests are positive. What is the most
probable diagnosis?
Cervical pregnancy
Polypus of the cervis of the uterus
Cancer of cervix of the uterus
Nascent fibroid
Leukoplakia
A primagravida in her 20th week of gestation complains of pain in her lower abdomen, blood smears
from the genital tracts. The uterus has an increased tonus, the patient feels the fetus movements.
Bimanual examination revealed that the uterus size corresponded with gestation, the uterine cervix
was contracted down to 0,5 cm, the external os was dilatated by 2 cm. The discharges were bloody
and smeary. What is the most likely diagnosis?
Incipient abortion
Risk of abortion
Abortion in progress
Incomplete abortion
Missed miscarriage
A patient was admitted to the hospital with complaints of periodical pain in the lower part of
abdomen that gets worse during menses, weakness, malaise, nervousness, dark bloody smears from
vagina directly before and after menses. Bimanual examination revealed that uterus body is enlarged,
appendages cannot be palpated, posterior fornix has tuberous surface. Laparoscopy revealed: ovaries,
peritoneum of rectouterine pouch and pararectal fat have "cyanotic eyes". What is the most probable
diagnosis?
Polycystic ovaries
Disseminated form of endometriosis
Chronic salpingitis
Tuberculosis of genital organs
Ovarian cystoma
A pregnant woman in her 8th week was admitted to the hospital for artificial abortion. In course of
operation during dilatation of cervical canal of uterus by means of Hegar's dilator № 8 the doctor
suspected uterus perforation. What is the immediate tactics for confirmation of this diagnosis?
Laparoscopy
Bimanual examination
C.
D. *
E.
33.
A. *
B.
C.
D.
E.
34.
A.
B.
C. *
D.
E.
35.
A.
B. *
C.
D.
E.
36.
A.
B.
C. *
D.
E.
37.
A.
B.
C.
D.
E. *
US examination
Uterine probing
Metrosalpingography
A 59 year old female patient applied to a maternity clinic and complained about bloody discharges
from the genital tracts. Postmenopause is 12 years. Vaginal examination revealed that external genital
organs had signs of age involution, uterus cervix was not erosive, small amount of bloody discharges
came from the cervical canal. Uterus was of normal size, uterine appendages were unpalpable.
Fornices were deep and painless. What
method should be applied for the diagnosis
specification?
Separated diagnosic curretage
Laparoscopy
Puncture of abdominal cavity through posterior vaginal fornix
Extensive colposcopy
Culdoscopy
A 25-year-old woman complains of profuse foamy vaginal discharges, foul, burning and itching in
genitalia region. She has been ill for a week. Extramarital sexual life. On examination: hyperemia of
vaginal mucous, bleeding on touching, foamy leucorrhea in the urethral area. What is the most
probable diagnosis?
Chlamydiosis
Gonorrhea
Trichomonas vaginitis
Vagina candidomicosis
Bacterial vaginosis
A 13 year old girl consulted the school doctor on account of moderate bloody discharge from the
genital tracts, which appeared 2 days ago. Secondary sexual characters are developed.What is the
most probable cause of bloody discharge?
Juvenile hemorrhage
Menarche
Haemophilia
Endometrium cancer
Werlhof's disease
After examination a 46-year-old patient was diagnosed with left breast cancer T2N2M0, cl. gr.II-a.
What will be the treatment plan for this patient?
Operation + radiation therapy
Operation only
Radiation therapy + operation + chemotherapy
Radiation therapy only
Chemotherapy only
During examination of a patient, masses in the form of condyloma on a broad basis are found in the
area of the perineum. What is the tactics of the doctor?
Antiviral treatment
Cryodestruction of condyloms
Surgical ablation of condyloms
Chemical coagulator treatment
To schgend a woman into dermatological and venerological centre
38.
A. *
B.
C.
D.
E.
39.
A.
B. *
C.
D.
E.
40.
A. *
B.
C.
D.
E.
41.
A.
B.
C. *
D.
E.
42.
A.
B.
C.
D. *
E.
A 28 year old woman has bursting pain in the lower abdomen during menstruation; chocolate-like
discharges from vagina. It is known from the anamnesis that the patient suffers from chronic
adnexitis. Bimanual examination revealed a tumour-like formation of heterogenous consistency 7х7
cm large to the left from the uterus. The formation is restrictedly movable, painful when moved.
What is the most probable diagnosis?
Endometrioid cyst of the left ovary
Follicular cyst of the left ovary
Fibromatous node
Exacerbation of chronic adnexitis
Tumour of sigmoid colon
A 68-year-old patient consulted a doctor about a tumour in her left mammary gland.Objectively: in
the upper internal quadrant of the left mammary gland there is a neoplasm up to 2,5 cm in diameter,
dense, uneven, painless on palpation. Regional lymph nodes are not enlarged. What is the most likely
diagnosis?
Cyst
Cancer
Fibroadenoma
Mastopathy
Lipoma
A 40-year-old female patient has been observing profuse menses accompanied by spasmodic pain in
the lower abdomen for a year. Bimanual examination performed during menstruation revealed a
dense formation up to 5 cm in diameter in the cervical canal. Uterus is enlarged up to 5-6 weeks of
pregnancy, movable, painful, of normal consistency. Appendages are not palpable. Bloody
discharges are profuse. What is the most likely diagnosis?
Protruded submucous fibromatous node
Abortion in progress
Cervical carcinoma
Cervical myoma
Algodismenorrhea
A 29-year-old patient complains of sterility. Sexual life is for 4 years being married, does not use
contraception. There was no pregnancy before. On physical examination, genitals are developed
normally. Uterine tubes are passable. Rectal temperature during three menstrual cycles is
monophase. What is the most probable reason for sterility?
Anomalies of genitals development
Chronic adnexitis
Anovulatory menstrual cycle
Immunologic sterility
Genital endometriosis
A 45 y.o. woman complains of contact bleedings during 5 months. On speculum examination:
hyperemia of uterus cervix, looks like cauliflower, bleeds on probing. On bimanual examination:
cervix is of densed consistensy, uterus body isn't enlarged, mobile, nonpalpable adnexa. What is the
most likely diagnosis?
Cervical pregnancy
Cancer of body of uterus
uterine cancer
Fibromatous node which is being born
cervical cancer
Polypose uterine cervix
43.
A. *
B.
C.
D.
E.
44.
A.
B.
C.
D. *
E.
45.
A.
B.
C.
D.
E. *
46.
A. *
B.
C.
D.
E.
47.
A. *
B.
C.
D.
E.
A 20 y.o. patient complains of amenorrhea. Objectively: hirsutism, obesity with fat tissue
prevailing on the face, neck, upper part of body. On the face there are acne vulgaris, on the
skin - striae cutis distense. Psychological and intellectual development is normal. Gynecological
condition: external genitals are moderately hairy, acute vaginal and uterine hypoplasia. What
diagnosis is the most probable?
Itsenko-Cushing syndrome
Turner's syndrome
Stein-Levental's syndrome
Shichan's syndrome
Babinski-Froehlich syndrome
A 27 y.o. woman suffers from pyelonephritits of the single kidney. She presents to the maternity
centre because of suppresion of menses for 2,5 months. On examination pregnancy 11 weeks of
gestation was revealed. In urine: albumine 3,3 g/L, leucocytes cover the field of vision. What is
doctor's tactics in this case?
Pregnancy interruption at 24-25 weeks
Pregnancy interruption after urine normalization
Maintenance of pregnancy till 36 weeks
Immediate pregancy interruption
Maintenance of pregnancy till delivery term
A 24-year-old female patient complains of acute pain in the lower abdomen that turned up after a
physical stress. She presents with nausea, vomiting, dry mouth and body temperature 36,6 0C. She
has a right ovarian cyst in history. Bimanual examination reveals that uterus is dense, painless, of
normal size. The left fornix is deep, uterine appendages aren't palpable, the right fornix is contracted.
There is a painful formation on the right of uterus. It's
round, elastic and mobile. It is 7х8 cm
large. In blood: leukocytosis with the left shit. What is
the most likely diagnosis?
Extrauterine pregnancy
Right-sided pyosalpinx
Subserous fibromyoma of uterus
Acute metritis
Ovarian cyst with pedicle torsion
A woman was hospitalised with full-term pregnancy. Examination: the uterus is tender, the
abdomen is tense, fetal heart tone is. What is the most probable complication of pregnancy?
Placental abruptio absent
Premature labor
Back occipital presentation
Acute hypoxia of a fetus
Hydramnion
A pregnant woman in her 40th week of pregnancy undergoes obstetric examination: the cervix of
uterus is undeveloped. The oxytocin test is negative. Examination at 32 weeks revealed: AP 140/90
mm Hg, proteinuria 1 g/l, peripheral edemata. Reflexes are normal. Choose the most correct tactics:
Labour stimulation after preparation
Absolute bed rest for 1 month
Complex therapy of gestosis for 2 days
Caesarian section immediately
Complex therapy of gestosis for 7 days
48.
A. *
B.
C.
D.
E.
49.
A.
B. *
C.
D.
E.
50.
A.
B.
C.
D. *
E.
51.
A.
B. *
C.
D.
E.
52.
A. *
B.
C.
D.
E.
A 26 year old woman had the second labour within the last 2 years with oxytocin application. The
child's weight is 4080 g. After the placent birth there were massive bleeding, signs of hemorrhagic
shock. Despite the injection of contractive agents, good contraction of the uterus and absence of any
cervical and vaginal disorders, the bleeding proceeds. Choose the most probable cause of bleeding:
Atony of the uterus
Injury of cervix of the uterus
Hysterorrhexis
Delay of the part of placenta
Hypotonia of the uterus
A woman is admitted to maternity home with discontinued labor activity and slight bloody
discharges from vagina. The condition is severe, the skin is pale, consciousness is confused. BP is
80/40 mm Hg. Heartbeat of the fetus is not heard. There was a Cesarian section a year ago.
Determine the diagnosis?
Cord presentation
Uterus rupture
Placental presentation
Expulsion of the mucous plug from cervix uteri
Premature expulsion of amniotic fluid
Rise in temperature up to 39 0С was registered the next day after a woman had labor. Fetal
membranes rupture took place 36 hours prior to labors. The examination of the bacterial flora of
cervix uteri revealed the following: haemolytic streptococcus of group A. The uterus tissue is soft,
tender. Discharges are bloody, with mixing of pus. Establish the most probable postnatal
complication.
Infective contamination of the urinary system
Thrombophlebitis of veins of the pelvis
Infected hematoma
Metroendometritis
Apostatis of stitches after the episiotomy
On the first day after labour a woman had the rise of temperature up to 39 0C. Rupture of fetal
membranes took place 36 hours before labour. Examination of the bacterial flora of cervix of the
uterus revealed hemocatheretic streptococcus of A group. The uterus body is soft, tender. Discharges
are bloody, with admixtures of pus. Specify the most probable postnatal complication:
Thrombophlebitis of veins of the pelvis
Metroendometritis
Infectious hematoma
Infective contamination of the urinary system
Apostasis of sutures after the episiotomy
A woman of a high-risk group (chronic pyelonephritis in anamnesis) had vaginal delivery. The day
after labour she complained of fever and loin pains, frequent urodynia. Specify the most probable
complication:
Infectious contamination of the urinary system
Thrombophlebitis of veins of the pelvis
Infectious hematoma
Endometritis
Apostasis of sutures after episiotomy
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57.
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58.
A.
In 8 months after the first labor a 24-year-old woman complains of amenorrhea. Cesarian section
was conducted as a result of abruption of placenta. Hemorrhage has made low fidelity of 2000 ml
due to breakdown of coagulation of blood. Choose the most suitable investigation.
Determination of the level of gonadotropin
Ultrasound of organs of a small pelvis
Progesteron test
Computer tomography of the head
Determination of the contents of testosteron-depotum in blood serum.
A 34 y.o. woman in her 29-th week of pregnancy, that is her 4-th labor to come, was admitted to the
obstetric department with complaints of sudden and painful bloody discharges from vagina that
appeared 2 hours ago. The discharges are profuse and contain grumes. Cardiac funnction of the fetus
is rhytmic, 150 strokes in the minute, uterus tone is normal. The most probable provisional diagnosis
will be:
Placental presentation
Detachment of normally located placenta
Vasa previa
Bloody discharges
Disseminated intravascular coagulation syndrome
A 34-year-old woman with 10-week pregnancy (the second pregnancy) has consulted gynaecologist
to make a record in patient chart. There was a hydramnion previous pregnancy, the birth weight of a
child was 4086 g. What tests are necessary first of all?
The test for tolerance to glucose
Determination of the contents of \alpha fetoprotein
Bacteriological test of discharge from the vagina
Fetus cardiophonography
Ultrasound of the fetus
A primagravida with pregnancy of 37-38 weeks complains of headache, nausea, pain in epigastrium.
Objective: the skin is acyanotic. Face is hydropic, there is short fibrillar twitching of blepharons,
muscles of the face and the inferior extremities. The look is fixed. AP- 200/110 mm Hg; sphygmus of
92 bpm, intense. Respiration rate is 32/min. Heart activity is rhythmical. Appreciable edemata of the
inferior extremities are present. Urine is cloudy. What medication should be administered?
Droperidolum of 0,25% - 2,0 ml
Dibazolum of 1% - 6,0 ml
Papaverine hydrochloride of 2% - 4,0 ml
Hexenalum of 1% - 2,0 ml
Pentaminum of 5% - 4,0 ml
An onset of severe preeclampsia at 16 weeks gestation might be caused by:
Hydatidiform mole
Anencephaly
Twin gestation
Maternal renal disease
Interventricular defect of the fetus
A woman had the rise of temperature up to 38,5?С on the first day after labour. The rupture of fetal
membranes took place 36 hours before labour. The investigation of the bacterial flora of cervix of the
uterus revealed hemocatheretic streptococcus of group A. The uterus body is soft, tender. Discharges
are bloody, mixed with pus. Specify the most probable postnatal complication:
Apostatis of junctures after the episiotomy
B.
C.
D.
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B.
C.
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E.
62.
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B.
C.
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63.
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B.
C.
Thrombophlebitis of pelvic veins
Infected hematoma
Infection of the urinary system
Metroendometritis
A pregnant woman may be diagnosed with hepatitis if it is confirmed by the presence of elevated:
SGOT (ALT)
Sedimentation rates
WBCs
Alkaline phosphatase
BUN
A pregnant woman (35 weeks), aged 25, was admitted to the hospital because of bloody discharges.
In her medical history there were two artificial abortions. In a period of 28-32 weeks there was noted
the onset of hemorrhage and USD showed a placental presentation. The uterus is in normotonus, the
fetus position is transversal (Ist position). The heartbeats is clear, rhythmical, 140 bpm. What is the
further tactics of the pregnant woman care?
To perform a delivery by means of Cesarean section
To perform the hemotransfusion and to prolong the pregnancy
To introduct the drugs to increase the blood coagulation and continue observation
Stimulate the delivery by intravenous introduction of oxytocin
To keep the intensity of hemorrhage under observation and after the bleeding is controlled to prolong
the pregnancy
Condition of a parturient woman has been good for 2 hours after live birth: uterus is thick,
globe-shaped, its bottom is at the level of umbilicus, bleeding is absent. The clamp put on the
umbilical cord remains at the same level, when the woman takes a deep breath or she is being pressed
over the symphysis with the verge of hand, the umbilical cord drows into the vagina. Bloody
discharges from the sexual tracts are absent. What is the doctor's further tactics?
To do manual removal of afterbirth
To apply Abduladze method
To apply Crede's method
To do curettage of uterine cavity
To introduct oxitocine intravenously
The woman who has delivered twins has early postnatal hypotonic uterine bleeding reached 1,5% of
her bodyweight. The bleeding is going on. Conservative methods to arrest the bleeding have been
found ineffective. The conditions of patient are pale skin, acrocyanosis, oliguria. The woman is
confused. The pulse is 130 bpm, BP– 75/50 mm Hg. What is the further treatment?
Uterine extirpation
Supravaginal uterine amputation
Uterine vessels ligation
Inner glomal artery ligation
Putting clamps on the uterine cervix
A 37 y.o. primigravida woman has been having labor activity for 10 hours. Labor pains last for 20-25
seconds every 6-7 minutes. The fetus lies in longitude, presentation is cephalic, head is pressed upon
the entrance to the small pelvis. Vaginal examination results: cervix of uterus is up to 1 cm long, lets
2 transverse fingers in. Fetal bladder is absent. What is the most probable diagnosis?
Primary uterine inertia
Secondary uterine inertia
Normal labor activity
D.
E.
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B.
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D.
E.
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E.
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B.
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E.
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B.
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D.
Discoordinated labor activity
Pathological preliminary period
A 26 y.o. woman complains of a mild bloody discharge from the vagina and pain in the lower
abdomen. She has had the last menstruation 3,5 months ago. The pulse is 80 bpm. The blood pressure
(BP) is 110/60 mm Hg and body temperature is 36,6 0C. The abdomen is tender in the lower parts.
The uterus is enlarged up to 12 weeks of gestation. What is your diagnosis?
Inevitable abortion
Incipient abortion
Incomplete abortion
Complete abortion
Disfunctional bleeding
A 20 y.o. pregnant woman with 36 weeks of gestation was admitted to the obstetrical hospital with
complains of pain in the lower abdomen and bloody vaginal discharge. The general condition of the
patient is good. Her blood pressure is 120/80 mm Hg. The heart rate of the fetus is 140 bpm,
rhythmic. Vaginal examination: the cervix of the uterus is formed and closed. The discharge from
vagina is bloody up to 200 ml per day. The head of the fetus is located high above the pelvis inlet. A
soft formation was defined through the anterior fornix of the vagina. What is the probable diagnosis?
Premature placental separation
Uterine rupture
Threatened premature labor
Placental presentation
Incipient abortion
A 28-year-old parturient complains about headache, vision impairment, psychic inhibition.
Objectively: AP- 200/110 mm Hg, evident edemata of legs and anterior abdominal wall. Fetus head
is in the area of small pelvis. Fetal heartbeats is clear, rhythmic, 190/min. Internal examination
revealed complete cervical dilatation, fetus head was in the area of small pelvis. What tactics of labor
management should be chosen?
Forceps operation
Cesarean
Embryotomy
Conservative labor management with episiotomy
Stimulation of labor activity
A 25 year old woman had the third labour and born a girl with manifestations of anemia and
progressing jaundice. The child's weight was 3 600 g, the length was 51 cm. The woman's blood
group is B (III) Rh-, the father's blood group is A (III) Rh+, the child's blood group is B (III) Rh+.
What is the cause of anemia?
Rhesus incompatibility
Antigen A incompatibility
Antigen B incompatibility
Antigen AB incompatibility
Intrauterine infection
A parturient complains about pain in the mammary gland. Palpation revealed a 3х4 cm large
infiltration, soft in the centre. Body temperature is 38,5 0C. What is the most probable diagnosis?
Acute purulent mastitis
Pneumonia
Pleuritis
Retention of milk
E.
69.
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B.
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D.
E.
70.
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B.
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D.
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B.
C.
D.
E.
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E.
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B.
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E.
Birth trauma
A secundipara has regular birth activity. Three years ago she had cesarean section for the reason of
acute intrauterine hypoxia. During labor she complains of extended pain in the area of postsurgical
scar. Objectively: fetus pulse is rhythmic - 140 bpm. Vaginal examination shows 5 cm cervical
dilatation. Fetal bladder is intact. What is the tactics of choice?
Cesarean section
Augmentation of labour
Obstetrical forceps
Waiting tactics of labor management
Vaginal delivery
A primagravida in her 20th week of gestation complains about pain in her lower abdomen, blood
smears from the genital tracts. The uterus has an increased tonus, the patient feels the fetus
movements. Bimanual examination revealed that the uterus size corresponded the term of gestation,
the uterine cervix was contracted down to 0,5 cm, the external orifice was open by 2 cm. The
discharges were bloody and smeary. What is the most likely diagnosis?
Incipient abortion
Risk of abortion
Abortion in progress
Incomplete abortion
Missed miscarriage
A woman consulted a doctor on the 14th day after labour about sudden pain, hyperemy and
induration of the left mammary gland, body temperature rise up to 39oC, headache. Objectively:
fissure of nipple, enlargement of the left mammary gland, pain on palpation. What pathology would
you think about in this case?
Lactational mastitis
Lacteal cyst with suppuration
Fibrous adenoma of the left mammary gland
Breast cancer
Phlegmon of mammary gland
A young woman applied to gynecologist due to her pregnancy of 4-5 weeks. The pregnancy is
desirable. Anamnesis stated that she had rheumatism in the childhood. Now she has combined
mitral heart disease with the priority of mitral valve deficiency. When will she need the inpatient
treatment (what periods of pregnancy)?
8-12 weeks, 28–32 weeks, 37 weeks
6-7weeks, 16 weeks, 38 weeks
16 weeks, 34 weeks, 39-40 weeks
10-12 weeks, 24 weeks, 37-38 weeks
12-16 weeks, 27-28 weeks, 37-38 weeks
A woman in the first half of pregnancy was brought to clinic by an ambulance. Term of pregnancy is
36 weeks. She complains of intensive pain in the epigastrium, had vomiting for 2 times. Pain started
after the patient had eaten vinaigrette. Swelling of lower extremities. BP - 140/100 mm Hg. Urine
became curd after boiling. What is the most probable diagnosis?
Preeclampsia
Nephropathy of the 3rd degree
Food toxicoinfection
Dropsy of pregnant women
Exacerbation of pyelonephritis
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B.
C.
D.
E.
Immediately after delivery a woman had haemorrhage, blood loss exceeded postpartum haemorrhage
rate and was progressing. There were no symptoms of placenta detachment. What tactics should be
chosen?
Manual removal of placenta and afterbirth
Uterus tamponade
Instrumental revision of uterine cavity walls
Removal of afterbirth by Crede's method
Intravenous injection of methylergometrine with glucose
A 30 y.o. woman has the 2-nd labour that has been lasting for 14 hours. Hearbeat of fetus is muffled,
arrhythmic, 100/min. Vaginal examination: cervix of uterus is completely opened, fetus head is in
outlet from small pelvis. Saggital suture is in the straight diameter, small is near symphysis. What is
the further tactics of handling the delivery?
Use of obstetrical forceps
Stimulation of labour activity by oxytocin
Cesarean section
Cranio-cutaneous (Ivanov's) forceps
Use of cavity forceps
In10 minutes after delivery a woman discharged placenta with a tissue defect 5х6 cm large.
Discharges from the genital tracts were bloody profuse. Uterus tonus was low, fundus of uterus was
located below the navel. Examination of genital tracts revealed that the uterine cervix, vaginal walls,
perineum were intact. There was uterine bleeding with following blood coagulation. Your actions to
stop the bleeding:
To make manual examination of uterine cavity
To apply hemostatic forceps upon the uterine cervix
To introduce an ether-soaked tampon into the posterior fornix
To put an ice pack on the lower abdomen
To administer uterotonics
On the 5th day after labor body temperature of a 24-year-old parturient suddenly rose up to 38,7 0C.
She complains about weakness, headache, abdominal pain, irritability. Objectively: AP- 120/70 mm
Hg, Ps- 92 bpm, t- 38,7 0C. Bimanual examination revealed that the uterus was enlarged up to 12
weeks of pregnancy, it was dense, slightly painful on palpation. Cervical canal dilated for two
fingers, discharges are moderate, turbid, with foul smell. In blood: leykocytosis, lymphopenia, ESR 30 mm/h. What is the most likely diagnosis?
Endometritis
Parametritis
Pelviperitonitis
Metrophlebitis
Lochiometra
A 27 y.o. gravida with 17 weeks of gestation was admitted to the hospital. There was a history of 2
spontaneous miscarriages. On bimanual examination: uterus is enlarged to 17 weeks of gestation,
uterus cervix is shortened, isthmus allows to pass the finger tip. The diagnosis is isthmico-cervical
insufficiency. What is the doctor's tactics?
To place suture on the uterus cervix
To administer tocolytic therapy
To interrupt pregnancy
To administer hormonal treatment
To perform amniocentesis
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E.
Examination of a just born placenta reveals defect 2x3 cm large. Hemorrhage is absent. What tactic is
the most reasonable?
Manual exploration of uterine cavity
Prescription of uterotonic medicines
External uterus massage
Parturient supervision
Uterine curretage
On the tenth day after discharge from the maternity house a 2-year-old patient consulted a doctor
about body temperature rise up to 39єC, pain in the right breast. Objectively: the mammary gland is
enlarged, there is a hyperemized area in the upper external quadrant, in the same place there is an
ill-defined induration, lactostasis, fluctuation is absent. Lymph nodes of the right axillary region are
enlarged and painful. What is the most likely diagnosis?
Lactation mastitis
Abscess
Erysipelas
Dermatitis
Tumour
A 28-years-old woman complains of nausea and vomiting about 10 times per day. She has been
found to have body weight loss and xerodermia. The pulse is 100 bpm. Body temperature is 37,20C.
Diuresis is low. USI shows 5-6 weeks of pregnancy. What is the most likely diagnosis?
Moderate vomiting of pregnancy
Mild vomiting of pregnancy
I degree preeclampsia
Premature abortion
Food poisoning
A 25 y.o. patient complains of body temperature rise up to 37 0С, pain at the bottom of her abdomen
and vaginal discharges. Three days ago, when she was in her 11th week of pregnancy, she had an
artificial abortion. Objectibely: cervix of uterus is clean, uterus is a little bit enlarged in size, painful.
Appendages cannot be determined. Fornixes are deep, painless. Vaginal discharges are
sanguinopurulent. What is the most probable diagnosis?
Postabortion endometritis
Hematometra
Pelvic peritonitis
Postabortion uterus perforation
Parametritis
A 25 y.o. pregnant woman in her 34th week was taken to the maternity house in grave condition.
She complains of headache, visual impairment, nausea. Objectively: solid edemata, AP- 170/130 mm
Hg. Suddenly there appeared fibrillary tremor of face muscles, tonic and clonic convulsions,
breathing came to a stop. After 1,5 minute the breathing recovered, there appeared some bloody
spume from her mouth. In urine: protein - 3,5 g/L. What is the most probable diagnosis?
Eclampsia
Epilepsy
Cerebral hemorrhage
Cerebral edema
Stomach ulcer
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C.
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86.
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87.
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C.
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88.
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B.
C.
D.
A primigravida woman appealed to the antenatal clinic on the 22.03.09 with complaints of boring
pain in the lower part of abdomen. Anamnesis registered that her last menstruation was on the
4.01.03. Bimanual examination revealed that uterine servix is intact, external os is closed, uterus is
enlarged up to the 9-th week of pregnancy, movable, painless. What complication can be suspected?
Risk of abortion in the 9-th week of pregnancy
Initial in the 9-th week of pregnancy
Hysteromyoma
Vesicular mole
Pathological preliminary period
An ambulance delivered a 21-year-old woman to the gynaecological department with complaints of
colicky abdominal pain and bloody discharges from the genital tracts. Bimanual examination
revealed that uterus was soft, enlarged to the size of 6 weeks of gestation, a gestational sac was
palpated in the cervical canal. Uterine appendages weren't palpable. Fornices are free, deep and
painless. Discharges from the genital tracts are bloody and profuse. What is the most likely
diagnosis?
Inavitable abortion
Cervical pregnancy
Threat of abortion
Incipient abortion
Interrupted fallopian pregnancy
A woman is 34 years old, it is her tenth labor at full term. It is known from the anamnesis that the
labor started 11 hours ago, labor was active, painful contractions started after discharge of waters and
became continuous. Suddenly the parturient got knife-like pain in the lower abdomen and labor
activity stopped. Examination revealed positive symptoms of peritoneum irritation, ill-defined uterus
outlines. Fetus was easily palpable, movable. Fetal heartbeats wasn't auscultable. What is the most
probable diagnosis?
Rupture of uterus
Uterine inertia
Discoordinated labor activity
Risk of uterus rupture
II labor period
Examination of placenta revealed a defect. An obstetrician performed manual investigation of uterine
cavity, uterine massage. Prophylaxis of endometritis in the postpartum period should involve
following actions:
Antibacterial therapy
Instrumental revision of uterine cavity
Haemostatic therapy
Contracting agents
Intrauterine instillation of dioxine
A pregnant woman was delivered to the gynecological unit with complaints of pain in the lower
abdomen and insignificant bloody discharges from the genital tracts for 3 hours. Last menstruation
was 3 months ago. Vaginal examination showed that body of womb was in the 10th week of
gestation, a fingertip could be inserted into the external orifice of uterus, bloody discharges were
insignificant. USI showed small vesicles in the uterine cavity. What is the most likely diagnosis?
Molar pregnancy
Abortion in progress
Incipient abortion
Threat of spontaneous abortion
E.
89.
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B.
C.
D.
E.
90.
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B.
C.
D.
E.
91.
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C.
D.
E.
92.
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C.
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93.
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C.
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E.
Incomplete abortion
A 28 y.o. primagravida, pregnancy is 15-16 weaks of gestation, presents to the maternity clinics with
dull pain in the lower part of the abdomen and in lumbar area. On vaginal examination: uterus cervix
is 2,5 cm, external isthmus allows to pass the finger tip. Uterus body is enlarged according to the
pregnancy term. Genital discharges are mucous, mild. What is the diagnosis?
Threatened spontaneous abortion
Spontaneous abortion which has begun
Stopped pregnancy
Hydatid molar pregnancy
Placenta presentation
A maternity house has admitted a primagravida complaining of irregular, intense labour pains that
have been lasting for 36 hours. The woman is tired, failed to fall asleep at night. The fetus is in
longitudinal lie, with cephalic presentation. The fetus heartbeat is clear and rhythmic, 145/min.
Vaginal examination revealed that the uterine cervix was up to 3 cm long, dense, with retroflexion;
the external orifice was closed; the discharges were of mucous nature. What is the most likely
diagnosis?
Pathological preliminary period
Uterine cervix dystocia
Primary uterine inertia
Physiological preliminary period
Secondary uterine inertia
In the department of pathology of the pregnant woman was hospitalized with second 38 weeks
pregnancy. The first ended in cesarean section due to cephalopelvic disproportion. The estimated
fetal weight - 3200. What method of delivery will choose?
Expect spontaneous onset of labor to make a vacuum - the extraction of the fetus
Elective caesarean section
Excitation of labor at 38 weeks, delivery lead conservative
Expect spontaneous onset of labor, eliminate attempts by forceps
Plan the delivery can only know the size of the pelvis
By the end of the 1st period of physiological labor clear amniotic fluid came off. Contractions lasted
35-40 sec every 4-5min. Heartbeat of the fetus was 100 bpm. The BP was 140/90 mm Hg. What is
the most probable diagnosis?
Acute hypoxia of the fetus
Premature labor
Premature detachment of normally posed placenta
Back occipital presentation
Hydramnion
Which gestational age gives the most accurate estimation of weeks of pregnancy by uterine
size?
Less that 12 weeks
Between 12 and 20 weeks
Between 21 and 30 weeks
Between 31 and 40 weeks
Over 40 weeks
94.
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95.
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97.
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B.
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E.
98.
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B.
C.
D.
E.
A 24 years old primipara was hospitalised with complaints about discharge of the amniotic
waters. The uterus is tonic on palpation. The position of the fetus is longitudinal, it is pressed
with the head to pelvic outlet. Palpitation of the fetus is rhythmical, 140 bpm, auscultated on the left
below the navel. Internal examination: cervix of the uterus is 2,5 cm long, dense, the external os is
closed, light amniotic waters out of it. Point a correct component of the diagnosis:
Antenatal discharge of the amniotic waters
Early discharge of the amniotic waters
The beginning of the 1st stage of labour
The end of the 1st stage of labour
Pathological preterm labour
A 36 year old woman in the 9th week of gestation (the second pregnancy) consulted a doctor of
antenatal clinic in order to be registered there. In the previous pregnancy hydramnion was observed,
the child's birth weight was 5000 g. What examination method should be applied in the first place?
The test for tolerance to glucose
Determination of the PAPP - protein
Bacteriological examination of discharges from vagina
.Determination of chorionic gonatotropin hormone
US of fetus
A pregnant woman (35 weeks), aged 25, was admitted to the hospital because of bloody discharges.
In her medical history there were two artificial abortions. In a period of 28-32 weeks there was noted
the onset of hemorrhage and USD showed a placental presentation. The uterus is in normotonus, the
fetus position is transversal (Ist position). The heartbeats is clear, rhythmical, 140 bpm. What is the
further tactics of the pregnant woman care?
To perform a delivery by means of Cesarean section
To perform the hemotransfusion and to prolong the pregnancy
To introduct the drugs to increase the blood coagulation and continue observation
Stimulate the delivery by intravenous introduction of oxytocin
Spasmoletics prescription
A woman consulted a doctor on the 14th day after labour about sudden pain, hyperemy and
induration of the left mammary gland, body temperature rise up to 39oC, headache, indisposition.
Objectively: fissure of nipple, enlargement of the left mammary gland, pain on palpation. What
pathology would you think about in this case?
Lactational mastitis
Lacteal cyst with suppuration
Fibrous adenoma of the left mammary gland
Breast cancer
Phlegmon of mammary gland
Immediately after delivery a woman had hemorrhage, blood loss exceeded postpartum hemorrhage
rate and was progressing. There were no symptoms of placenta detachment. What tactics should be
chosen?
Manual removal of placenta and afterbirth
Uterus tamponade
Instrumental revision of uterine cavity walls
Removal of afterbirth by Crede's method
Intravenous injection of methylergometrine with glucose
99.
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B.
C.
D.
E.
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B.
C.
D.
E.
101.
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D.
E.
102.
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C.
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E.
Internal obstetric examination of a parturient woman revealed that the sacrum hollow was totally
occupied with fetus head, ischiadic spines couldn't be detected. Sagittal suture is in the straight
diameter, occipital fontanel is directed towards symphysis. In what plane of small pelvis is the
presenting part of the fetus?
Plane of pelvic outlet
Wide pelvic plane
Narrow pelvic plane
Plane of pelvic inlet
Over the pelvic inlet
Vaginal inspection of a parturient woman revealed: cervix dilation is up to 2 cm, fetal bladder is
intact. Sacral cavity is free, sacral promontory is reachable only with a bent finger, the inner surface
of the sacrococcygeal joint is accessible for examination. The fetus has cephalic presentation. Sagittal
suture occupies the transverse diameter of pelvic inlet, the small fontanel to the left, on the side.
What labor stage is this?
Cervix dilatation stage
Preliminary stage
Prodromal stage
Stage of fetus expulsion
Placental stage
A parturient woman is 23 years old. Vaginal obstetric examination reveals full cervical dilatation.
There is no fetal bladder. Fetal head is in the plane of pelvic inlet. Sagittal suture is in mesatipellic
pelvis, anterior fontanel and posterior fontanee are presented. The fetal head diameter in such
presentation will be:
Suboccipito-bregmaticus
Fronto-occipitalis recta
Biparietal
Suboccipitio-frontalis
Mento-occipitalis
After delivery and revision of placenta there was found the defect of placental lobule. General
condition of woman is normal, uterus is firm, and there is moderate bloody discharge. Speculum
examination of birth canal shows absence of lacerations and ruptures. What action is necessary?
Manual exploration of the uterine cavity
External massage of uterus
Introduction of uterine contracting agents
Urine drainage, cold on the lower abdomen
Introduction of hemostatic medications
A parturient woman is 25 years old, it is her second day of postpartum period. It was her first
full-term uncomplicated labour. The lochia should be:
Bloody
Sanguino-serous
Mucous
Purulent
Serous
104.
A. *
B.
C.
D.
E.
105.
A.
B.
C. *
D.
E.
106.
A. *
B.
C.
D.
E.
107.
A.
B. *
C.
D.
E.
108.
A. *
B.
C.
D.
E.
109.
A woman is 34 years old, it is her tenth labor at full term. It is known from the anamnesis that the
labor started 11 hours ago, labor was active, painful contractions started after discharge of waters and
became continuous. Suddenly the parturient got knife-like pain in the lower abdomen and labor
activity stopped. Examination revealed positive symptoms of peritoneum irritation, ill-defined uterus
outlines. Fetus was easily palpable, movable. Fetal heartbeats weren’t auscultable. What is the most
probable diagnosis?
Rupture of uterus
Uterine inertia
Discoordinated labor activity
Risk of uterus rupture
II labor period
At which gestational age does multipara feel first fetal movements?
Less that 12 weeks
At 20 week
At 18 week
At 23 week
At 30 week
A 22-year-old woman is having interm labor continued for 5 hours. Light amniotic fluid came off.
The fetus head is fixed to the orifice in the small pelvis. The probable fetal weight is 4000,0 g.
Heartbeat of the fetus is normal. In vaginal examination – cervix is dilated to 1 cm, the fetal
membranes are not present. In which stage of labor does the woman present?
First, latent phase
First, active phase
First, spontaneous phase
Second, active phase
Third, latent phase
A woman in her 40th week of pregnancy, the second labour, has regular birth activity. Uterine
contractions take place every 3 minutes. What criteria describe the beginning of the II labor stage the
most objective?
Cervical dilatation by no less than 4 cm
Cervical dilation to 10 cm
Duration of uterine contractions over 30 seconds
Presenting part is in the lower region of small pelvis
Rupture of fetal bladder
A woman in her 39-th week of pregnancy, the second labor, has regular birth activity. Uterine
contractions take place every 3 minutes. All of the below indicate the beginning of the II stage of
labor EXEPT:
Cervical dilatation to .4 cm
Cervical dilation to 9-10 cm
Duration of uterine contractions more than 30 seconds
Presenting part is in 0 station
Rupture of membranes
A 24 years old primipara was hospitalised with complaints about discharge of the amniotic
waters. The uterus is tonic on palpation. The position of the fetus is longitudinal, it is pressed
with the head to pelvic outlet. Palpitation of the fetus is rhythmical, 140 bpm, auscultated on the left
below the navel. Internal examination: cervix of the uterus is 2,5 cm long, dense, the external os is
closed, light amniotic waters out of it. Point a correct component of the diagnosis:
A. *
B.
Antenatal discharge of the amniotic waters
Early discharge of the amniotic waters
The beginning of the 1st stage of labour
The end of the 1st stage of labour
Pathological preterm labour
A 32 year old woman in the 12th week of gestation (the second pregnancy) consulted a doctor of
antenatal clinic in order to be registered there. In the previous pregnancy hydramnion was observed,
the child's birth weight was 5000 g. What examination method should be applied in the first place?
The test for tolerance to glucose
Determination of the contents of fetoproteinum
Bacteriological examination of discharges from vagina
A cardiophonography of fetus
US of fetus
At term of a gestation of 40 weeks height of standing of a uterine fundus is less then assumed for the
given term. The woman has given birth to the child in weight of 2500 g, length of a body 53 cm, with
an assessment on Apgar score of 4-6 points. Labor were fast. The cause of such state of the child
was:
Placental dysfunction
Acute fetal distress
Placental detachment
Infection of a fetus
Prematurity
41 years old woman, primigravida, with infertility in the medical history, on the 42-43 week of
pregnancy. Labour activity is weak. Longitudinal lie of the fetus, I position, anterior variety. The
head of the fetus is engaged to pelvic inlet. Fetus heart rate is 140 bmp,rhythmic. Cervix dilation is .6
cm. One hour before green colored amniotic fluid released. Cranial bones are dense, cranial sutures
and small fontanels are diminished. What should be management delivery?
Caesarean section
Amniotomy, labour stimulation, fetal hypoxia treatment
Fetal hypoxia treatment, in the ІІ period - forceps delivery
Fetal hypoxia treatment, conservative delivery
Medication sleep, amniotomy, labour stimulation
Examination of a placenta after delivery reveals defect 3x5 cm large. Hemorrhage is absent. What
management is the most appropriate?
Manual exploration of uterine cavity
Prescription of uterotonic medicines
External uterus massage
Observation for the patient
Uterine curretage
A woman consulted a doctor on the 21th day after labor about discharge from vagina. Objectively
body temperature is normal. Pulse rate is 72 beats per minute, blood pressure 120/60mm.Hg. What
character of the discharge should be normally at this day of postpartum period?
Bloody
Purulent
C.
D. *
E.
Bloody-serous
Serous
Serous-bloody
B.
C.
D.
E.
110.
A. *
B.
C.
D.
E.
111.
A. *
B.
C.
D.
E.
112.
A. *
B.
C.
D.
E.
113.
A. *
B.
C.
D.
E.
114.
A.
115.
A.
B.
C.
D. *
E.
116.
A.
B.
C.
D.
E. *
117.
A. *
B.
C.
D.
E.
118.
A. *
B.
C.
D.
E.
21 years old woman consulted a doctor on the 2 day after labor about the examinations which she
should pass at postpartum period. Objectively body temperature is normal. Pulse rate is 72 beats per
minute, blood pressure is 120/60mm.Hg. All of the below examination the woman should pass before
discharge from hospital EXEPT:
Genaral blood analysis
General urine analysis
Bacterioscopic examionation of the vaginal discarge
Analysis of the feces
Ultrasonography of the uterus
In 14 min after .delivery by a 22-year-old woman, the placenta was spontaneousely delivered and 50
ml of blood came out. Woman weight is 60kg, infant weight - 3100g, length - 52 cm. The uterus
contracted. In 15 minutes the hemorrhage renewed and the total amount of blood loss is 250 ml.
What amount of blood loss is physiologic for this woman?
400 ml
1000 ml
450 ml
650 ml
300 ml
A pregnant woman was registered in a maternity clinic in her 10th week of pregnancy. She was being
under observation during the whole term, the pregnancy course was normal. Choose the document
which the doctor should give to the pregnant woman to authorize her hospitalization in maternity
hospital?
Exchange card
Appointment card for hospitalization
Individual prenatal record
Medical certificate
Sanitary certificate
A 26 years old primapara with pelvis size 23-26-18-18 cm has active labor activity. Amniotic fluid
gush occurs in full cervical dilation. Probable fetal weight is is 4200 g, the head is engaged to the
small pelvis inlet. Vasten's sign is positive. Cervix of uterus is fully dilated. Amniotic sac is absent.
The fetus heartbeat is clear, rhythmic, 136 bpm. Which complication occur in labor?
Clinical contracted pelvis
Acute fetal distress
Chronic fetal distress
Preterm releasing of amniotic fluid
Uterine inertia
Назва наукового напрямку (модуля):
Семестр: 1
Акушерство та гінекологія Ситуаційні задачі
Опис:
5 курс 10 семестр
Перелік питань:
1.
A. *
B.
C.
D.
E.
2.
A.
B.
C.
D.
E. *
3.
A.
B.
C.
D. *
E.
4.
A. *
B.
C.
D.
E.
5.
A.
B.
C.
D.
E. *
6.
A.
29 years old woman is presented in first stage of the second labor. Uterine contractions are every 3
minutes by 25 seconds. In Leopold maneuvers you have palpated fetal head above the pelvis inlet and
fetal buttocks in the uterine fundus. Which lie is determined by a doctor?
Longitudinal
Transverse
Oblique
Breech
Cephalic
34 years old woman is presented in first stage of labor. Uterine contractions are every 4 minutes by
20 seconds. In Leopold maneuvers you have palpated fetal head above the pelvis inlet and fetal
buttocks in the uterine fundus. Which presentation is determined by a doctor?
Longitudinal
Transverse
Oblique
Breech
Cephalic
32 years old woman is presented in first stage of the labor. Uterine contractions are every 4 minutes
by 20 seconds. In Leopold maneuvers you have palpated fetal buttocks above the pelvis inlet and
fetal head in the uterine fundus. Which presentation is determined by a doctor?
Longitudinal
Transverse
Oblique
Breech
Cephalic
42-years old patient is hospitalized to Pathologic Pregnancy Department at 38 week of gestation.
During external obstetric examination transverse lie of the fetus was diagnosed. Fetal head is
presented to the left uterine wall. Which fetal position is diagnosed in the patient?
I
II
III
IV
V
42-years old patient is hospitalized to Pathologic Pregnancy Department at 39 week of gestation.
During external obstetric examination transverse lie of the fetus is diagnosed. Fetal head is presented
to the right uterine wall. Indicate the fetal presentation.
Cephalic
Breech
Shoulder
Knee
Presented part is absent
42-years old patient is hospitalized to Pathologic Pregnancy Department at 38 week of gestation.
During external obstetric examination transverse lie of the fetus is diagnosed. Fetal head is presented
to the right uterine wall. Which fetal position is diagnosed in the patient?
I
B. *
C.
D.
E.
7.
A.
B. *
C.
D.
E.
8.
A.
B. *
C.
D.
E.
9.
A. *
B.
C.
D.
E.
10.
A.
B. *
C.
D.
E.
11.
A. *
B.
C.
D.
E.
12.
II
III
IV
V
38-years old patient is hospitalized to Pathologic Pregnancy Department at 40 week of gestation.
During external obstetric examination fetal head is in the mother’s hip. Which fetal lie is diagnosed
in the patient?
Transverse
Oblique
Longitudinal
Cephalic
Breech
28-years old patient is hospitalized to Pathologic Pregnancy Department at 40 week of gestation.
During external obstetric examination fetal head is in the mother’s hip. Which fetal lie is diagnosed
in the patient?
Transverse
Oblique
Longitudinal
Cephalic
Breech
42-years old patient is hospitalized to Pathologic Pregnancy Department at 38 week of gestation.
During external obstetric examination transverse lie of the fetus is diagnosed. Fetal head is presented
to the left uterine wall. Which fetal position is diagnosed in the patient?
I
II
III
IV
V
22-years old patient is hospitalized to Pathologic Pregnancy Department at 37 week of gestation.
During external obstetric examination fetal head is in the right mother’s hip. Which fetal position is
diagnosed in the patient?
I
II
III
IV
V
28-years old patient is hospitalized to Pathologic Pregnancy Department at 37 week of gestation.
During external obstetric examination fetal head is in the left mother’s hip. Which fetal position is
diagnosed in the patient?
I
II
III
IV
V
27-years old patient is hospitalized to Pathologic Pregnancy Department at 40 week of gestation.
During external obstetric examination fetal buttocks are in the mother’s hip. Which fetal lie is
diagnosed in the patient?
A.
B. *
C.
D.
E.
13.
A.
B. *
C.
D.
E.
14.
A. *
B.
C.
D.
E.
15.
A.
B. *
C.
D.
E.
16.
A. *
B.
C.
D.
E.
17.
A.
B.
C.
Transverse
Oblique
Longitudinal
Cephalic
Breech
22 years old woman is presented in first stage of the labor. Uterine contractions are every 5 minutes
by 20 seconds. In Leopold maneuvers fetal buttocks are palpated to the right uterine wall and fetal
head to the left. Which lie is determined by a doctor?
Longitudinal
Transverse
Oblique
Breech
Cephalic
Patient M. in 39 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 4cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the right
oblique size, a small fontanel is to the right close to the sacral bone. Determine the position and the
variety of the fetus?
II position, the posterior variety
I position, the anterior variety
I position, the posterior variety
II position, the anterior variety
Cephalic position, anterior variety
Patient N. in 38 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 5cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the right
oblique size, a small fontanel is to the left anteriorly. Determine the position and the variety of the
fetus?
II position, the posterior variety
I position, the anterior variety
I position, the posterior variety
II position, the anterior variety
Cephalic position, anterior variety
Patient F. in 38 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 6cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the left
oblique size, a small fontanel is to the left close to a sacral bone. Determine the position and the
variety of the fetus?
I position, the posterior variety
I position, the anterior variety
II position, the posterior variety
II position, the anterior variety
Cephalic position, anterior variety
Patient F. in 38 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 6cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the left
oblique size, a small fontanel is to the right anteriorly. close to a sacral bone. Determine the position
and the variety of the fetus?
II position, the posterior variety
I position, the anterior variety
I position, the posterior variety
D. *
E.
18.
A. *
B.
C.
D.
E.
19.
A.
B. *
C.
D.
E.
20.
A. *
B.
C.
D.
E.
21.
A. *
B.
C.
D.
E.
22.
A. *
B.
C.
D.
E.
II position, the anterior variety
Cephalic position, anterior variety
Patient M. in 39 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 4cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the right
oblique size, a small fontanel is to the right close to the sacral bone. Choose the place for the best
fetal heart rate auscultation.
From the right below the umbilicus
From the left below the umbilicus
On the level of umbilicus
From the right above umbilicus
From the left above umbilicus
Patient N. in 38 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 5cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the right
oblique size, a small fontanel is to the left anteriorly. Determine the position and the variety of the
fetus?
From the right below the umbilicus
From the left below the umbilicus
On the level of umbilicus
From the right above umbilicus
From the left above umbilicus
Patient F. in 38 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 6cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the left
oblique size, a small fontanel is to the right anteriorly. Determine the position and the variety of the
fetus?
From the right below the umbilicus
From the left below the umbilicus
On the level of umbilicus
From the right above umbilicus
From the left above umbilicus
Patient F. in 38 week of gestation is presented in the first stage of labor. In vaginal examination the
cervix is effaced and 6cm dilated, fetal head is in the pelvic inlet. A sagittal suture is in the left
oblique size, a small fontanel is to the right anteriorly. close to a sacral bone. Determine the position
and the variety of the fetus?
From the right below the umbilicus
From the left below the umbilicus
On the level of umbilicus
From the right above umbilicus
From the left above umbilicus
Patient N., II labor. The patient’ condition is satisfactory. Uterine contractions are active. Fetal head
is palpated on the left side from umbilicus, fetal buttocks from the right side. Your initial diagnosis
is:
Transverse lie, first position
Breech presentation
Transverse position
Sinciput vertex presentation
Transverse lie, second position
23.
A.
B.
C.
D.
E. *
24.
A.
B.
C. *
D.
E.
25.
A.
B.
C.
D. *
E.
26.
A.
B. *
C.
D.
E.
27.
A.
B.
C. *
D.
E.
28.
A. *
B.
C.
D.
Patient S., II labor. The patient’ condition is satisfactory. Uterine contractions are active. Fetal head
is palpated on the right side from umbilicus, fetal buttocks from the left side. Your initial diagnosis
is:
Transverse lie, first position
Breech presentation
Transverse position
Sinciput vertex presentation
Transverse lie, second position
33 years old patient is presented in the first stage of labor. Fetal head is on -2 station. Fetal back is
to the left, buttocks are presented. Fetal heart rate is clear, rhythmic, 136 in 1min. Which lie is
present in the patient?
Transverse lie
Oblique
Longitudinal
Breech
Shoulder
In vaginal examination of a multipara the cervix is 100% effaced and 5 cm dilated. Fetal buttocks
are palpated in the level of pelvic inlet. The intertrochanteric diameter is in the right oblique size, the
fetal sacrum is anteriorly. What is the diagnosis?
I position, the posterior variety
I position, the anterior variety
II position, the posterior variety
II position, the anterior variety
Cephalic position, anterior variety
In vaginal examination of a multipara the cervix is 100% effaced and 6 cm dilated. Fetal buttocks
are palpated in -1 station. The intertrochanteric diameter is in the left oblique size, the fetal sacrum is
anteriorly. What is the diagnosis?
I position, the posterior variety
I position, the anterior variety
II position, the posterior variety
II position, the anterior variety
Cephalic position, anterior variety
In vaginal examination of 41 years old patient the cervix is 100% effaced and 6 cm dilated. Fetal
buttocks are palpated in -2 stations. The intertrochanteric diameter is in the left oblique size, the fetal
sacrum is posteriorly. What is the diagnosis?
I position, the posterior variety
I position, the anterior variety
II position, the posterior variety
II position, the anterior variety
Cephalic position, anterior variety
In vaginal examination of 33 years old patient the cervix is 100% effaced and 7 cm dilated. Fetal
buttocks are palpated in 0 station. The intertrochanteric diameter is in the right oblique size, the fetal
sacrum is posteriorly. What is the diagnosis?
I position, the posterior variety
I position, the anterior variety
II position, the posterior variety
II position, the anterior variety
E.
29.
A. *
B.
C.
D.
E.
30.
A.
B. *
C.
D.
E.
31.
A.
B. *
C.
D.
E.
32.
A.
B.
C.
D.
E. *
33.
A. *
B.
C.
D.
E.
Cephalic position, anterior variety
Patient N., II labor. The patient’ condition is satisfactory. Uterine contractions are active. Fetal head
is palpated on the right from umbilicus; fetal buttocks from the left. Uterine cervix is dilated to 3cm,
amniotic membranes are absent. Your obstetric diagnosis:
Transverse lie, right position
Transverse lie, left position
Oblique lie
Breech presentation
Cephalic position, anterior variety
Patient N., II labor. The patient’ condition is satisfactory. Uterine contractions are active. Fetal head
is palpated on the left from umbilicus; fetal buttocks from the right. Uterine cervix is dilated to 3cm,
amniotic membranes are absent. Your obstetric diagnosis is:
Transverse lie, right position
Transverse lie, left position
Oblique lie
Breech presentation
Cephalic position, anterior variety
36 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 10cm, amniotic fluid is absent, fetal head is
presented at 0 station at vaginal examination. What does 0 point of the measuring stake mean?
Linea terminalis
Ischial spines
Promontory
Ischial tubes
Coccyx
27 years old patient is presented in labor. Uterine contractions are every 4 minutes by 25 seconds.
Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart rate is 136 beats per minute.
Cervical dilation is 10 cm, amniotic membranes are absent, top of the fetal head reaches 0 station.
What does 0 point of the measuring stake mean?
Crowning
Top of fetal head reaches line terminalis
Top of fetal head reaches ischial tubes
Fetal head is floating
Fetal head is engaged
31 years old patient is presented in labor. Pushing efforts are every 2 minutes by 55 seconds. Fetal
lie is longitudinal, cephalic presentation is diagnosed. Fetal heart rate is 136 beats per minute.
Cervical dilation is 10cm, amniotic membranes are absent, top of the fetal head reaches +3 station.
What does +3 point of the measuring stake mean?
Crowning
Top of fetal head reaches linea terminalis
Top of fetal head reaches ischial tubes
Fetal head is floating
Fetal head is engaged
34.
A.
B.
C.
D. *
E.
35.
A. *
B.
C.
D.
E.
36.
A.
B.
C.
D.
E. *
37.
A.
B. *
C.
D.
E.
38.
A.
B.
26 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 10cm, amniotic fluid is absent, fetal head is
presented at 0 station at vaginal examination. Sagittal suture is located in the right oblique diameter
of the midpelvis, posterior fontanel to the left anteriorly. Which fetal position is diagnosed?
Anterior
Posterior
Oblique
First
Second
40 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 10cm, amniotic fluid are absent, fetal head is
presented at 0 station at vaginal examination. Sagittal suture is located in the right oblique diameter
of the midpelvis, posterior fontanel to the left anteriorly. Which fetal variety is diagnosed?
Anterior
Posterior
Oblique
First
Second
Patient N., 33 years old is presented in the first stage of labor. Uterine contractions are every 3
minutes by 35-40 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 4cm, amniotic membranes are intact, fetal head is
presented at -2 station at vaginal examination. Sagittal suture is located in the left oblique diameter of
the pelvic inlet; posterior fontanel is to the right anteriorly. Which fetal position is diagnosed?
Anterior
Posterior
Oblique
First
Second
Patient N., 33 years old is presented in the first stage of labor. Uterine contractions are every 3
minutes by 35-40 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Cervical
dilation is 4cm, amniotic membranes are intact, fetal head is presented at -2 station at vaginal
examination. Sagittal suture is located in the left oblique diameter of the pelvic inlet; posterior
fontanel is to the right anteriorly. Fetal heart rate is 136 beats per minute. Which fetal variety is
diagnosed?
Anterior
Posterior
Oblique
First
Second
26 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 10cm, amniotic fluid is absent, fetal head is
presented at 0 station at vaginal examination. Sagittal suture is located in the right oblique diameter
of the midpelvis, posterior fontanel is to the right posteriorly. Which fetal position is diagnosed?
Anterior
Posterior
C.
D.
E. *
39.
A.
B. *
C.
D.
E.
40.
A.
B.
C.
D. *
E.
41.
A.
B. *
C.
D. *
E.
42.
A. *
B.
C.
D.
E.
Oblique
First
Second
40 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 10cm, amniotic fluid is absent, fetal head is
presented at 0 station at vaginal examination. Sagittal suture is located in the right oblique diameter
of the midpelvis, posterior fontanel is to the right posteriorly. Which fetal variety is diagnosed?
Anterior
Posterior
Oblique
First
Second
Patient N., 33 years old is presented in the first stage of labor. Uterine contractions are every 3
minutes by 35-40 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 4cm, amniotic membranes are intact, fetal head is
presented at -2 station at vaginal examination. Sagittal suture is located in the left oblique diameter of
the pelvic inlet; posterior fontanel is to the left posteriorly. Which fetal position is diagnosed?
Anterior
Posterior
Oblique
First
Second
Patient N., 33 years old is presented in the first stage of labor. Uterine contractions are every 3
minutes by 35-40 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 136 beats per minute. Cervical dilation is 4cm, amniotic membranes are intact, fetal head is
presented at -2 station at vaginal examination. Sagittal suture is located in the left oblique diameter of
the pelvic inlet; posterior fontanel is to the left posteriorly. Which fetal variety is diagnosed?
Anterior
Posterior
Oblique
First
Second
24 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 72/min, BP - 120/80 mm Hg. Mammary glands are
moderately swollen, nipples are clean without fissures. Lactation is characterized by colostrum.
Abdomen is soft and painless. Uterine fundus height is 3 fingers below the umbilicus. Lochia are
bloody, moderate. The most appropriate day for postpartum period would be:
3 day
2 day
1 day
5 day
4 day
43.
A.
B.
C.
D. *
E.
44.
A.
B. *
C.
D.
E.
45.
A.
B. *
C.
D.
E.
46.
A. *
B.
C.
D.
E.
47.
A.
B. *
C.
D.
28 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
moderately swollen, nipples are clean without fissures. Lactation is characterized by immature milk.
Abdomen is soft and painless. Uterine fundus height is in the midway between symphysis and
umbilicus. Lochia are bloody-serous, moderate. The most appropriate day for postpartum period
would be:
3 day
2 day
1 day
5 day
4 day
22 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are
moderately swollen, nipples are clean without fissures. Lactation is characterized by colostrum.
Abdomen is soft and painless. Uterine fundus - 2 fingers below the umbilicus. Lochia are bloody,
moderate. The most appropriate day for postpartum period would be:
3 day
2 day
1 day
5 day
4 day
25 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are
soft, nipples are clean without fissures. Lactation is good. Abdomen is soft and painless. Uterine
fundus is located 8cm above symphysis. The lochia should be:
Bloody
Bloody-serous
Mucous
Purulent
Serous
22 years old woman is presented at postpartum period after physiological delivery. At objective
examination her temperature is 36,7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are soft,
nipples are clean without fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is
located 6cm below umbilicus. The lochia should be:
Bloody
Bloody-serous
Mucous
Purulent
Serous
19 years old woman is presented in postpartum period after physiological delivery At objective
examination her temperature is 36,8 0C, Ps - 72/min, BP - 120/80 mm Hg. Mammary glands are
normal, colostrum is presented. Abdomen is soft and painless. Uterine fundus height is 2 cm below
the umbilicus. Lochia are bloody, moderate. The most appropriate day for postpartum period would
be:
3 day
2 day
1 day
5 day
E.
48.
A.
B.
C.
D.
E. *
49.
A.
B.
C. *
D.
E.
50.
A. *
B.
C.
D.
E.
51.
A. *
B.
C.
D.
E.
52.
A.
B.
C. *
D.
4 day
33 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
moderately swollen, nipples are clean without fissures. Lactation characterizes by immature milk.
Uterine fundus height is 4 fingers below umbilicus. Lochia are bloody-serous, moderate. The most
appropriate day for postpartum period would be:
3 day
2 day
1 day
5 day
4 day
35 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
normal without infiltration. Lactation characterizes by immature milk. Uterine fundus height is 4
fingers above symphysis. Lochia are bloody-serous, moderate. The most appropriate day for
postpartum period would be:
3 day
2 day
6day
5 day
4 day
29 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
normal. Lactation is good. Uterine fundus height is 3 fingers above symphysis. Lochia are
serous-bloody, moderate. The most appropriate day for postpartum period would be:
7 day
2 day
1 day
5 day
4 day
28 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
normal without infiltrations. Lactation is good. Uterine fundus height is 4cm above symphysis.
Lochia are serous-bloody, moderate. The most appropriate day for postpartum period would be:
8 day
2 day
1 day
5 day
4 day
28 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
normal. Lactation is good. Uterine fundus height is 2cm above symphysis. Lochia are
serous-bloody, moderate. The most appropriate day for postpartum period would be:
7 day
2 day
9 day
5 day
E.
53.
A.
B.
C. *
D.
E.
54.
A.
B. *
C.
D.
E.
55.
A.
B. *
C.
D.
E.
56.
A. *
B.
C.
D.
E.
57.
A. *
B.
C.
D.
E.
4 day
24 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36, 8 0C, Ps - 84/min, BP - 120/80 mm Hg. Mammary glands are
normal. Lactation is good. Lochia are serous in small amount. The most appropriate day for
postpartum period would be:
7 day
2 day
10day
5 day
4 day
25 years old woman is presented in postpartum period after physiological delivery at objective
examination her temperature is 36,7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are soft,
nipples are clean without fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is
located 8cm below umbilicus. The lochia should be:
Bloody
Bloody-serous
Mucous
Purulent
Serous
25 years old woman is presented in postpartum period after physiological delivery. At objective
examination her temperature is 36,7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are soft,
nipples are clean without fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is
located in the midway between umbilicus and xiphoid process. The lochia should be:
Bloody
Bloody-serous
Mucous
Purulent
Serous
22 years old woman is presented at postpartum period after physiological delivery. At objective
examination her temperature is 36,7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are soft,
nipples are clean without fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is
located 2cm below umbilicus. The lochia should be:
Bloody
Bloody-serous
Mucous
Purulent
Serous
22 years old woman is presented at postpartum period. At objective examination her temperature is
36,7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are soft, nipples are clean without
fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is located 4cm below
umbilicus. The lochia should be:
Bloody
Bloody-serous
Mucous
Purulent
Serous
58.
A.
B.
C. *
D.
E.
59.
A.
B.
C.
D.
E. *
60.
A.
B. *
C.
D.
E.
61.
A.
B.
C. *
D.
E.
62.
A. *
B.
C.
D.
E.
18 years old woman is presented at postpartum period. At objective examination her temperature is
36,7 0C, Ps - 72/min, AP - 110/70 mm Hg. Mammary glands are soft, nipples are clean without
fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is located 2cm below
umbilicus. Routine postpartum care should include searching for all of the following EXEPT:
Fever
Anemia
Diabetes
Depression
Thrombophlebitis
44 years old woman is presented at postpartum period after fifth physiological delivery. At objective
examination her temperature is 36,7 0C, Ps - 72/min, BP - 110/70 mm Hg. Mammary glands are soft,
nipples are clean without fissures. Lactation is good. Abdomen is soft and painless. Uterine fundus is
located 6cm below umbilicus. Condition to consider before performing a postpartum sterilization
include all of the following EXEPT:
A signed permit
Normal coagulogram
Negative pap smear
The infants’ well being
The patient awareness of hormonal suppression therapy
A patient is presented at 14 day of postpartum period after second physiological delivery. She is
found to have spotting and increasing of the temperature. At objective examination her temperature is
38,7 0C, Ps - 100/min, BP - 110/70 mm Hg. Mammary glands are soft, nipples are clean without
fissures. Lactation is good. Abdomen is soft and painful in the lover parts. In bimanual examination
the uterus is enlarged and tender. The primary diagnosis would be:
Pyelonephritis
Endometritis
Parametritis
Mastitis
Vaginitis
A patient is presented at 12 day of postpartum period after first physiological delivery. She is found
to have high temperature, pain in the left mammary gland. At objective examination her temperature
is 39, 7 0C, Ps - 110/min, BP - 110/70 mm Hg. Left mammary gland is swollen, painful. Lactation
is prominent. In bimanual examination the uterus is normal. The primary diagnosis would be:
Pyelonephritis
Endometritis
Lactostasis
Peritonitis
Vaginitis
A 20-year-old primapara is presented in labor for 14 hours. The probable fetal weight is 4200, 0 g.
Fetal heart rate is normal. In vaginal examination the cervix is dilated to 4 cm, amniotic membranes
are presented. The fetal head station is -1. Woman is exhausted. What is necessary to do firstly?
Therapeutic rest
Augmentation by oxytocin
Fetal distress prevention
Induction by prostaglandins
Amniotomy
63.
A.
B.
C.
D.
E. *
64.
A. *
B.
C.
D.
E.
65.
A. *
B.
C.
D.
E.
66.
A. *
B.
C.
D.
E.
67.
A.
B.
C. *
D.
A 22-year-old multipara is presented in labor for 6 hours. The probable fetal weight is 3800, 0 g.
Fetal heart rate is normal. In vaginal examination the cervix is dilated to 4 cm, amniotic membranes
are presented. The fetal head station is -1. Oligohydramnios is presented. What is necessary to do to
prevent uterine inertia?
Therapeutic rest
Augmentation by oxytocin
Fetal distress prevention
Induction by prostaglandins
Amniotomy
24 years old primipara is hospitalized with complaints of irregular painful uterine contractions which
are presented for 7 hours hypertonic uterine dysfunction is presented. Longitudinal lie, cephalic
presentation is diagnosed during external objective examination. Fetal heart rate is rhythmic, 140
bpm. Uterine cervix is 2,5cm long, dense, the external os is closed in vaginal examination. What is
the correct diagnosis:
False labor
First stage of labor
Second stage of labor
Discoordinative uterine activity
Pathological preterm labor
29 years old primipara is hospitalized with complaints of irregular painful uterine contractions during
8 hours. Hypertonic uterine dysfunction is presented. Longitudinal lie, cephalic presentation is
diagnosed during external objective examination. Fetal heart rate is rhythmic, 140 bpm. Uterine
cervix is 2,5cm long, dense, the external os is closed in vaginal examination. The most appropriate
treatment would be:
Therapeutic rest
Induction by oxytocin
Fetal distress prevention
Induction by prostaglandins
Amniotomy
28 years old primipara is hospitalized with complaints of regular uterine contractions every 4-5
minutes by 20 seconds. She is in labor for 10 hours. Uterine contractions become weaker. She is
exhausted. Fetal lie is longitudinal, fetal head is fixated to pelvic inlet. Fetal heart rate is rhythmic,
140 bpm. In obstetric exam cervical dilation is 2 cm. Amniotic sac is intact. What is the adequate
management of patient?
Therapeutic rest
Augmentation of labor by oxytocin
Amniotomy
Augmentation of labor by prostaglandins
Fetal destroying operation
28 years old primipara is hospitalized with complaints of regular uterine contractions every 4-5
minutes by 20 seconds. She is in labor for 10 hours. Uterine contractions become weaker. She is
exhausted. Fetal lie is longitudinal, fetal head is fixated to pelvic inlet. Fetal heart rate is rhythmic,
140 bpm. In obstetric exam cervical dilation is 2 cm. Amniotic sac is intact. Therapeutic rest is
prescribed for her. What you should do firstly after patient awakening?
Spasmolytics prescriptions
Augmentation of labor by oxytocin
Amniotomy
Augmentation of labor by prostaglandins
E.
68.
A.
B. *
C.
D.
E.
69.
A. *
B.
C.
D.
E.
70.
A. *
B.
C.
D.
E.
71.
A. *
B.
C.
D.
E.
72.
A.
B.
C.
D.
Fetal destroying operation
28 years old primipara is hospitalized with complaints of regular uterine contractions every 4-5
minutes by 20 seconds. She is in labor for 10 hours. Uterine contractions become weaker. She is
exhausted. Fetal lie is longitudinal, fetal head is fixated to pelvic inlet. Fetal heart rate is rhythmic,
140 bpm. In obstetric exam cervical dilation is 2 cm. Amniotic sac is intact. She undergo for
therapeutic rest and amniotomy. What is the next step in your management?
Spasmolytics prescriptions
Augmentation of labor by oxytocin
Tokolytics prescriptions
Augmentation of labor by prostaglandins
Fetal destroying operation
28 years old primipara is hospitalized with complaints of regular uterine contractions every 4-5
minutes by 20 seconds. She is in labor for 10 hours. Uterine contractions become weaker. She is
exhausted. Fetal lie is longitudinal, fetal head is fixated to pelvic inlet. Fetal heart rate is rhythmic,
140 bpm. In obstetric exam cervical dilation is 2 cm. Amniotic sac is intact. She undergo for
therapeutic rest and amniotomy. Which drug belongs to the first line medication for labor’
augmentation?
Oxytocin
Miphepristone
Misoprostol
Duphaston
Carboprost
28 years old primipara undergoes labor augmentation as a result of primary uterine inertia. Fetal lie is
longitudinal, fetal head is fixated to pelvic inlet after performed therapeutic rest and amniotomy.
Fetal heart rate is rhythmic, 140 bpm. In obstetric exam cervical dilation is 2 cm and amniotic
membranes are absent. What is the initial rate for intravenous oxytocin in labor’ augmentation?
6-8 drops per minute
10-14 drops per minute
18-20 drops per minute
2-24 drops per minute
28-30 drops per minute
28 years old primipara is hospitalized with complaints of regular uterine contractions every 4-5
minutes by 20 seconds. She is 14 hours in labor. Uterine contractions are weak. She is exhausted.
Fetus is in longitudinal lie, cephalic presentation. Fetal heart rate is rhythmic, 140 bpm. Cervical
dilation is 2 cm. Amniotic sac is presented. The initial diagnosis would be:
Primary uterine inertia
Secondary uterine inertia
Pushing efforts inertia
Precipitatous labor
Discoordinative uterine activity
28 years old primipara undergoes augmentation by oxytocin as a result of primary uterine inertia.
Fetal lie is longitudinal, fetal head is fixated to pelvic inlet after performed therapeutic rest and
amniotomy. Fetal heart rate is rhythmic, 140 bpm. Which rate of oxytocin is the highest during
augmentation?
16-18 drops per minute
20-22 drops per minute
28-30 drops per minute
30-32 drops per minute
E.
73.
A. *
B.
C.
D.
E.
74.
A.
B.
C.
D.
E. *
75.
A. *
B.
C.
D.
E.
76.
A. *
B.
C.
D.
E.
77.
A. *
B.
C.
D.
E.
38-40 drops per minute
50-year-old primapara is presented in labor for 15 hours. The probable fetal weight is 3200, 0 g. Fetal
heart rate is normal. In vaginal examination the cervix is dilated to 5 cm, amniotic membranes are
presented. The fetal head station is -2. Woman is exhausted. What is necessary to do firstly?
Therapeutic rest
Augmentation by oxytocin
Fetal distress prevention
Induction by prostaglandins
Amniotomy
28-year-old multipara is presented in labor for 7 hours. In vaginal examination the cervix is dilated
to 3 cm, amniotic membranes are presented. The fetal head station is - 2. Oligohydramnios is
presented during ultrasonography. What is necessary to do to prevent uterine inertia?
Therapeutic rest
Augmentation by oxytocin
Fetal distress prevention
Induction by prostaglandins
Amniotomy
Patient F., 28 years old is hospitalized with complaints of irregular painful uterine contractions
which have been presented for 10 hours. Longitudinal lie, cephalic presentation is diagnosed in
Leopold’s maneuvers. Fetal heart rate is rhythmic, 136 bpm. Uterine cervix is 3,5cm long, dense,
the external os is closed in vaginal examination. What is the correct diagnosis:
False labour
First stage of labor
Second stage of labor
Discoordinative uterine activity
Pathological preterm labour
Patient M., 39 years old is hospitalized with complaints of irregular painful uterine contractions
during11 hours. Longitudinal lie, cephalic presentation is diagnosed. Fetal heart rate is rhythmic,
160 bpm. Uterine cervix is 3,0cm long, dense, the external os is closed in vaginal examination.
The most appropriate treatment would be:
Therapeutic rest
Induction by oxytocin
Fetal distress prevention
Induction by prostaglandins
Amniotomy
38 years old primipara is hospitalized with complaints of regular uterine contractions every 5-6
minutes by 10-15 seconds. She is in labor for 11 hours. Uterine contractions become weaker. She is
exhausted. Fetal lie is longitudinal, fetal head is fixated to pelvic inlet. Fetal heart rate is rhythmic,
140 bpm. In obstetric exam cervical dilation is 1 cm. Amniotic sac is intact. What is the adequate
management of patient?
Therapeutic rest
Augmentation of labor by oxytocin
Amniotomy
Augmentation of labor by prostaglandins
Fetal destroying operation
78.
A.
B.
C. *
D.
E.
79.
A.
B. *
C.
D.
E.
80.
A. *
B.
C.
D.
E.
81.
A. *
B.
C.
D.
E.
82.
A. *
B.
C.
D.
E.
83.
21 years old primipara is hospitalized with complaints of regular uterine contractions every 5-6
minutes by 20 seconds and general weakness. She is in labor for 9 hours. She is exhausted. Fetal lie
is longitudinal, fetal head is fixated to pelvic inlet. Fetal heart rate is rhythmic, 140 bpm. In obstetric
exam cervical dilation is 2 cm. Amniotic sac is presented. Therapeutic rest is prescribed for her. What
you should do firstly after patient awakening?
Spasmolytics prescriptions
Augmentation of labor by oxytocin
Amniotomy
Augmentation of labor by prostaglandins
Fetal destroying operation
28 years old primipara undergoes for therapeutic rest and amniotomy as a result of uterine inertia.
What is the next step in your management?
Spasmolytics prescriptions
Augmentation of labor by oxytocin
Tokolytics prescriptions
Augmentation of labor by prostaglandins
Fetal destroying operation
26 years old primipara is hospitalized with complaints of regular uterine contractions every 5-6
minutes by 20-25 seconds. She is in labor for 14 hours. She undergo for therapeutic rest and
amniotomy. Which drug belongs to the first line medication for labor’ augmentation?
Oxytocin
Miphepristone
Misoprostol
Duphaston
Carboprost
40 years old primapara is presented on 42-43 week of pregnancy. Uterine contractions are weak.
Fetal head is arrested to pelvic inlet. Vasten sign is positive. Fetal heart rate is 140 bmp, rhythmic.
Cervical dilation is 6 cm. Cranial bones are dense, sagittal suture is not palpated. What is the
management of labor?
Caesarean section
Amniotomy
Forceps delivery
Labor induction
Vacuum application
40 years old primapara is presented on 42-43 week of pregnancy. Uterine contractions are weak.
Fetal head is arrested to pelvic inlet. Vasten sign is positive. Fetal heart rate is 140 bmp, rhythmic.
Cervical dilation is 6 cm. Cranial bones are dense, sagittal suture is not palpated. Which complication
is presented?
Cephalo-pelvic disproportion
Fetal distress
Uterine inertia
False labor
Hypertonic uterine dysfunction
40 years old primapara is presented on 42-43 week of pregnancy. Uterine contractions are weak.
Fetal head is arrested to pelvic inlet. Vasten sign is positive. Fetal heart rate is 140 bmp, rhythmic.
Cervical dilation is 7 cm. Cranial bones are dense, sagittal suture is not palpated. What is the reason
of labor complication?
A. *
B.
C.
D.
E.
84.
A. *
B.
C.
D.
E.
85.
A.
B.
C. *
D.
E.
86.
A.
B. *
C.
D.
E.
87.
A. *
B.
C.
D.
Postterm pregnancy
Deflexed presentation
Breech presentation
Multiple pregnancy
Polyhydramnios
39 years old primapara at 40 week of pregnancy is admitted to the hospital with complaints of regular
uterine contractions every 2- 3minutes by 45 seconds. Longitudinal fetal lie, cephalic presentation
was diagnosed. Vasten sign is positive. Fetal heart rate is 142 in 1min, clear, rhythmic. The sizes of
pelvis are normal. Probable fetal weight is 4200 g. Uterine cervix is dilated to 8 cm, edematous.
Amniotic membranes are absent. Fetal head is above the pelvic inlet. Promontorium is not reached.
What is the adequate management of labor?
Immediate cesarean section
Fetal destroying operation
Medical treatment
Augmentation of labor
Spasmolytic prescription
39 years old primapara at 40 week of pregnancy is admitted to the hospital with complaints of regular
uterine contractions every 2- 3minutes by 45 seconds. Longitudinal fetal lie, cephalic presentation
were diagnosed. Vasten sign is positive. Fetal heart rate is 142 in 1min, clear, rhythmic. The sizes of
pelvis are normal. Probable fetal weight is 4200 g. Uterine cervix is dilated to 8 cm, edematous.
Amniotic membranes are absent. Fetal head is above the pelvic inlet. Promontorium is not reached.
Which of the below pelvic sizes are considered to be normal for such woman?
20-22-24-29cm
22-22-24-28cm
25-28-30-20cm
28-28-30-20cm
23-24-25-26cm
37 years old primapara at 41 week of pregnancy is admitted to the hospital with complaints of regular
uterine contractions every 2- 3minutes by 45 seconds. Longitudinal fetal lie, cephalic presentation
were diagnosed. Vasten sign is positive. Fetal heart rate is 142 in 1min, clear, rhythmic. The sizes of
pelvis are normal. Probable fetal weight is 4200 g. Uterine cervix is dilated to 8 cm, edematous.
Amniotic membranes are absent. Fetal head is above the pelvic inlet. Promontorium is not reached.
Positive Vasten sign suggest about:
Adequate cervical dilation
Cephalo-pelvic disproportion
Uterine inertia
Uterine rupture
Hypertonic uterine dysfunction
39 years old primapara at 39 week of gestation is admitted with complaints of regular uterine
contractions every 2- 3minutes by 45 seconds. Lie of the fetus is longitudinal, cephalic presentation.
Vasten sign is positive. Fetal heart rate is 136 beats per minute, rhythmic. Pelvic sizes are normal.
Probable fetal weight is 4100g. Uterine cervix is dilated to 9 cm, edematous. Amniotic membranes
are absent. Fetal head is above the pelvic inlet. Promontorium is not reached. Which complication
has been occurred in labor?
Clinical contracted pelvis
Uterine rupture
Fetal distress
Uterine inertia
E.
88.
A. *
B.
C.
D.
E.
89.
A.
B.
C.
D. *
E.
90.
A.
B. *
C.
D.
E.
91.
A.
B.
C.
D.
E. *
92.
A. *
B.
C.
D.
E.
General contracted pelvis
A 29 years old woman at 38 weeks of gestation complaints of regular contractions. Pelvic sizes:
25-28-30-21cm. The patient is found to have 100% effaced cervix and 3 cm cervical dilation.
Diagonal conjugate has 13cm. Which type of the pelvis is presented in the patient?
Normal pelvis
General contracted pelvis
Simple flat pelvis
Flat rachitic pelvis
Transverse contracted pelvis
A 21 years old woman at 40 weeks of gestation woman presents with complaints of pain in the lower
abdomen. Pelvic sizes: 26 – 26 – 30 - 21 cm. Uterine contractions are regular and last every 5
minutes by 20seconds. The patient is found to have 100 % effaced cervix for 1 cm dilated. Diagonal
conjugate has 11cm. Which type of the pelvis is presented in this patient?
Normal pelvis
General contracted pelvis
Simple flat pelvis
Flat rachitic pelvis
Transverse contracted pelvis
29 years old woman at 32 week of gestation woman presents with complaints of regular uterine
contractions. Pelvic sizes: 23 – 25 – 29 - 18 cm. Uterine contractions are regular and last every 5
minutes by 20seconds. The patient is found to have 100 % effaced cervix for 2 cm dilated. Diagonal
conjugate has 11cm. Which type of the pelvis is presented in this patient?
Normal pelvis
General contracted pelvis
Simple flat pelvis
Flat rachitic pelvis
Transverse contracted pelvis
29 years old woman at 35 week of gestation woman presents with complaints of regular uterine
contractions. Pelvic sizes: 23 – 25 – 29 - 18 cm. Solovjov index is 14 cm. Uterine contractions are
regular and last every 5 minutes by 20seconds. The patient is found to have 100 % effaced cervix for
2 cm dilated. How many centimeters do obstetric conjugate have?
15cm
14cm
13cm
11cm
9cm
29 years old woman at 35 week of gestation woman presents with complaints of regular uterine
contractions. Pelvic sizes: 23 – 25 – 29 - 18 cm. Solovjov index is 14 cm. Uterine contractions are
regular and last every 5 minutes by 20seconds. The patient is found to have 100 % effaced cervix for
2 cm dilated. Which degree of pelvic contraction does the patient have?
I
II
III
IV
V
93.
A 21 years old woman at 40 weeks of gestation woman presents with complaints of pain in the lower
abdomen. Pelvic sizes: 26 – 26 – 30 - 21 cm. Uterine contractions are regular and last every 5
minutes by 20seconds. Solovjov index is 15cm. The patient is found to have 100 % effaced cervix for
1 cm dilated. Diagonal conjugate has 13cm. How much centimeters does obstetric conjugate have?
A.
15cm
14cm
13cm
11cm
9cm
A 24 years old primipara was hospitalized with complaints of irregular painful uterine
contractions. The uterus is tonic on palpation. The position of the fetus is longitudinal, fetal head is
fixated to pelvic inlet. Fetal heart rate is rhythmic, 140 bpm. Vertical size of Michaelis rhomb has
11cm, and transverse has 10cm. In obstetric exam cervix of the uterus is 2,5 cm long, dense, the
external cervical os is closed. How much centimeters does obstetric conjugate have?
11
10
8
7
6
A 24 years old primipara was hospitalized with complaints of irregular painful uterine contractions.
The uterus is tonic on palpation. The position of the fetus is longitudinal, fetal head is fixated to
pelvic inlet. Fetal heart rate is rhythmic, 140 bpm. Vertical size of Michaelis rhomb has 10cm, and
transverse has 9cm. In obstetric exam cervix of the uterus is 2,5 cm long, dense, the external cervical
os is closed. How much centimeters does obstetric conjugate have?
11
10
8
7
6
B.
C.
D. *
E.
94.
A. *
B.
C.
D.
E.
95.
A.
B. *
C.
D.
E.
96.
A.
B.
C. *
D.
E.
97.
A. *
B.
C.
N., 21 years old, primapara, 38 weeks of pregnancy. The labor started 5 hours ago. The membranes
ruptured 2 hours ago. Pelvic sizes: 22,24,29,19 cm. Solovjov index is 14 cm. Fetal head rate 140 per
minute with satisfactory characteristics. Per vaginum: the cervix is 6 cm dilated. The amniotic sac is
absent. Diagonal conjugate is 10 cm. Fetal buttocks are palpated in the pelvic inlet. Which type of the
pelvis does the woman have?
Simple flat pelvis
Flat rachitic pelvis
General contracted pelvis
Osteomalatic pelvis
Transverse contracted pelvis
K., 23 years old, primapara, 39 weeks of pregnancy. The labor started 5 hours ago. The membranes
ruptured 2 hours ago. Pelvic sizes: 22,24,29,19 cm. Solovjov index is 14 cm. Fetal head rate 140 per
minute with satisfactory characteristics. Cervix is 6 cm dilated in vaginal examination. The amniotic
sac is absent. Diagonal conjugate is 10 cm. Fetal buttocks are palpated in the pelvic inlet. Which
degree of pelvic contraction does the woman have?
I
II
III
D.
E.
98.
A.
B.
C.
D.
E. *
99.
A.
B. *
C.
D.
E.
100.
A.
B. *
C.
D.
E.
101.
A.
B. *
C.
D.
E.
102.
A.
B. *
C.
IV
Normal pelvic sizes
N., 21 years old, primapara, 39 weeks of pregnancy. The labor has been started 6 hours ago. The
membranes ruptured 2 hours ago. Pelvic sizes: 25,28,31,20 cm. Solovjov index is 14 cm. Fetal heart
rate is 140 per minute with satisfactory characteristics. Cervix is 6 cm dilated in vaginal examination.
The amniotic sac is presented. Diagonal conjugate is 13 cm. Fetal head is presented at – 1 station.
Which type of the pelvis does the woman have?
Simple flat pelvis
Flat rachitic pelvis
General contracted pelvis
Osteomalatic pelvis
Normal pelvis
39-years old primapara at 38 week of gestation complaints of regular uterine contractions every 3
minutes by 25 seconds. Fetal head is presented at – 2 station. Fetal head rate 140 per minute with
satisfactory characteristics. Uterine cervix is 6 cm dilated in vaginal examination. The amniotic
sac is presented. Diagonal conjugate is 13 cm. At the sacrococcygeal region 2cm exostosis is
presented. What is management of labor?
Spontaneous vaginal delivery
Cesarean section
Obstetric forceps
Vacuum extraction
Fetal destroying operation
A woman with obliquely dislocated pelvis in her 40th week of pregnancy, first labor has regular birth
activity. Uterine contractions are every 3 minutes by 25 seconds. Fetal head is presented at – 2
station. Fetal heart rate is 140 per minute with satisfactory characteristics. Cervix is 6 cm dilated in
vaginal examination. The amniotic sac is presented. Diagonal conjugate has 13 cm. What is
management of labor?
Spontaneous vaginal delivery
Cesarean section
Obstetric forceps
Vacuum extraction
Fetal destroying operation
A woman with obliquely contracted pelvis has regular birth activity. Uterine contractions take place
every 3 minutes by 30 seconds. Fetal head is presented at – 2 station. Fetal heart rate is 140 per
minute with satisfactory characteristics. Cervix is 7 cm dilated. The amniotic sac is present.
Diagonal conjugate is 11 cm. What is management of labor?
Spontaneous vaginal delivery
Cesarean section
Obstetric forceps
Vacuum extraction
Fetal destroying operation
25 years old woman at 38 week of gestation woman presents with complaints of regular uterine
contractions. Pelvic sizes: 23 – 25 – 29 - 17 cm. Solovjov index is 14 cm. Uterine contractions are
regular and last every 5 minutes by 20seconds. The patient is found to have 100 % effaced cervix for
4 cm dilated. Which degree of pelvic contraction does the patient have?
I
II
III
D.
E.
103.
A.
B.
C. *
D.
E.
104.
A.
B.
C. *
D.
E.
105.
A.
B. *
C.
D.
E.
106.
A.
B. *
C.
D.
E.
107.
A.
B.
C.
IV
V
21 years old woman at 40 week of gestation woman presents with complaints of regular uterine
contractions. Pelvic sizes: 22 – 24 – 27 - 16 cm. Solovjov index is 14 cm. Uterine contractions are
regular and last every 5 minutes by 20seconds. The patient is found to have 100 % effaced cervix for
5 cm dilated. Which degree of pelvic contraction does the patient have?
I
II
III
IV
V
21 years old woman at 40 week of gestation woman presents with complaints of regular uterine
contractions. Pelvic sizes: 22 – 24 – 27 - 16 cm. Solovjov index is 14 cm. Uterine contractions are
regular and last every 5 minutes by 20seconds. The patient is found to have 100 % effaced cervix for
5 cm dilated. What is best management of labor?
Vacuum extraction
Forceps application
Cesarean section
Vaginal delivery
Fetal destroying operation
M., 28 years old, para 2. Full term of pregnancy. Initiation of labor was 8 hours ago. The membranes
ruptured 20 minutes ago. Pelvic sizes: 25, 28, 31, 20 cm. Vasten sign is positive. Fetal heart rate is
132 per minute with satisfactory characteristics. Uterine cervix is is 9cm dilated in vaginal
examination. The amniotic sac is absent. Fetal head is in in the pelvic inlet. The chin is palpated near
sacral region. What is the best management of labor?
Spontaneous vaginal delivery
Cesarean section
Obstetric forceps
Vacuum extraction
Fetal destroying operation
F., 29 years old, para 2. Full term of pregnancy. Labor has been started 8 hours ago. The membranes
ruptured 20 minutes ago. Pelvic sizes: 25, 28, 31, 20 cm. Fetal heart rate is 132 per minute with
satisfactory characteristics. Vasten sign is positive. Uterine cervix is 9cm dilated. The amniotic sac
is absent. Fetal head is in in the pelvic inlet. The chin is palpated near sacral region. Which
complication is presented in the patient?
General contracted pelvis
Clinical contracted pelvis
Fetal distress
Primary uterine inertia
Secondary uterine inertia
F., 29 years old, para 2. Full term of pregnancy. Labor has been started 8 hours ago. The membranes
ruptured 20 minutes ago. Pelvic sizes: 25, 28, 31, 20 cm. Fetal heart rate is 132 per minute with
satisfactory characteristics. Vasten sign is positive. Uterine cervix is 9cm dilated. The amniotic sac
is absent. Fetal head is in in the pelvic inlet. The chin is palpated near sacral region. What is the
reason of cephalo-pelvic disproportion?
General contracted pelvis
Uterine inertia
Cephalic presentation
D.
E. *
108.
A.
B. *
C.
D.
E.
109.
A. *
B.
C.
D.
E.
110.
Breech presentation
Face presentation
M., 22 years old, nullipara. Full term of pregnancy. Labor has been started 8 hours ago. The
membranes ruptured are intact. Pelvic sizes: 25,28,31,20 cm. Fetal heart rate is 140 per minute with
satisfactory characteristics. Per vaginum: the cervix is 8 cm dilated. The amniotic sac is persent. Fetal
head is in the plane of inlet. Face line is in the right oblique size, the chin is palpated near sacral
region of the symphysis. Which complication is presented in the patient?
General contracted pelvis
Cephalopelvic disproportion
Fetal distress
Primary uterine inertia
Secondary uterine inertia
M., 25 years old, nullipara. Full term of pregnancy. Labor has been started 9 hours ago. The
membrane is intact. Pelvic sizes: 25,28,31,20 cm. Vasten sign is positive. Fetal heart rate is 140 per
minute with satisfactory characteristics. Cervix is 9 cm dilated in vaginal examination. The amniotic
sac is presented. Fetal head is in the plane of inlet. Face line is in the right oblique size, the chin is
palpated near sacral region of the symphysis. What is the reason of cephalopelvic disproportion?
Face anterior presentation
General contracted pelvis
Face posterior presentation
Sinciput vertex presentation
Brow presentation
Primipara N., 25 years old. Delivery at term. The labor started 6 hours ago. The membranes ruptured
1 hour ago. Pelvic sizes: 23,26,29,19 cm. Solovjov index is 15cm. Fetal heart rate is 140 per minute
with satisfactory characteristics. Uterine contractions occur every 4-5 minutes. The probable fetal
weight by Volskov is 4200 g. Uterine cervix dilatation is 7 cm. The amniotic sac is absent. Fetal head
is -1 station. Sagittal suture is in the right oblique size. Small and large fontanels are palpated. The
large fontanel is under the symphysis. Which degree of pelvic contraction is presented in woman?
A. *
B.
C.
I
II
III
D.
E.
111.
IV
V
Primipara N., 25 years old. Delivery at term. The labor started 6 hours ago. The membranes ruptured
1 hour ago. Pelvic sizes: 23,26,29,19 cm. Solovjov index is 15cm. Fetal heart rate 140 per minute
with satisfactory characteristics. Uterine contractions occur every 4-5 minutes. The probable fetal
weight by Volskiy is 4200 g. Uterine cervix dilatation is 8 cm. The amniotic sac is absent. Fetal head
is -1 station. Sagittal suture is in the right oblique size. Small and large fontanels are palpated. The
large fontanel is under the symphysis. Which complication is presented in labor?
Cephalopelvic disproportion
Uterine inertia primary
Uterine inertia secondary
Uterine rupture
Discoordinative uterine activity
A. *
B.
C.
D.
E.
112.
A.
B.
C.
D.
E. *
113.
A.
B.
C.
D. *
E.
114.
A.
B.
C.
D. *
E.
115.
A.
B.
C.
D. *
E.
116.
A.
B.
C.
D.
E. *
Pregnant N., 25 weeks of pregnancy. During the last 2 months complains of general weakness,
violation of taste, the promoted fragility of hair and nails. Uterine height is 20cm above the
symphysis. Laboratory findings: erythrocytes - 2,8x10 12/ L, Hb - 98 G/L. The most common fetal
complication would be:
Macrosomia
Avitaminosis
Izoimmunisation
Asphyxia
Fetal growth retardation
26 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate
is 60 beats per minute. Cervical dilation is 10cm, amniotic fluid are absent, fetal head is presented at
+2 station at vaginal examination. The most likely diagnosis is:
Preterm labor
Uterine inertia
Preeclampsia
Fetal distress
Breech presentation
26 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate
is 60 beats per minute. Cervical dilation is 10cm, amniotic fluid are absent, fetal head is presented at
+2 station at vaginal examination. The appropriate management is:
Augmentation of labor
Spasmolytics prescription
Corticosteroids prescriptions
Obstetric forceps application
Cesarean section
28 years old patient is presented in the second stage of labor. Uterine contractions are every 1-2
minutes by 50-55 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate
is 70 beats per minute. Cervical dilation is 10cm, amniotic fluid are absent, fetal head is presented at
+3 station at vaginal examination. The appropriate management is:
Augmentation of labor
Spasmolytics prescription
Corticosteroids prescriptions
Vacuum application
Cesarean section
32 years old patient is presented in the first stage of labor. Uterine contractions are every 4 minutes
by 25-30 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate is 60
beats per minute. Cervical dilation is 2 cm, amniotic fluid is absent, fetal head is presented at -2
station at vaginal examination. The appropriate management is:
Augmentation of labor
Spasmolytics prescription
Corticosteroids prescriptions
Obstetric forceps application
Cesarean section
117.
A.
B.
C.
D. *
E.
118.
A.
B.
C.
D. *
E.
119.
A.
B.
C.
D. *
E.
120.
A.
B.
C.
D.
E. *
121.
A. *
B.
C.
D.
E.
36 years old patient is presented in the second stage of labor. Uterine contractions are every 2
minutes by 45-50 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate
is 60 beats per minute. Cervical dilation is 10cm, amniotic fluid is absent, fetal head is presented at
+1 station at vaginal examination. The most likely diagnosis is:
Preterm labor
Uterine inertia
Preeclampsia
Fetal distress
Breech presentation
39 years old patient is presented in the second stage of labor. Uterine contractions are every 1-2
minutes by 50-55 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate
is 70 beats per minute. Cervical dilation is 10cm, amniotic fluid is absent, fetal head is presented at
+1 station at vaginal examination. The appropriate management is:
Augmentation of labor
Spasmolytics prescription
Corticosteroids prescriptions
Vacuum application
Cesarean section
33 years old patient is presented in the second stage of labor. Uterine contractions are every 1-2
minutes by 50-55 seconds. Fetal lie is longitudinal, cephalic presentation is presented. Fetal heart rate
is 70 beats per minute. What you should do firstly?
Augmentation of labor
Spasmolytics prescription
Corticosteroids prescriptions
Vaginal examination
Cesarean section
Patient F., 33 years old is admitted to Pathologic Pregnancy department at 36 week of gestation. She
complaints of general weakness, dizziness, increasing of fetal activity. Uterine fundus height is
situated at the level of the umbilicus. Fetal lie is longitudinal, cephalic presentation is diagnosed.
Fetal heart rate is 124 beats per minute. The most likely diagnosis is:
Multiple pregnancy
Oligohydramnios
Fetal hypoxia
Fetal distress
Fetal growth retardation
Patient F., 33 years old is admitted to Pathologic Pregnancy department at 36 week of gestation. She
complaints of general weakness, dizziness, increasing of fetal activity. Uterine fundus height is
situated at the level of the umbilicus. Fetal lie is longitudinal, cephalic presentation is diagnosed.
Fetal heart rate is 124 beats per minute. Appropriate studies to be performed would be:
Biophysical profile, umbilical cord Doppler
Fetal cells for karyotyping
Fetal echocardiography
Amniotic fluid alpha-fetoprotein
Cervical culture
122.
A. *
B.
C.
D.
E.
123.
A. *
B.
C.
D.
E.
124.
A. *
B.
C.
D.
E.
125.
A. *
B.
C.
D.
E.
126.
A.
B.
C.
D.
E. *
Patient M., 35 years old is admitted to Pathologic Pregnancy department at 35 week of gestation. She
complaints of general weakness, increasing of fetal activity. Uterine fundus height is situated 2 cm
above umbilicus. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart rate is 136
beats per minute. Biophysical profile test score is 10. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient M., 35 years old is admitted to Pathologic Pregnancy department at 36 week of gestation. She
complaints of general weakness, increasing of fetal activity. Uterine fundus height is situated 3 cm
above umbilicus. Fetal lie is longitudinal, breech presentation is diagnosed. Fetal heart rate is 136
beats per minute. Biophysical profile test score is 9. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient L., 30 years old is admitted to Pathologic Pregnancy department at 30 week of gestation. She
complaints of general weakness, increasing of fetal activity. Uterine fundus height is situated 4 cm
above umbilicus. Fetal lie is longitudinal, breech presentation is diagnosed. Fetal heart rate is 160
beats per minute. Biophysical profile test score is 8. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient L., 30 years old is admitted to Pathologic Pregnancy department at 30 week of gestation. She
complaints of general weakness, increasing of fetal activity. Uterine fundus height is situated 4 cm
above umbilicus. Fetal lie is longitudinal, breech presentation is diagnosed. Fetal heart rate is 160
beats per minute. Biophysical profile test score is 8. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient S., 34 years old is admitted to Pathologic Pregnancy department at 32 week of gestation. She
complaints of weak fetal activity. Uterine fundus height is situated 4 cm above umbilicus. Fetal lie is
transverse. Fetal heart rate is 160 beats per minute. Biophysical profile test score is 6. Your
Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
127.
A.
B.
C.
D.
E. *
128.
A.
B.
C. *
D.
E.
129.
A.
B.
C. *
D.
E.
130.
A.
B.
C. *
D.
E.
131.
A.
B.
C. *
D.
E.
132.
Patient W., 29 years old is admitted to Pathologic Pregnancy department at 33 week of gestation. She
complaints of weak fetal activity. Uterine fundus height is situated 4 cm above umbilicus. Fetal lie is
transverse. Fetal heart rate is 160 beats per minute. Biophysical profile test score is 5. Your
Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient W., 39 years old is admitted to Pathologic Pregnancy department at 34 week of gestation with
moderate degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 4 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 160 beats per minute.
Biophysical profile test score is 4. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient K., 38 years old is admitted to Pathologic Pregnancy department at 35 week of gestation with
moderate degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 5 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 160 beats per minute.
Biophysical profile test score is 3. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient A., 41 years old is admitted to Pathologic Pregnancy department at 36 week of gestation with
severe degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 2 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 124 beats per minute.
Biophysical profile test score is 2. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient Z., 41 years old is admitted to Pathologic Pregnancy department at 36 week of gestation with
severe degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 2 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 124 beats per minute.
Biophysical profile test score is 1. Your Biophysical Profile is considered to be:
Normal
Decreased
Abnormal
Pathologic
Equivocal
Patient W., 39 years old is admitted to Pathologic Pregnancy department at 35 week of gestation with
moderate degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 4 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 160 beats per minute.
Biophysical profile test score is 4. Appropriate management of the patient is:
A.
B.
C. *
D.
E.
133.
A.
B.
C. *
D.
E.
134.
A.
B.
C. *
D.
E.
135.
A.
B.
C. *
D.
E.
136.
A.
B.
C.
D. *
E.
137.
A.
B.
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Fetal heart rate monitoring
Tocolytic prescription
Patient K., 38 years old is admitted to Pathologic Pregnancy department at 35 week of gestation with
moderate degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 5 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 160 beats per minute.
Biophysical profile test score is 3. Appropriate management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Fetal heart rate monitoring
Tocolytic prescription
Patient A., 41 years old is admitted to Pathologic Pregnancy department at 36 week of gestation with
severe degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 2 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 124 beats per minute.
Biophysical profile test score is 2. Appropriate management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Fetal heart rate monitoring
Tocolytic prescription
Patient Z., 41 years old is admitted to Pathologic Pregnancy department at 36 week of gestation with
severe degree of preeclampsia. She complaints of weak fetal activity. Uterine fundus height is
situated 2 cm above umbilicus. Fetal lie is longitudinal. Fetal heart rate is 124 beats per minute.
Biophysical profile test score is 1. Appropriate management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Fetal heart rate monitoring
Tocolytic prescription
Patient S., 34 years old is admitted to Pathologic Pregnancy department at 35 week of gestation. She
complaints of weak fetal activity. Uterine fundus height is situated 4 cm above umbilicus. Fetal lie is
transverse. Fetal heart rate is 160 beats per minute. Biophysical profile test score is 6. Appropriate
management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Repeat test within 24hours
Tocolytic prescription
Patient W., 29 years old is admitted to Pathologic Pregnancy department at 36 week of gestation. She
complaints of weak fetal activity. Uterine fundus height is situated 4 cm above umbilicus. Fetal lie is
transverse. Fetal heart rate is 160 beats per minute. Biophysical profile test score is 5. Appropriate
management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
C.
D. *
E.
138.
A.
B.
C. *
D.
E.
139.
A.
B.
C. *
D.
E.
140.
A.
B. *
C.
D.
E.
141.
A.
B. *
C.
D.
E.
142.
Immediate delivery
Repeat test within 24hours
Tocolytic prescription
33 Patient years old is admitted to Pathologic Pregnancy department at 36 week of gestation. She
complaints of general weakness. Uterine fundus height is situated 2 fingers above umbilicus. Left
occipital anterior presentation is diagnosed. Fetal heart rate is 110 beats per minute. Reversed blood
flow is diagnosed at umbilical cord Doppler. Appropriate management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Repeat umbilical cord Doppler within 2 days
Tocolytic prescription
32 Patient years old is admitted to Pathologic Pregnancy department at 36 week of gestation. She
complaints of general weakness. Uterine fundus height is situated 2 fingers above umbilicus. Left
occipital anterior presentation is diagnosed. Fetal heart rate is 110 beats per minute. Blood flow is
absent at umbilical cord Doppler. Appropriate management of the patient is:
Metabolic drugs prescription
Corticosteroids prescription
Immediate delivery
Repeat umbilical cord Doppler within 2 days
Tocolytic prescription
Patient Q., 32 years old is admitted to Pathologic Pregnancy department at 32 week of gestation.
Signs of moderate preeclampsia are diagnosed in the patient. Longitudinal lie, cephalic presentation
is diagnosed. Fetal heart rate is 160 beats per minute. Bishop score cervical evaluation has 4 points.
Blood flow is absent at umbilical cord Doppler during 3 days monitoring. Corticosteroids have been
prescribed for her. Biophysical profile test score is 4. Appropriate management of the patient is:
Metabolic drugs prescription
Cesarean section immediately
Vaginal delivery
Repeat biophysical profile within 24hours
Tocolytic prescription
Patient X., 32 years old is admitted to Pathologic Pregnancy department at 32 week of gestation.
Signs of moderate preeclampsia are diagnosed in the patient. Longitudinal lie, cephalic presentation
is diagnosed. Fetal heart rate is 160 beats per minute. Bishop score cervical evaluation has 4 points.
Reversed blood flow is diagnosed at umbilical cord Doppler during 3 days monitoring.
Corticosteroids have been prescribed for her. Biophysical profile test score is 3. Appropriate
management of the patient is:
Metabolic drugs prescription
Cesarean section immediately
Vaginal delivery
Repeat biophysical profile within 24hours
Tocolytic prescription
Patient N., 33 years old is presented in the first stage of labor. Uterine contractions are every 3
minutes by 35-40 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 100 beats per minute. During fetal heart rate monitoring pathological decelerations have been
diagnosed. Cervical dilation is 4cm, amniotic membranes are intact, fetal head is presented at -2
station at vaginal examination. Sagittal suture is located in the left oblique diameter of the pelvic
inlet; posterior fontanel is to the left posteriorly. Appropriate management of the patient is:
A.
B. *
C.
D.
E.
143.
A. *
B.
C.
D.
E.
144.
A.
B. *
C.
D.
E.
145.
A.
B.
C. *
D.
E.
146.
A.
B.
C.
D. *
E.
Metabolic drugs prescription
Cesarean section immediately
Vaginal delivery
Biophysical profile
Umbilical cord Doppler
Patient N., 33 years old is presented in the first stage of labor. Uterine contractions are every 3
minutes by 35-40 seconds. Fetal lie is longitudinal, cephalic presentation is diagnosed. Fetal heart
rate is 100 beats per minute. During fetal heart rate monitoring pathological decelerations have been
diagnosed. Cervical dilation is 4cm, amniotic membranes are intact, fetal head is presented at -2
station at vaginal examination. Sagittal suture is located in the left oblique diameter of the pelvic
inlet; posterior fontanel is to the left posteriorly. Your diagnosis:
Fetal distress
Fetal hypoxia
Placental dysfunction
Fetal growth retardation
Placental insufficiency
Patient Q., 42 years old is admitted to Pathologic Pregnancy department at 33 week of gestation with
mild preeclampsia. Longitudinal lie, cephalic presentation is diagnosed. Fetal heart rate is 100 beats
per minute. Bishop score cervical evaluation has 4 points. Blood flow is absent at umbilical cord
Doppler during 3 days monitoring. Corticosteroids have been prescribed for her. Biophysical profile
test score is 6. Appropriate management of the patient is:
Metabolic drugs prescription
Cesarean section immediately
Vaginal delivery
Repeat umbilical cord Doppler within 24hours
Tocolytic prescription
Pregnant B, 20 years, complaints of weak fetal movement. Pregnancy 38 weeks. Uterine
contractions are absent. The fetal heart rate is 170 bpm. The estimation of the biophysical profile of
the fetus is 6 points. Appropriate management of the pregnant is:
Fetal distress therapy
Cesarean section immediately
Hospitalisation, repeat the biophysical profile within 24 hours
Amniocentesis
Fetal heart rate monitoring
Primapara C., is presented in the first stage of labor which has been started 10 hours ago. Suddenly
she complains of releasing green colored amniotic fluid with meconium. Uterine contractions are
every 3 minutes by 35 seconds. Longitudinal lie, breech presentation is diagnosed. Fetal heart rate is
90 beats per minute. Pathologic decelerations are presented during fetal heart rate monitoring. Cervix
is dilated to 4 cm at vaginal examination. Buttocks are presented. Appropriate management of the
patient is:
Forceps application
Vacuum extraction
Breech extraction
Cesarean section
Fetal heart rate monitoring
147.
A.
B.
C. *
D.
E.
148.
A.
B.
C.
D.
E. *
149.
A.
B.
C. *
D.
E.
150.
A. *
B.
C.
D.
E.
151.
A. *
B.
C.
D.
Multipara with pelvis sizes 25-28-31-20 cm is presented in labor. Pushing efforts are every 2 minutes
by 45 seconds. Longitudinal lie, cephalic presentation is diagnosed. The fetal hear rate is green
colored, arrhythmic 80 bpm. At vaginal examination the cervix is totally dilated, Amniotic sac is
absent. fetal head is presented in +2 station. Sagittal suture is in anteroposterior diameter of the pelvic
outlet. What is the best management of this situation?
Caesarean section
Vacuum extraction of the fetus
Obstetric forceps
Conservative tactics of labor
Stimulation of the labor activity
25 years old multipara woman is in the second labor for 12hours. Fetal lie is longitudinal, breech
presentation is presented. Heartbeat of fetus is arrhythmic, 80beats per min. Cervix of uterus is
completely dilated, fetal buttocks are on the pelvic floor. What is the best management of such
obstetric situation?
Use of obstetric forceps
Augmentation of labor
Cesarean section
Vacuum extraction
Breech extraction
Pregnant C., 26 years, entered maternity department with regular uterine contractions. Term of
pregnancy 39 weeks. Abdominal circumference - 126 cm, uterine fundus height – 41 cm. The fetal lie
is longitudinal, breech presentation. Uterus in normal tonus. The fetal heart rate is 130 in 1 min,
rhythmic. Vaginally: cervical dilatation is full, vagina is filled by an amniotic sac. During
examination about 5 L of amniotic fluid came out, buttocks are in the pelvic cavity. Diagnosis?
Large fetus. Breech presentation
Multifetal pregnancy. Incomplete presentation of the I fetus
Franc breech presentation. Polyhydramnion
Polyhydramnion. Complete breech presentation
Polyhydramnion
A patient in a term 37 weeks of pregnancy was admitted to female dispensary. Patient feels the fetal
motions in all abdomen. Abdomen is increased due to a pregnant uterus. Circumference of abdomen 122 cm, level of uterine fundus - 40 cm. 2 round and firm parts of the fetus is palpated [to the right at
the level of umbilicus and in the uterine fundus]. Presenting part is mobile above the pelvic inlet.
Fetal heart rate is listened to in many points, 140 in 1 min, rhythmic. What is most probable
diagnosis?
Multifetal pregnancy
Hydramnion
Pregnancy and myoma of uterus
Molar pregnancy
Large fetus
Pregnant visited the doctor with complaints about the sharp increase of volume of abdomen after the
acute infection. Abdominal circumference – 98 cm, uterine fundus height 36 cm. Fetal lie is
longitudinal, the fetal head is -3 station, mobile. The fetal heart rate 120 in 1 min. What medical
treatment is conducted?
Medical treatment by antibiotics
Medical treatment by diuretics
Medical treatment is contraindicated
Medical treatment bycardiac drugs
E.
152.
A.
B.
C.
D.
E. *
153.
A. *
B.
C.
D.
E.
154.
A.
B. *
C.
D.
E.
155.
A.
B.
C.
D.
E. *
156.
A.
B.
C.
D.
Medical treatment by hypotensive drugs
Pregnancy A, multiple, 15-16 weeks of gestation. The table of contents of alpha-fetoprotein in the
blood of pregnant exceeds a norm. How to interpret the anomalous level of alpha-fetoprotein in this
case?
Violation of osteogenesis.
Defect of the fetal neural tube.
Fetal anomalies.
Necrosis of liver.
The sign of multifetal pregnancy
At a woman 28 years at the second labor a 3400 g girl was born with anemia and increasing icterus.
Blood type at a woman B(ІІІ) Rh-, at the father of new-born B(ІІІ) Rh+, at newborn B(ІІІ) Rh+.
What is the most credible diagnosis?
Rh-izoimmunization.
Conflict on an antigen A.
Conflict on an antigen B.
Conflict on an antigen AV.
Infection
The pregnant S. was admitted in pathologic of pregnant department. Pregnancy ІІ, 37 weeks.
Complaints about the gradual enlargement of abdominal sizes after viral infection. Circumference of
abdomen – 110 cm, uterine height – 36 cm. The fetal lie is longitudinal, cephalic presentation, head
of the rounded shape, dense, above the pelvic inlet. The fetal heart rate is clear, rhythmic 130 in 1
min. The diagnosis: chronic polyhydramnion. Which antibiotics of the first line used for medical
treatment?
Doxycycline
Erythromycin
Amoxill
Gentamycin
Clyndamycin
Patient in 37 weeks of pregnancy was presented in female dispensary. An abdomen is enlarged due to
a pregnant uterus. Abdominal circumference - 122 cm, uterine height - 40 cm. Two great parts of
fetus are palpated to the right and to the left at the level of umbilicus. Presenting part is not
determined. The fetal heart rate is auscultating in many points at the level of umbilicus, 140 and 130
in 1 min, rhythmic. What is the diagnosis?
Fetal macrosomia
Polyhydramnion
Pregnancy and uterine fibromioma
Molar pregnancy
Multifetal pregnancy
122. The pregnant Х. in 32 weeks of pregnancy visited the doctor of female dispensary with
complaints about the increasing of abdominal volume after the acute infection a week ago. The
patient’ condition is satisfactory, the edema are absent. The abdominal circumference is 98 cm,
uterine fundus level – 36 cm. The fetal lie is longitudinal, the fetal head as in 32 weeks of pregnancy,
above the pelvic inlet, mobile. The fetal heart rate 120 in 1 min. What pathology is presented?
Multifetal pregnancy
Chronic polyhydramnion
Breech position of fetus
Transversal position of fetus
E. *
157.
A. *
B.
C.
D.
E.
158.
A.
B. *
C.
D.
E.
159.
A.
B.
C. *
D.
E.
160.
A.
B.
C.
D.
E. *
161.
A.
B.
Acute polyhydramnion
133. Primipara F., 24 years old. Multiply pregnancy at term. The labor started 6 hours ago. The
membranes are intact. Pelvic sizes: 25,28,31,21 cm. In Leopolds maneuvers – longitudinal lie of both
fetuses, breech presentation of the first fetus and cephalic – of the second one. Fetal heart rates 140
per minute with satisfactory characteristics. Uterine contractions occur every 7-8 minutes. Per
vaginum: the uterine cervix dilatation is 5 cm. The amniotic sac is absent. Buttocks of the first fetus
is presented. Which type of breech presentation is presented?
Multiply pregnancy. The frank breech presentation of the first fetus.
Multiply pregnancy. Complete breech presentation of the first fetus.
Multiply pregnancy. Complete foot-ling presentation of the first fetus.
Multiply pregnancy. Incomplete foot-ling presentation of the first fetus.
Multiply pregnancy. Knee-ling presentation of the first fetus.
134. Primipara F., 24 years old. Multiply pregnancy at term. The labor started 6 hours ago. The
membranes are intact. Pelvic sizes: 25,28,31,21 cm. In Leopolds Maneuvers – longitudinal lie of both
fetuses, breech presentation of the first fetus and cephalic – of the second one. Fetal heart rates 140
per minute with satisfactory characteristics. Uterine contractions occur every 7-8 minutes. Per
vaginum: the uterine cervix dilatation is 5 cm. The amniotic sac is absent. Buttocks of the first fetus
is presented. What is the management of labor?
Manual aid by Tsovianov II
Cesarean section
Subtotal breech extraction
Classic manual aid
Total breech extraction
The woman is admitted to the maternity home with discontinued uterine contractions and slight
bloody discharges from the vagina. The condition is severe, skin is pale, and consciousness is
confused. BP – 80/40 mm Hg. Fetal heart rate of the fetus is absent. Lover uterine segment is painful.
There was a cesarean section one year ago. What is the clinical diagnosis:
Placental abruption
Placental presentation
Uterine rupture
Premature expulsion of the amniotic fluids
Couveler uterus
25-years old pregnant woman at 32 weeks of gestation is admitted to the hospital with complaints of
bloody discharge like spotting. Placenta previa is diagnosed during ultrasonography. The uterine
tone is normal, fetal heart rate is 136 beats per minute. What is the best management of the pregnant
woman?
Induction of labor by prostaglandins
Blood transfusion
Induction of labor by oxytocin
Cesarean section.
Tranexamic acid prescription, female monitoring for the intensity of hemorrhage and fetal wellbeing,
dexamethasone administration
Pregnant N., 25 years is delivered in the maternity department with complaints of periodic pain in
lower part of abdomen and lumbar region. Bloody discharge has appeared one hour before. Fetal
heart rate is 136 in 1min. At vaginal examination: the uterine cervix is effaced, 6-7 cm dilated.
Spongy tissue is palpated laterally. Blood loss is 250 ml and continues. Your management.
Stimulation of labor
Amniotomy
C.
D.
E. *
162.
A.
B.
C. *
D.
E.
163.
A.
B.
C. *
D.
E.
164.
A.
B.
C. *
D.
E.
165.
A. *
B.
C.
D.
E.
166.
A.
B.
C.
D. *
Obstetric forceps
The fetal destroying operation
Cesarean section
Sharp pain in the uterine fundus with profuse bleeding has appeared in the in primapara during the
first stage of labor. Uterus is in hypertonus. Fetal heart rate is 200 beats per minute. Uterine cervix
is effaced, and 4 cm dilated on vaginal examination. Blood was presented in amniotic fluid during
amniotomy. Your management.
Labor induction
Treatment of fetal distress
Cesarean section immediately
Tocolytics prescription
Coagulants prescription
Sharp pain in the uterine fundus with profuse bleeding has appeared in the in primapara during the
first stage of labor. Uterus is in hypertonus. Fetal heart rate is 200 beats per minute. Uterine cervix
is effaced, and 4 cm dilated on vaginal examination. Blood was presented in amniotic fluid during
amniotomy. Your diagnosis.
Low lying placenta
Placenta previa
Placenta abruption
Hypertonic dysfunction
DIC-syndrome
Uterine contractions have stopped suddenly in 25 years old patient after excessive uterine
contractions. Vasten sign is positive. Bloody excretions are presented. Fetal heart rate is absent. The
condition of patient suddenly became worse, BP went down to 70 mm Hg, pulse 140 in a 1 minute, a
skin is pale. What is the reason such condition?
Threatened rupture of uterus
Placenta abruption
Uterine rupture
Couveler uterus
Placenta previa
Postpartum patient 28 years. 3800 grams girl was born. Placenta was delivered as a result of active
management of the placenta. Bleeding continues. Cervical and vaginal lacerations are absent.
Ruptured vessels are presented during inspection of the placenta. What is the management of this
situation?
To perform manual exploration of uterine cavity
Total hysterectomy
Contractile drugs prescription
External massage of uterus
Antishock garment application
25 years old woman is admitted to the hospital on a 38 week of pregnancy with regular uterine
contractions and bloody discharge from vagina. The uterine cervix is effaced and 4 cm dilated, soft
spongy tissue is presented. Bleeding increased in vaginal examination. What is the reason of bleeding
increasing?
Amniotic fluid embolism
Bleeding from the rupture of uterine cervix
Premature removing of the normally located placenta
Complete placenta previa
E.
167.
A.
B. *
C.
D.
E.
168.
A.
B. *
C.
D.
E.
169.
A.
B.
C.
D. *
E.
170.
A.
B. *
C.
D.
E.
171.
DIC - syndrome
Patient at 39 week of gestation is admitted to the hospital with complaints of sudden acute pain in
upper part of abdomen, dizziness, bleeding from vagina. The uterine contractions are regular. Skin
and visible mucus membranes are pale, BP 80/50 mm Hg, pulse 126 per minute. Painful infiltrate is
palpated in the fundal area. Fetal heart rate is 170, arrhythmic. At vaginal examination the uterine
cervix is effaced and 5 cm dilated, amniotic membranes are presented, parts of placenta are not
determined. Fetal head is at -2 station. Bloody discharges are visible. What is the most likely
diagnosis?
Uterine rupture
Placenta abruption
Placenta previa
Hypotonic uterine contraction
The uterine tetanus
Patient at 39 week of gestation is admitted to the hospital with complaints of acute pain in lower
abdomen, dizziness, and bloody discharge from vagina. The uterine contractions are regular every5
minutes by 40 seconds, amniotic membranes are intact. Objectively: skin and visible mucus
membranes are pale, BP 80/50 mm Hg, pulse is 126 beats per minute. Uterus is dense. Painful
infiltrate is determined on the fundus. Fetal heart rate is 170, arrhythmic. At vaginal examination:
cervix is effaced and dilated to 4cm, amniotic membranes are presented, parts of placenta are not
determined, fetal head of is at -2 station. Bleeding discharge without clots is presented. What is
the management of this situation?
Therapeutic rest
Cesarean section
Oxytocin prescription
Fetal destroying operation
Uterine curettage
Multipara. Uterine contractions occur every 4-5 hours by 25 seconds. Bloody excretions began at
once after appearance of contractions. Fetal heart rate is 100-110 beats per minute . Uterine cervix is
effaced and dilated till 6 cm, placenta tissue is presented totally. Diagnosis?
Threatening rupture of uterus.
Couveler uterus
Partial placenta previa
Complete placenta previa.
Placenta abruption
Multipara. Uterine contractions occur every 4-5 hours. Bloody excretions began at once after
appearance of contractions. Fetal heart rate 100-110 in min. At vaginal examination the uterine cervix
is effaced and dilated till 6 cm. In the cervix placental tissue is determined. What will be adequate
management?
Therapeutic rest
Cesarean section
Oxytocin prescription
Fetal destroying operation
Uterine curettage
Labor started at 39 weeks of pregnancy. There was one induced abortion, which was complicated by
endometritis in the past. At active management of labor placenta doesn’t separated. Considerable
bloody excretions appeared at an attempt to do the manual separation of placenta. The blood loss is
600 ml. An attempt of manual separation of placenta from the uterus was not successful. What is the
doctor’ management?
A. *
B.
C.
D.
E.
172.
A.
B. *
C.
D.
E.
173.
A.
B.
C. *
D.
E.
174.
A.
B.
C. *
D.
E.
175.
A.
B.
C. *
D.
E.
176.
A.
B.
C. *
D.
E.
177.
A. *
Hysterectomy
Uterine curettage
To continue the manual separation of placenta
Vasoconstrictors prescription
Contractile drugs prescription
Massive hypotonic uterine bleeding began after labor by dead child in postpartum period. The blood
loss was reached to 1600ml. Venous bleeding was presented. Thrombocytes level was 80 x10 9/l.
There were hemorrhages from the places of injections. Which stage of DIC-syndrome was developed
at postpartum patient?
I
III
II
V
IV
The girl by 3100g weight was delivered in 35 years old patient. During active management of labor
placenta doesn’t separated from uterine cavity. What is the most probable diagnosis?
Hypertonus of uterus
Placenta previa
Placenta accreta
Uterine rupture
Uterine atony
The boy by 3700g was delivered in 36 years old woman. During active management of labor
placenta doesn’t separated from uterine cavity. What is the most probable diagnosis?
Hypertonus of uterus
Placenta previa
Abnormal placenta adherence
Uterine rupture
Uterine atony
The boy by 3300g was delivered in 36 years old woman. During active management of labor
placenta doesn’t separated from uterine cavity. What is the most probable diagnosis?
Hypertonus of uterus
Placenta previa
Placenta increta
Uterine rupture
Uterine atony
The boy by 3300g was delivered in 36 years old woman. During active management of labor
placenta doesn’t separated from uterine cavity. What is the most probable diagnosis?
Hypertonus of uterus
Placenta previa
Placenta percreta
Uterine rupture
Uterine atony
Widespread extravasation of blood into the uterine wall was revealed during cesarean section which
was performed as a result of placenta abruption. The uterus is soft, hypotonic bleeding was presented.
The uterus had a purplish appearance, owing to such extravasation of blood. Diagnosis?
Couveler’s uterus
B.
C.
D.
E.
178.
A.
B.
C.
D.
E. *
179.
A. *
B.
C.
D.
E.
180.
A.
B.
C.
D. *
E.
181.
A.
B. *
C.
D.
E.
182.
A.
B.
C. *
D.
E.
Placenta previa
Uterine atony
Placenta abruption
Inevitable abortion
Widespread extravasation of blood into the uterine wall was revealed during cesarean section which
was performed as a result of placenta abruption. The uterus is soft, hypotonic bleeding was presented.
The uterus had a purplish appearance, owing to such extravasation of blood. Your initial management
is:
Total Hysterectomy
Blood transfusion
Subtotal hysterectomy
Uterine curettage
Pabal prescription, ligation of the a. iliac internal
Widespread extravasation of blood into the uterine wall was revealed during cesarean section. The
uterus is soft, hypotonic bleeding was presented. The uterus had a purplish appearance, owing to such
extravasation of blood. What was the indication to cesarean section in the patient?
Placenta abruption
Ectopic pregnancy
Low lying placenta
Molar pregnancy
Breech presentation
Widespread extravasation of blood into the uterine wall was revealed during cesarean section which
was performed as a result of placenta abruption. The uterus is soft, hypotonic bleeding was presented.
The uterus had a purplish appearance, owing to such extravasation of blood. Which dose of pabal
(Carbetocin) should be prescribed initially for the patient?
10 mkg
25 mkg
50 mkg
100mkg
1000 mkg
42 years old patient was admitted to the maternity hospital in 38 weeks of gestation with bloody
discharge like spotting. Complete placenta previa was revealed at ultrasound. Uterine cervix is
closed in vaginal examination. What is the adequate management of labor?
Augmentation of labor
Cesarean section
Fetal destroying operation
Obstetric forceps application
Vacuum extraction
30-years old edematous patient is admitted to the hospital in the second stage of labor. Fetal head is
in the pelvic outlet. Profuse hemorrhage have appeared suddenly. Fetal heart rate is 80 beats per
minute. What is the adequate management of labor?
Cesarean section
Fetal heart rate monitoring
Obstetric forceps
Episiotomy
Induction of labor
183.
A. *
B.
C.
D.
E.
184.
A. *
B.
C.
D.
E.
185.
A. *
B.
C.
D.
E.
186.
A.
B.
C.
D. *
E.
187.
A. *
B.
C.
D.
E.
188.
A.
B. *
C.
D.
30-years old edematous patient is admitted to the hospital in the second stage of labor. Fetal head is
in the pelvic outlet. Profuse hemorrhage have appeared suddenly. Fetal heart rate is 80 beats per
minute. What is the most probable diagnosis?
Placenta abruption
Placenta previa
Uterine atony
Couveler uterus
Placenta increta
The bleeding began right after childbirth. The blood loss is 300 ml. In active management of third
stage of labor placenta is nor separated. Signs of the placental separation are negative. What is the
most probable diagnosis?
Subtotal placenta adherens
Total placenta adherens
Couveler’s uterus
Placenta previa
Placenta abruption
The bleeding began right after childbirth. The blood loss is 550 ml. What is the most appropriate
management?
Manual separation of placenta and exploration of the uterine cavity
Prescription of contractile drugs
Total hysterectomy
Uterine curretage
Uterine artery ligation
On the 6 day of the postpartum period a 26 years-old woman complaints of profuse bleeding from
vagina. Pelvic examination reveals 23-24 weeks increased uterus with clots inside. During
examination bloody discharge increases. Diagnosis?
Total placenta adherens
Subtotal placenta adherens
Couveler’s uterus
Late postpartum hemorrhage
Placenta previa
On the 6 day of the postpartum period a 26 years-old woman complaints of profuse bleeding from
vagina. Pelvic examination reveals 22-23 weeks increased uterus with clots inside. During
examination bloody discharge increases. What is the most appropriate management of this situation?
Uterine curettage
Uterine artery ligation
Total hysterectomy
Manual exploration of the uterine cavity
Prescription of contractile drugs
4500g infant was delivered in 42 years old patient. Placenta was delivered by active management. All
membranes and parts of the placenta were presented during inspection. Blood loss was 350 ml.
After 5 min bloody excretions increased. At external uterine massage uterus did not contract well,
was soft and large. Diagnosis?
Placental abruption
Atonic bleeding
Uterine rupture
Couveler’s uterus
E.
189.
A.
B.
C.
D. *
E.
190.
A.
B.
C.
D. *
E.
191.
A.
B.
C.
D. *
E.
192.
A.
B.
C. *
D.
E.
193.
A.
B. *
C.
D.
Rupture of the cervix
First pregnancy 35 week of gestation. Woman complaints of spotting from the vagina. Blood loss
is 50 ml. Uterine tone is normal. Fetal heart rate is clear, rhythmic, 136 beats per minute. Head of the
fetus is mobile above the pelvic inlet. Uterine cervix is closed. What is the initial management of the
patient?
Bed rest
Cesarean section immediately
Amniotomy
Bed rest, hemostatic agents
Bed rest, adequate tokolysis
First pregnancy 32week of gestation. Woman complaints of spotting from the vagina. Blood loss is
50 ml. Uterine tone is normal. Fetal heart rate is clear, rhythmic, 136 beats per minute. Head of the
fetus is mobile above the pelvic inlet. Uterine cervix is closed. What is the initial management of the
patient?
Bed rest
Cesarean section immediately
Amniotomy
Bed rest, hemostatic, corticosteroids prescriptions
Bed rest, adequate tokolysis
First pregnancy 33 week of gestation. Woman complaints of spotting from the vagina. Blood loss
is 50 ml. Uterine tone is normal. Fetal heart rate is clear, rhythmic, 136 beats per minute. Head of the
fetus is mobile above the pelvic inlet. Uterine cervix is closed. What is the aim of corticosteroids
prescription?
Anti-inflammatory
Hemostatic
Sedative
Prevention of respiratory distress syndrome
Adequate tokolysis
Massive postpartum bleeding has developed in 34 years old patient with twins. Placenta is intact.
Vagina and perineum are without lacerations. Uterine fundus is 5cm above the umbilicus, soft.
What is the most likely reason of bleeding?
Couveler uterus
Uterine rupture
Uterine atony
Placenta abruption
DIC - syndrome
Patient is admitted to the hospital with regular uterine contractions. During hospitalization the
condition is satisfactory, pulse - 84 in 1 min, BP - 150/90 and 160/90 mm of Hg. Suddenly patient
complains of severe pain in abdomen, general weakness, and dizziness. Pulse - 120 in min, AT 80/40 and 90/45 mm Hg. Uterus is tense, very painful. Fetal heart rate is not auscultated. Uterine
cervix is effaced, 5 cm dilated at vaginal examination. Amniotic membrane is whole, tense. The head
is in the pelvic inlet. Insignificant bloody discharge has appeared from vagina. What is the most
likely diagnosis?
Uterine rupture
Placental abruption
Amniotic fluid embolism
Molar pregnancy
E.
194.
A.
B.
C. *
D.
E.
195.
A.
B. *
C.
D.
E.
196.
A.
B. *
C.
D.
E.
197.
A. *
B.
C.
D.
E.
198.
A.
B.
C.
D. *
E.
199.
Placenta previa
Considerable bloody discharge has appeared at 30week of gestation in 35 years old patient. Total
placenta previa is diagnosed during ultrasonography. General blood loss is 500 ml and bleeding
continues. What is the management?
Tocolitics prescription
Cervical cerclage
Cesarean section immediately
Hemostatics
Vaginal delivery
The bleeding began right after childbirth. The blood loss was 300 ml. In attempt to remove placenta
during traction it did not separate. Doctors’ tactics.
Cesarean section
Manual removal of placenta
Cerclage
Total hysterectomy
Ligation of uterine vessels
28 years old pregnant women complains of vaginal bleeding at 40 weeks. Fetal heart rate is 140
BPM. The results of the obstetrics examination: cervix is incompletely effaced, 3 cm dilated, the
placental tissue is palpated. Diagnosis?
Abnormal placenta adherence
Complete placenta previa
Uterine atony
Uterine rupture
Placental abruption
28 years old pregnant women complaints of vaginal bleeding at 40 week of gestation. Fetal heart
rate is 140 BPM. The results of the obstetrics examination: cervix is incompletely effaced, 4 cm
dilated, the placental tissue is palpated. Management?
Cesarean section
Manual removal of placenta
Cerclage
Total hysterectomy
Ligation of ovarian vessels
29 years old woman at 39 weeks of pregnancy complaints of small amount of bloody discharge till 50
ml and regular uterine contractions which have been started 5 hours ago. Fetal head rate is 132 per
minute with satisfactory characteristics. Cervix is dilated till 5 cm in obstetric examination The
amniotic sac is present. Fetal head is in plane of pelvic inlet. The edge of the placenta lies adjacent to
the internal os. Diagnosis?
Abnormal placenta adherence
Complete placenta previa
Uterine atony
Incomplete placenta previa
Placental abruption
30 years old primapara at 39 week of pregnancy complaints of small amount of bloody discharge and
regular uterine contractions which have been started 5 hours ago. Fetal head rate 132 per minute with
satisfactory characteristics. At obstetric exam cervix is dilated till 2 cm. The amniotic sac is present.
Fetal head is in plane of pelvic inlet. The edge of the placenta lies adjacent to the internal os. Blood
loss is 300 ml and continues. What is the best management of labor?
A. *
B.
C.
D.
E.
200.
A. *
B.
C.
D.
E.
201.
A. *
B.
C.
D.
E.
202.
A. *
B.
C.
D.
E.
203.
A.
B.
C.
D. *
E.
204.
A.
B.
C.
D. *
E.
Cesarean section
Manual removal of placenta
Amniotomy, oxytocin prescription
Total hysterectomy
Ligation of ovarian vessels
21 years old, primapara at 38 week of pregnancy complaints of profuse bleeding till 400ml.
Contractions are regular. At obstetric exam cervix is dilated till 4 cm. The amniotic sac is present.
Fetal head is in plane of pelvic inlet. The leading edge of the placenta is 2 cm from the internal
cervical os. What is the best management of labor?
Cesarean section
Manual removal of placenta
Amniotomy, oxytocin prescription
Total hysterectomy
Ligation of ovarian vessels
34 years old, primapara at 37 week of pregnancy complaints of small amount of bloody discharge.
Contractions are irregular. Fetal heart rate is 132 per minute with satisfactory characteristics. At
obstetric exam cervix is closed. The leading edge of the placenta is 1 cm from internal cervical os.
What is the management of the pregnancy?
Cesarean section
Manual removal of placenta
Amniotomy, oxytocin prescription
Total hysterectomy
Ligation of ovarian vessels
What is the first step in postpartum hemorrhage treatment?
Call for help
Insert intravenous access
Recognize circulatory problem. Administer for face oxygen mask
Abdominal examination to confirm uterus well contracted
Vaginal examination for laceration
30 years old undergoes spontaneous delivery of a 3900 g boy. 10 units of oxytocin were
administered. After successful umbilical cord traction placenta was delivered. Placental tissue is
expelled with umbilical cord, but vaginal hemorrhage ensues immediately thereafter. The placenta is
clearly not intact. What are appropriate immediate interventions in this situation?
Total hysterectomy
Subtotal hysterectomy
Uterine curettage
Manual exploration of uterine cavity
External uterine massage
30 years old undergoes spontaneous delivery of a 3900 g boy. 10 units of oxytocin were
administered. After successful umbilical cord traction placenta was delivered. Placental tissue is
expelled with umbilical cord, but vaginal hemorrhage ensues immediately thereafter. The placenta is
clearly not intact. What is the most probable diagnosis?
Placenta accreta
Placenta increta
Placenta percreta
Retained placenta tissue
Placenta previa
205.
A. *
B.
C.
D.
E.
206.
A. *
B.
C.
D.
E.
207.
A. *
B.
C.
D.
E.
208.
A.
B.
C.
D.
E. *
209.
A.
B.
C. *
D.
E.
210.
A 30-year-old pregnant was admitted to a maternity hospital with interm pregnancy. She complains
of severe pain in the uterus that started 1 hour ago, nausea, vomiting, cold sweat. Cesarean section
was performed 2 years ago. Uterine contractions have stopped. Skin and mucous membranes are
pale. Heart rate is 100/min. BP is 90/60 mm Hg. Uterus is sharply painful. Fetal heart rate is not
auscultated. Moderate bloody discharge from the uterus is observed. Uterus cervix is 4 cm open.
Presenting part is not palpated. The most probably diagnosis is:
Uterine rupture
Placenta previa
Placenta abruption
Premature separation of normally localized placenta
Compression of inferior pudendal vein
Examination of a just delivered placenta reveals 2x3cm defect. Vaginal bleeding is presented. Your
initial management:
Manual exploration of uterine cavity
Abduladze method
Crede's method
Uterine curettage
Oxytocin intravenously
Examination of a just delivered placenta reveals 2x3cm defect. Vaginal bleeding is absent. Your
initial management:
Manual exploration of uterine cavity
Abduladze method
Crede's method
Uterine curettage
Oxytocin intravenously
Examination of a just delivered placenta reveals 2x3cm defect. Vaginal bleeding is presented.
Manual exploration of the uterine cavity is indicated. Which method of anesthesia you would
choose?
You don’t need anesthesia
Intrauterine
Paravaginal
Paracervical
Intravenous
36 years old multipara at 41 week of pregnancy complaints of vaginal bleeding like spotting.
Contractions are regular. At obstetric exam cervix is dilated till 5 cm. The amniotic sac is present.
Fetal head is in the pelvic inlet. The leading edge of the placenta is 4 cm from the internal cervical os
at ultrasonography. What is the best management of labor?
Cesarean section
Manual removal of placenta
Amniotomy, oxytocin prescription
Total hysterectomy
Ligation of ovarian vessels
32 years old multipara at 40 week of pregnancy complaints of vaginal bleeding like spotting.
Contractions are every 3-4 minutes by 30 seconds. Cervix is dilated to 6 cm during vaginal
examination. Amniotic membranes are intact. Fetal head is in the pelvic inlet. The leading edge of the
placenta is 3 cm from the internal cervical os at ultrasonography. What is the best management of
labor?
A.
B.
C. *
D.
E.
211.
A. *
B.
C.
D.
E.
212.
A.
B.
C.
D.
E. *
213.
A.
B. *
C.
D.
E.
214.
A.
B.
C.
D.
Cesarean section
Manual removal of placenta
Amniotomy, oxytocin prescription
Total hysterectomy
Ligation of ovarian vessels
29 years old primapara at 38 week of pregnancy is admitted to the hospital with complaints of bloody
discharge, general weakness and regular uterine contractions which have been started 5 hours ago. In
examination pulse is 100 beats per minute, BP – 100/60 and 95/55 mm of Hg. Uterus is tense, very
painful in the fundal area. Fetal heart rate is not auscultated. Uterine cervix is effaced, 5 cm dilated at
vaginal examination. Amniotic membranes are intact. The head is in the pelvic inlet. Blood loss
reaches 1000ml. Which degree of hemorrhagic shock is presented in the patient?
I
II
III
IV
V
29 years old primapara at 38 week of pregnancy is admitted to the hospital with complaints of bloody
discharge, general weakness and regular uterine contractions which have been started 5 hours ago. In
examination pulse is 100 beats per minute, BP – 100/60 and 95/55 mm of Hg. Uterus is tense, very
painful in the fundal area. Fetal heart rate is not auscultated. Uterine cervix is effaced, 5 cm dilated at
vaginal examination. Amniotic membranes are intact. The head is in the pelvic inlet. Blood loss
reaches 1000ml.What is the general amount of infusion therapy should be prescribed?
500ml
1000ml
1500ml
2000ml
2500ml
34 years old primapara at 40 week of pregnancy is admitted to the hospital with profuse vaginal
bleeding, loss of consciousness. In examination pulse is 120 beats per minute, BP – 80/60 and
75/55 mm of Hg. Uterus is tense, very painful in the fundal area. Fetal heart rate is not auscultated.
Uterine cervix is effaced, 6 cm dilated at vaginal examination. Amniotic membranes are intact. The
head is in the pelvic inlet. Blood loss reaches 1500ml. Which degree of hemorrhagic shock is
presented in the patient?
I
II
III
IV
V
34 years old primapara at 40 week of pregnancy is admitted to the hospital with profuse vaginal
bleeding, loss of consciousness. In examination pulse is 120 beats per minute, BP – 80/60 and
75/55 mm of Hg. Uterus is tense, very painful in the fundal area. Fetal heart rate is not auscultated.
Uterine cervix is effaced, 6 cm dilated at vaginal examination. Amniotic membranes are intact. The
head is in the pelvic inlet. Blood loss reaches 1500ml. What is the general amount of infusion
therapy should be prescribed?
500ml
1000ml
1500ml
2000ml
E. *
215.
A.
B.
C.
D. *
E.
216.
A. *
B.
C.
D.
E.
217.
A.
B.
C. *
D.
E.
218.
A.
B.
C. *
D.
E.
219.
A.
B.
C.
D. *
E.
220.
3000ml
A primigravid client at 37 weeks' gestation has been hospitalized for several days with severe
preeclampsia. While caring for the client, the physician observes that the client is beginning to have a
seizure. Which of the following actions should the physician do first?
Pad the side rails of the client's bed.
Turn the client to the right side.
Insert a padded tongue blade into the client's mouth.
Call for immediate assistance in the client's room.
Catheterize central vein
The husband of a client, who at 24 weeks' gestation has been admitted to the hospital for
preeclampsia, screams to the physician that his wife just had a seizure. The physician's immediate
action should be to:
Turn the client's head to the side
Place an airway into the client's mouth
Check the client for a spontaneous birth
Assess the fetal heart rate for decelerations
Monitor uterine contraction
A 29-year-old multigravid client at 37 weeks' gestation is being treated for severe preeclampsia. She
has magnesium sulfate infusing at 3 grams per hour. Before administering IV magnesium sulfate
therapy the physician should assess the client's:
Temperature and respirations
Urinary glucose and specific gravity
Urinary output and patellar reflexes
Level of consciousness and funduscopic appearance
Fetal heart rate and cervical dilatation
A client with preeclampsia is admitted to the labor and birthing suite. Her blood pressure is 130/90
mm Hg, she has 2+ protein in her urine, and edema of the hands and face. As part of the admission
history, the physician should ask the client about:
Constipation, edema, visual problems, and headache
Visual disturbances, headache, constipation, and bleeding
Headache, visual disturbances, edema, and abdominal pain
Leakage of amniotic fluid, bleeding, edema, and abdominal pain
Increase urinary output, edema, and abdominal pain
A 24-year-old primigravid client at 38 weeks' gestation is admitted to the labor and birthing suite.
Her blood pressure is 170/130 mm Hg, she has 3+ protein in her urine, and edema of the hands and
face. Severe preeclampsia was diagnosed and given an IV infusion of magnesium sulfate. The
physician recognizes that magnesium sulfate is being given primarily because it is a:
Hypotensive that relaxes smooth muscles
Cholinergic that increases the release of acetylcholine
Muscle relaxant that decreases the severity of uterine contractions
Central nervous system depressant that blocks neuromuscular transmissions
Source of microelements
The physician on the high-risk unit assesses a 20-year-old primigravid client at 38 weeks' gestation
admitted with severe preeclampsia. Her blood pressure is 190/140 mm Hg, she has 4+ protein in her
urine, and edema of the hands and face. The client has audible crackles in the lower left lobe, slight
blurring of vision in the right eye, and epigastric discomfort. Which sign or symptom would most
likely indicate the potential for a seizure?
A.
B.
C. *
D.
E.
221.
A.
B.
C. *
D.
E.
222.
A.
B.
C. *
D.
E.
223.
A. *
B.
C.
D.
E.
224.
A.
B.
C.
D. *
E.
225.
A.
B.
Audible crackles
Blurring of vision
Epigastric discomfort
Generalized facial edema
Uterine contraction
The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the
Pitocin infusion, the physician reviews the woman's latest laboratory test findings that reveal a
platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit.
What is lab results are indicative for?
Eclampsia
Disseminated intravascular coagulation
HELLP syndrome
Idiopathic thrombocytopenia
Thrombophilia
A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe
preeclampsia for 24 hours. On assessment, the physician finds the following vital signs: temperature
of 37.3° C, pulse rate of 88 beats per minute, respiratory rate of 10 breaths per minute, blood pressure
of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The client complains, “I'm so
thirsty and warm.” The physician:
Calls for a stat magnesium sulfate level
Administers oxygen
Discontinues the magnesium sulfate infusion
Prepares to administer hydralazine
Measure level of proteinuria
A woman with severe preeclampsia has been receiving magnesium sulfate by intravenous infusion
for 8 hours for preeclampsia. The physician assesses the woman and documents the following
findings: temperature of 37.1° C, pulse rate of 96 beats per minute, respiratory rate of 24 breaths per
minute, blood pressure of 155/112 mm Hg, 3+ deep tendon reflexes, and no ankle clonus. Which
prescriptions should be done?
Hydralazine
Magnesium sulfate bolus
Diazepam
Calcium gluconate
Furosemide
A woman at 39 weeks' gestation with a history of PIH is admitted to the labor and birth unit. She
suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal
bleeding, and a tense, painful abdomen. The physician suspects the onset of:
Eclamptic seizure
Rupture of the uterus
Placenta previa
Abruptio placentae
Term delivery
A client has been on magnesium sulfate for 20 hours for treatment of preeclampsia. She just
delivered a viable infant girl 30 minutes ago. What uterine findings would you expect to
observe/assess in this client?
Absence of uterine bleeding in the postpartum period
Fundus firm below the level of the umbilicus
C.
D. *
E.
226.
A.
B.
C.
D. *
E.
227.
A.
B.
C.
D. *
E.
228.
A.
B. *
C.
D.
E.
229.
A.
B.
C. *
D.
E.
230.
A.
B.
C. *
D.
E.
231.
A.
Scant lochia flow
A boggy uterus with heavy lochia flow
Prolong placenta separation
A 17-year-old primigravida 36 weeks’ gestation has gained 1.9 kg since her last prenatal visit 2
weeks ago. Her blood pressure is 140/92. The most important action is to:
caution her to avoid salty foods and to return in 2 weeks.
advise her to cut down on fast foods that are high in fat.
recommend she stay home from school for a few days to reduce stress.
assess weight gain, location of edema, and urine for protein.
perform vaginal examination and auscultation o fetal heart rate/
A 22-year-old primigravida 38 weeks’ gestation is admitted to the labor and birth unit. On
assessment, the physician finds the following vital signs: temperature of 36.6° C, pulse rate of 90
beats per minute, respiratory rate of 16 breaths per minute, blood pressure of 180/135 mm Hg. A
magnesium sulfate infusion for treatment of severe preeclampsia was prescribed. 2 hours late signs of
magnesium sulfate toxyсity were diagnosed. Which medication should be prescribed
Furosemide
Hydralzine
Nifedipine
Calcium gluconate
Diazepam
Louise Perkins is admitted to the hospital at 32 weeks' gestation with a diagnosis of severe
preeclampsia. Ms. Perkins receives intravenous infusion of 4 grams of magnesium sulfate. What is
the purpose of magnesium sulfate for this client?
to lower blood pressure
to prevent seizures
to inhibit labor
to block dopamine receptors
to stimulate labor
Louise Perkins is admitted to the hospital at 32 weeks' gestation with a diagnosis of severe
preeclampsia. Ms. Perkins receives intravenous infusion of 4 grams of magnesium sulfate. When
assessing Mg s. Perkins's deep tendon reflexes (DTRs), the physician notes that they are 2+. What is
the implication of this finding?
The client needs a higher dose of magnesium sulfate.
The client needs a lower dose of magnesium sulfate.
A therapeutic level of magnesium sulfate has been reached.
Magnesium sulfate should be discontinued.
it is not influence on continuous if magnesium sulfate infusion
A client at 32 weeks' gestation who has pregnancy-induced hypertension is attending the prenatal
clinic for the routine checkup. The first sign of fluid retention suggestive of this complication is:
Abdominal enlargement
Facial swelling
Sudden weight gain
Swelling of the feet and ankles
General edema
A client at 36 weeks' gestation who has pregnancy-induced hypertension is present in the prenatal
clinic. She has all the signs below. What is the most dangerous symptom?
Diarrhea
B.
C. *
D.
E.
232.
A. *
B.
C.
D.
E.
233.
A. *
B.
C.
D.
E.
234.
A.
B.
C. *
D.
E.
235.
A.
B.
C. *
D.
E.
236.
A.
B.
C.
D. *
E.
Decreased urine output
Blurred vision
Backache
Facial swelling
The patient who is 28 weeks pregnant with chronic hypertension visit for routine checkup. What is
the main recommendation physician should give her?
Activity restriction
Balanced nutrition
Increased fluid intake to ensure adequate hydration
Instruction about the effect of diuretics
Increased nutrition
A client at 36 weeks' gestation who has severe preeclampsia was prescribed intravenous magnesium
sulfate infusion. Which assessment should be performed during this infusion?
Count respirations and report a rate of less than 12 breaths per minute.
Count respirations and report a rate of more than 20 breaths per minute.
Check blood pressure and report a rate of less than 100/60.
Monitor urinary output and report a rate of less than 100 ml per hour.
Monitor reflexes and report increased reflexes
At 32 weeks' gestation, a 15-year-old primgravida client who is 1.57 m tall has gained a total of 9 kg,
with a 450g gain in the last 2 weeks. Urinalysis reveals negative glucose and a trace of protein.
Which of the following factors increases this client's risk for preeclampsia?
Total weight gain.
Short stature.
Adolescent age group.
D. Proteinuria.
E. Gestational age
A 32-year-old multigravida returns to the clinic for a routine prenatal visit at 36 weeks' gestation. She
has had a prior pregnancy with pregnancy induced hypertension. The assessments during this visit
include BP 140/90, Ps 80, and + 2 edema of the ankles and feet. Based on the client's past history and
current assessment, what further infor_mation should the physician obtain to determine if this client
is becoming preeclamptic?
Headaches.
Blood glucose level.
Proteinuria.
Edema in lower extremities.
Gestational age of previous pregnancy when preeclampsia was diagnosed
A primigravid client's baseline blood pressure at her initial visit at 12 weeks' gestation was 110/70
mm Hg. During an assessment at 38 weeks' gestation, which of the following data would indicate
mild preeclampsia?
Blood pressure of 160/110 mm Hg on two separate occasions.
Proteinuria, more than 5 g in 24 hours.
Serum creatinine concentration of 1.4 ml/dl.
Weight gain of 900g in the last week.
Swelling of the feet and ankles
237.
A.
B.
C.
D. *
E.
238.
A. *
B.
C.
D.
E.
239.
A.
B. *
C.
D.
E.
240.
A.
B. *
C.
D.
E.
241.
A.
B.
C. *
D.
E.
242.
A. *
B.
During a routine checkup of a 16-year-old client at 34weeks' gestation diagnosed with mild
preeclampsia, assessment reveals that the client has gained 900 g in the past week and her current
blood pressure is 130/85 mm Hg. Which of the following assessment findings would provide further
evidence to support the client's diagnosis?
Pounding headache after reading.
History of urinary tract infection.
Frequent voiding in large amounts.
Mild edema in hands and face.
Blood pressure last week 140/85 mm Hg
A 17-year-old client at 33 weeks' gestation diagnosed with mild preeclampsia is prescribed bed rest.
The physician instructs the client to contact the nurse immediately if she experiences which of the
following?
Blurred vision.
Ankle edema.
Increased energy levels.
Mild backache.
General weakness
One week after her prenatal visit, a primigravid client at 38 weeks' gestation diagnosed with mild
preeclampsia calls the clinic physician complaining of a continuous headache for the past 2 days
accompanied by nausea. The client does not want to take aspirin. Which of the following responses
by the physician would be most appropriate?
"Take two acetaminophen tablets. They aren't as likely to upset your stomach."
"You should be examined today. Come to the clinic this morning."
"You need to lie down and rest. Have you tried placing a cool compress over your head?"
"Take aspirin with codeine.”
"Don’t worry. Sometimes pregnant woman feels headache."
When reviewing the prenatal records of a 16-year-old primigravid client at 37 weeks' gestation
diagnosed with severe preeclampsia, the physician would interpret which of the following as most
indicative of the client's diagnosis?
Blood pressure of 138/94 mm Hg.
Severe blurring of vision.
Less than 2 g of protein in a 24-hour sample.
Weight gain of 450 g in 1 week.
Ankle edema
The physician orders intravenous magnesium sul_fate for a primigravid client at 38 weeks' gestation
diag_nosed with severe preeclampsia. Which of the following medications would the physician have
readily available at the client's bedside?
Diazepam.
Hydralazine.
Calcium gluconate.
Oxytocin.
Nifedipine
For the 29-year-old multigravid client at 37 weeks' gestation who is receiving intravenous
magnesium sulfate for severe preeclampsia, which of the following assessment findings would alert
to suspect hypermagnesemia?
Decreased deep tendon reflexes.
Cool skin temperature.
C.
D.
E.
243.
A.
B. *
C.
D.
E.
244.
A.
B.
C.
D. *
E.
245.
A.
B.
C. *
D.
E.
246.
A. *
B.
C.
D.
E.
247.
A.
B.
C. *
D.
E.
248.
Rapid pulse rate
Tingling in the toes.
Decrease of ankle edema
A 28-year-old multigravid client at 37 weeks' gestation arrives at the emergency department via
ambulance with a blood pressure of 160/104 mm Hg and +3 reflexes without clonus. The client, who
is diagnosed with severe preeclampsia, asks the physician, "What is the cure for my high blood
pressure?" Which of the following would the physician identify as the primary cure?
Administration of glucocorticoids.
Vaginal or cesarean delivery of the fetus.
Sedation with anti-seizure medication.
Reduction of fluid retention with thiazide diuretics.
Administration of antihypertensive medication.
Which of the following would the physician identify as the priority to achieve when developing the
plan of care for a primigravid client at 38 weeks' gestation who is hospitalized with severe
preeclampsia and receiving intravenous magnesium sulfate?
Decreased generalized edema within 8 hours.
Decreased urinary output during the first 24 hours
Sedation and decreased reflex excitability within 48 hours.
Absence of any seizure activity during the first 48 hours.
Decreased breath movement less than 12 per minute
When administering intravenous magnesium sulfate as ordered for a client at 34 weeks' gestation
with severe preeclampsia, the physician would explain to the client and her family that this drug acts
as which of the following?
Peripheral vasodilator
Antihypertensive.
Central nervous system depressant.
Sedative-hypnotic.
Diuretic
Soon after admission of a primigravid client at 38 weeks' gestation with severe preeclampsia, the
physician orders a continuous intravenous infusion of 5% dextrose in Ringer's solution and 4 g of
magnesium sulfate. While the medication is being administered, which of the following assessment
findings should the physician report immediately?
Respiratory rate of 12 breaths /minute
Patellar reflex of+2.
Blood pressure of 160/88 mm Hg.
Urinary output exceeding intake.
Increase of deep tendon reflexes
As the physician enters the room of a newly admitted primigravid client diagnosed with severe
preeclampsia, the client begins to experience a seizure. Which of the following should the physician
do first?
Insert an airway to improve oxygenation.
Note the time when the seizure begins and ends.
Call for immediate assistance.
Turn the client to her left side.
Catheterize central vein
After administering hydralazine 5 mg intravenously as ordered for a primigravid client with severe
preeclampsia at 39 weeks' gestation, the physician would be alert for which of the following?
A. *
B.
C.
D.
E.
249.
A.
B.
C.
D. *
E.
250.
A.
B.
C. *
D.
E.
251.
A. *
B.
C.
D.
E.
252.
A.
B.
C. *
D.
E.
253.
A.
B.
C. *
D.
E.
Tachycardia.
Bradypnea.
Polyuria.
Dysphagia.
Constipation
A primigravid client at 40 weeks' gestation with severe preeclampsia exhibits hyperactive, very brisk
patellar reflexes with two beats of ankle clonus present. The physician documents the patellar
reflexes as which of the following?
1+
2+
3+
4+
5+
A 16-year-old unmarried primigravid client at 37 weeks' gestation with severe preeclampsia is in
early active labor. Her mother is at the bedside. The client's blood pressure is 164/110 mm Hg.
Which of the following would alert the physician that the client may be about to experience a
seizure?
Decreased contraction intensity.
Decreased temperature.
Epigastric pain.
Hyporeflexia.
Increased ankle edema
If a client at 36 weeks' gestation with eclampsia begins to exhibit signs of labor after an eclamptic
seizure, for which of the following would the physician assess?
Abruptio placentae.
Transverse lie.
Placenta accreta.
Uterine atony.
Placenta previa
For a multigravid client at 39 weeks' gestation with suspected HELLP syndrome, the physician would
immediately notify which of the following laboratory test results?
Hyperfibrinogenemia.
Decreased liver enzymes
Thrombocytopenia.
Hypernatremia.
Anemia
A 16-year-old primigravid client admitted at 38 weeks' gestation with severe pregnancy-induced
hypertension is given intravenous magnesium sulfate and lactated Ringer's solution. Which of the
following assessments should the physician prescribe?
Urinary output even'8 hours.
Deep tendon reflexes even' 4 hours.
Respiratory rate every hour.
Blood pressure every 6 hours.
Uterine contraction every 4 hours
254.
A.
B.
C.
D. *
E.
255.
A.
B. *
C.
D.
E.
256.
A.
B.
C. *
D.
E.
257.
A. *
B.
C.
D.
E.
258.
A.
B. *
C.
D.
E.
259.
A.
B.
C.
D. *
A woman is using the basal body temperature method of contraception. She calls the clinic and tells
the physician, “My period is due in a few days and my temperature has not gone up.” The physician's
most appropriate response would be:
“This probably means you are pregnant.”
“Don't worry; it is probably nothing.”
“Have you been sick this month?”
“You probably did not ovulate during this cycle.”
“You are pregnant.”
A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the
physician about the pill as a contraceptive choice. The physician's most appropriate response would
be:
“This is a highly effective method, but it has some side effects.”
“Your current medications will decrease the effectiveness of the pill.”
“The pill will decrease the effectiveness of your seizure medication.”
“This is a good choice for your age and personal history.”
“This method is contraindicated for you”
A woman who has just undergone a first trimester abortion will be using oral contraceptives. To be
protected from pregnancy, she should be advised to:
Avoid sexual contact for at least 10 days after starting the pill.
Use condoms and foam for the first few weeks as backup.
Use another method of contraception for one week after starting the pill.
Begin sexual relations once vaginal bleeding has ended.
Contraceptive pill start work after next period
A woman was treated recently for toxic shock syndrome. She has intercourse occasionally and uses
over-the-counter protection. Based on her history, what contraceptive method should she and her
partner avoid?
Cervical cap
Condom
Vaginal film
Vaginal sheath
Combine contraceptive pill
An unmarried young woman visit to family planning center for consultation. She describes her sex
life as “active” with “many” partners. She wants a contraceptive method that is reliable and does not
interfere with sex. She requests an intrauterine device (IUD). The physician's most appropriate
response would be:
“The IUD does not interfere with sex.”
“The risk of pelvic inflammatory disease (PID) will be higher for you.”
“The IUD will protect you from sexually transmitted infections.”
“Pregnancy rates are high with the IUDs.”
“The IUD is the best choice for you”
A married couple is discussing male and female sterilization with the physician. Which of the
following statements is most appropriate for the physician to make?
“Male and female sterilization methods are 100% effective.”
“A vasectomy may have a slight effect on sexual performance.”
“Tubal ligation can be easily reversed if you change your mind in the future.”
“Major complications after sterilization are rare.”
E.
260.
A.
B.
C. *
D.
E.
261.
A.
B.
C. *
D.
E.
262.
A.
B.
C.
D. *
E.
263.
A. *
B.
C.
D.
E.
264.
A.
B. *
C.
D.
E.
265.
A.
“A vasectomy is more preferable than tubal ligation”
A woman had unprotected intercourse 36 hours ago and is concerned that she may become pregnant
because it is her “fertile” time. She asks the physician about emergency contraception. The physician
would tell her that:
It is too late since she needed to begin treatment within 24 hours after intercourse.
Prevent, an emergency contraceptive method, is 98% effective in preventing pregnancy.
An over-the-counter antiemetic can be taken 1 hour prior to each contraceptive dose to prevent
nausea and vomiting.
The most effective approach is to use a progestin-only preparation.
don’t worry you have additional 48 hour to make decision about taking the pill
A client 34 years old with 14 years history of diabetes asks the physician for advice regarding
methods of birth control. Which method of birth control is most suitable for the client with diabetes?
Vaginal ring
Oral contraceptives
Diaphragm
Contraceptive sponge
Progestine only pill
The adolescent client asks the physician why she has a 26-day cycle and her friend has a 29-day
cycle? The physician's best response is: "The length of your menstrual cycle is individual and is
controlled by hormones from the:
Uterus and no other structure
Ovaries and the uterus
Pituitary gland and uterus
Ovaries and pituitary gland
Pituitary gland and no other structure
A 22-year-old nulligravid client tells the physician that she and her husband have been considering
using condoms for family planning. Which of the following instructions would the physician include
about the use of condoms as a method for family planning?
Using a spermicide with the condom offers added protection against pregnancy.
Natural skin condoms protect against sexually transmitted diseases.
The typical failure rate for couples using condoms is about 25%.
Condom users commonly report penile gland sensitivity.
It is not effective method for married couple
A 32-year-old female client visit to family planning center for contraceptive counseling and
selection. She is married and together with her husband makes decision about using diaphragm as
family planning method. Which of the following would the physician include in the teaching plan for
this client?
Douching with an acidic solution after intercourse is recommended.
Diaphragms should not be used if the client develops acute cervicitis.
The diaphragm should be washed in a weak solution of bleach and water.
The diaphragm should be left in place for 2 hours after intercourse.
The diaphragm should be changed after each intercourse
Garry, 36 years old male, visit to family planning center for contraceptive counseling and selection of
effective contraceptive method. He is married, he has 3 kids and he thinks that rich desired family
size. He thinks about vasectomy. When describing a vasectomy to Garry inquiring about this
procedure, the physician would explain that which of the following is clamped or excised?
Ejaculatory duct.
B.
C.
D. *
E.
266.
A.
B. *
C.
D.
E.
267.
A.
B.
C. *
D.
E.
268.
A.
B.
C.
D. *
E.
269.
A.
B.
C. *
D.
E.
270.
A.
B.
C.
D. *
E.
271.
Seminiferous tubules.
Seminal vesicles.
Vas deferens.
Prostate gland
A 23-year-old nulliparous client visiting the clinic for a routine examination tells the physician that
she desires to use the basal body temperature method for family planning. The physician should
instruct the client to do which of the following?
Check the cervical mucus to see if it is thick and sparse.
Take her temperature at the same time every morning before getting out of bed.
Document ovulation when her temperature decreases at least 1°F.
Avoid coitus for 10 days after a slight rise in temperature.
you still infertile before rising temperature
A multigravid client will be using medroxyprogesterone acetate (Depo-Provera) as a family planning
method. After the physician instructs the client about this method, which of the following client
statements indicates effective teaching?
"This method of family planning requires monthly injections."
"I should have my first injection during my menstrual cycle."
"One possible adverse effect is absence of a menstrual period."
"This drug will be given by subcutaneous injections."
“I should massage injection site every day”
Which of the following instructions should the physician expect to include in the teaching plan for a
30-year-old multiparous client who will be using an intrauterine device (IUD) for family planning?
Amenorrhea is a common adverse effect of IUDs.
The client needs to use additional protection for conception.
IUDs are more costly than other forms of contraception.
Severe cramping may occur when the IUD is inserted.
The client needs to check displacement of IUD every week
Carol LeBec, age 16, comes to the clinic for contraceptive counseling and selection. Before
counseling Ms. LeBec, what should the physician do first?
Obtain a complete health history.
Perform a thorough physical examination.
Evaluate personal beliefs about family planning.
Determine why the client seeks counseling.
Ask about menarche
Sintia, age 20, comes to the clinic for contraceptive counseling and selection. The physician advises
to teach Sintia about oral contraceptives because they are easy to use. How should the physician
proceed?
Review all contraceptive choices so that the client will understand the ease of taking one pill every
day.
Discuss barrier methods because the client may forget to take the pill every day.
Ask the client which method she would like to learn about
Check for contraindications and discuss methods that best fit the client's needs and life-style.
Explain advantages of barrier method
Laura Hunt, age 37, comes to the family planning clinic for contraceptive advice. Her history reveals
frequent urinary tract infections. Which of the following contraceptive methods would be most
appropriate for her?
A. *
B.
C.
D.
E.
272.
A. *
B.
C.
D.
E.
273.
A.
B. *
C.
D.
E.
274.
A.
B.
C. *
D.
E.
275.
A.
B. *
C.
D.
E.
276.
A.
B. *
C.
D.
E.
277.
A.
condom
cervical cap
contraceptive sponge
diaphragm
spermicide
Neatha, age 32, comes to the family planning clinic for contraceptive advice. Her history reveals
frequent urinary tract infections. Which of the following assessment findings would contraindicate an
oral contraceptive for Ms. Hunt?
history of a benign liver tumor
10 pounds under her ideal weight
history of dysmenorrhea since age 15
family history of ovarian cancer
monogamous relationship
Terry, age 27, comes to the family planning clinic for contraceptive advice. Her history reveals
frequent urinary tract infections. Terry inquires about the symptothermal contraceptive method. In
this method, the client notes which of the following signs to help detect the fertile period?
breast enlargement and tenderness
clear, thin, elastic cervical mucus
decreased libido
weight gain of 2 to 3 pounds
irregular period
Betty, age 24, has been using an oral contraceptive for the past 5 years. Now she wants to become
pregnant. What advice should the physician give Betty?
Attempt to conceive as soon as possible after discontinuing the oral contraceptive.
Discontinue the oral contraceptive and wait 1 month before attempting to conceive.
Discontinue the oral contraceptive and wait 3 months before attempting to conceive.
Attempt to conceive after a physical assessment confirms a return to normal hormone levels.
You should visit to reproductologist for consultation.
Two days ago Mary had intercourse during which her partner's condom broke. She has come to the
clinic today for a morning-after contraceptive. Which of the following statements accurately
describes this form of contraception?
The morning-after contraceptive must be used within 24 hours of unprotected intercourse.
The morning-after contraceptive may cause mild nausea for 1 to 2 days.
The morning-after contraceptive creates a local, sterile inflammatory reaction in the uterus.
The morning-after contraceptive has a relatively low effectiveness rate.
The morning-after contraceptive is not used after broking of condom.
Maria, age 26, married, calls the clinic because she has forgotten to take her oral contraceptive for the
past 2 days. What advice should the physician give to Maria?
Discard the rest of the pack and use another contraceptive method for the rest of the cycle.
Take two pills for the next 2 days and use another contraceptive method for the rest of the cycle.
Continue to take the remaining pills for the rest of the cycle.
Take two pills immediately and then take one pill daily for the rest of the cycle.
IUD should be placed during next 5 days
The physician is teaching Sarah unmarried, age 24, about diaphragm use and care. Which of the
following statements should be part of this teaching session?
Use only petroleum jelly for vaginal lubrication, if needed.
B.
C.
D.
Check the diaphragm for tears or holes after each use.
Have the diaphragm refitted after a loss or gain of 10 pounds or more.
Store the diaphragm in its container in a cool, dry place.
Continue to use diaphragm during the period
Maria, age 18, has become pregnant as a result of a rape 10 weeks ago. She asks the physician about
pregnancy interruption. The physician describes various procedures, including vacuum curettage and
dilatation and curettage (D & C). How do they compare?
D & C requires uterus scraping with a metal curette; vacuum curettage does not
D & C is performed more frequently than vacuum curettage.
D & C uses crushing instruments; vacuum curettage uses suction equipment
D & C carries a higher risk of complications than vacuum curettage.
D & C carries a lower risk of complications than vacuum curettage
Donna, age 23, has become pregnant as a result of a rape 7 weeks ago. She asks the physician about
pregnancy interruption. The physician describes various procedures, including vacuum curettage and
dilatation and curettage (D & C). If Donna postpones the decision until she is 10 weeks pregnant,
which method of pregnancy interruption is most likely to be used?
dilatation and curettage
dilatation and evacuation
prostaglandin suppository
RU-4S6 administration
cesarean section
Liz, age 28, has become pregnant as a result of a rape 10 weeks ago. She asks the physician about
pregnancy interruption. The physician describes various procedures, including vacuum curettage and
dilatation and curettage (D & C). After Liz undergoes a first-trimester pregnancy interruption, the
physician provides postoperative care. Which of the following statements should be part of the
postoperative teaching session?
Wipe the perineum from front to back.
Douche once a week until the follow-up visit
Avoid sexual intercourse for 3 to 4 weeks.
Expect the next menstrual period in about 3 weeks.
Intrauterine Device (IUD) is a method of choice for you
While pregnant with her fourth child, Anita discusses sterilization with her husband John. They ask
the physician to tell them about tubal ligation and its effects. How does this procedure terminate
fertility?
It prevents ovulation and menstruation.
It removes the entire uterus.
It occludes the cervix.
It blocks ova from the fallopian tubes.
Suppress ovulation
While pregnant with her fourth child, Olivia discusses sterilization with her husband Mike. They ask
the physician to tell them about tubal ligation and its effects. Olivia decides to undergo sterilization
after delivery while she is still in the hospital. Which procedure is most appropriate for her?
minilaparotomy
laparoscopy
hysteroscopy
hysterectomy
E.
colposcopy
C.
D. *
E.
278.
A.
B.
C.
D. *
E.
279.
A.
B.
C. *
D.
E.
280.
A. *
B.
C.
D.
E.
281.
A.
B.
C.
D. *
E.
282.
A. *
B.
283.
A.
B.
C. *
D.
E.
284.
A. *
B.
C.
D.
E.
285.
A.
B.
C.
D. *
E.
286.
A.
B. *
C.
D.
E.
287.
A.
B. *
C.
D.
E.
288.
A. *
B.
C.
Rick is scheduled for a vasectomy on Friday. His partner Anne asks the physician when they can
begin having unprotected intercourse. What is the physician's best response?
when desired because sterilization is immediate
as soon as scrotal edema and tenderness disappear
when the sperm count reflects sterilization
after about 6 to 10 ejaculations
after one month
Rita is scheduled for a tubal ligation on Wednesday. Her partner John asks the physician when they
can begin having unprotected intercourse. What is the physician's best response?
when desired because sterilization is immediate
as soon as wound edema and tenderness disappear
after next menstrual period
6 month later
you should use barrier method at least 2 weeks
A 26-year-old woman is scheduled for a first trimester abortion in the morning. A laminaria tent is
inserted as part of the vacuum aspiration procedure. The physician explains to the woman that
laminaria is used to:
Stimulate the uterus to contract.
Prevent postabortion infection.
Reduce pain by numbing the cervix.
Dilate the cervix for easier insertion of the aspirator.
Prevent postabortion hemorrhage
A married 23 years old woman visit to family planning center for consultation. She uses the basal
body temperature method of contraception. She describes her sexual life as mogamous with husband.
She wants to use Basal Body Temperature as family planning method. She asks physician what does
the Basal Body Temperature (BBT) chart tell about.
Problems with ovulation
Time of ovulation
Time of next ovulation
None of these
Time of previous ovulation
A married 23 years old woman visit to family planning center for contraceptive advice. She describes
her sex life as “active” with “many” partners. She wants a contraceptive method that is reliable and
does not interfere with sex. Which method of contraception will be most appropriate for this client:
Vaginal rings
Condoms
Patches
Progestin only pill
Intrauterine device
Mona, is a 23-year-old healthy, non-smoking woman without medical complications. She has no
contraindications for the use of oral contraceptives. When during her cycle should BB begin her oral
contraceptives?
Take the first tablet on the first day of menses; this avoids the risk of early ovulation and the need to
use alternative methods of contraception
Take the first tablet on the first Sunday after the beginning of menstruation and use alternative
method of contraception for the first 14 days.
Take the first tablet on the first day of menses; and use alternative method of contraception for the
first 14 days
D.
E.
289.
A.
B. *
C.
D.
E.
290.
A.
B. *
C.
D.
E.
291.
A.
B. *
C.
D.
E.
292.
A.
B.
C.
D.
E. *
293.
A.
B.
Take the first tablet on the first Sunday after the beginning of menstruation this avoids the risk of
early ovulation and the need to use alternative methods of contraception
Take the first tablet days after visit; and use alternative method of contraception for the next cycle
Nadia is a 30-year-old mother of three children. She has been exclusively breastfeeding her youngest
child, who is 5 months old. Nadia is planning to begin supplementing her infant’s diet and weaning
her baby next month. Today, she has come to clinic to make choice about family planning method.
Which method of contraception will be most available for Nadia?
Lactational amenorrhea
Progestin only pill
Sterilization
Calendar method
Basal body temperature method
Nelly is a 26-year-old mother of two children. She has been exclusively breastfeeding her youngest
child, who is 5,5 months old. Nelly is planning to begin supplementing her infant’s diet and weaning
her baby next month. Today, she has come to clinic to make choice about family planning method.
She wants to use combine oral contraceptives. What is the mechanism of action of this method?
make the cervical mucus thin
prevent the release of eggs from the ovaries
stimulate peristaltic waves of fallopian tube
destroy ovum
decrease speed of sperm movement
Ashley, a 23-year-old unmarried, comes for an initial visit to request birth control. She asks about
birth control pills, but also wants information about the newer hormonal methods on the market. Vital
signs: 1,68 m tall, 95 kg., BMI 33.9, Ps 76, RR 16, T 36,6.7 C, BP 142/88 mm Hg. What information
do you NOT need prior to starting Ashley on hormonal contraception?
Blood pressure
Smoking history
Pap smear and pelvic exam
History of migraines with auras
Family history of thrombotic disorders
Olga, a 33-year-old unmarried, comes for an initial visit to request birth control. She asks about birth
control pills, but also wants information about the newer hormonal methods on the market. Vital
signs: 1,68 m tall, 95 kg., BMI 33.9, Ps 76, RR 16, T 36,6.7 C, BP 142/88 mm Hg. Olga should
watch for all of the following side effects with an OCP EXCEPT
headache
nausea
spotting
breast tenderness
amenorrhea
Irma, a 26-year-old unmarried, comes for an initial visit to request birth control. She asks about birth
control pills, but also wants information about the newer hormonal methods on the market. After
listening to your instructions on how to use an oral contraceptive, Irma worries that she will not be
reliable in taking the pill every day, and asks about other options. Physician recommends her depot
medroxyprogesterone acetate (DMPA, Depo-Provera ® ). Her vital signs: 1,68 m tall, 95 kg., BMI
33.9, Ps 76, RR 16, T 36,6.7 C, BP 142/88 mm Hg. Which of the following side effects is Not true
about depot medroxyprogesterone acetate (DMPA, Depo-Provera ® )?
Irregular bleeding is uncommon during the first 6-9 months of use
DMPA never causes amenorrhea
C.
Fertility may be delayed after discontinuation
D.
E. *
294.
Weight gain is not a reported side effect
DMPA affect bone mineral density
Kanisha, a 35-year-old female comes to your clinic to ask about contraception. She and her husband
have one child. She wants some type of birth control that she doesn't have to think about for as long
as possible. She is otherwise healthy, and her only complaint is heavy periods. She is currently using
the “rhythm method” and adding condoms during high-risk times. Which of the following
contraceptives would you recommend?
Tubal ligation
Basal body temperature method
Spermicides
IUD (Intrauterine Device)
Progestin only pill
A woman's obstetric history indicates that she is pregnant for the fourth time and all her children
from prior pregnancies are living. One was born at 39 weeks' gestation, twins at 34 weeks' gestation,
and another at 35 weeks' gestation. What is her gravity and parity using the GTPAL system?
3-1-1-1-3
4-1-2-0-4
3-0-3-0-3
4-2-1-0-3
4-0-2-1-3
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks' gestation
and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravity and
parity using the GTPAL system?
2-0-0-1-1
2-1-0-1-0
3-1-0-1-0
3-0-1-1-0
3-2-1-1
Juanita has just moved to the United States from Mexico. She is 3 months pregnant and has arrived
for her first prenatal visit. During her assessment interview, you discover that Juanita has not had any
immunizations. Which of the following immunizations should Juanita receive at this point of her
pregnancy?
HIV
Diphtheria
Chickenpox
Rubella
Varicella Zoster
Nancy is a 31-year-old woman who believes she may be pregnant. She took an over-the-counter
pregnancy test one week after a missed period test that turned positive. During her assessment
interview, the physician inquires about Nancy’s LMP and if she is taking any medications. Nancy
states that she takes medicine for epilepsy. She has been under much stress lately at work and has not
been sleeping well. She also has a history of irregular periods. Nancy’s physical exam does not
indicate that she is pregnant. Nancy has an ultrasound that reveals she is not pregnant. What is the
most likely cause for obtaining false-positive pregnancy test results?
Nancy took the pregnancy test too early
Nancy takes anticonvulsants
A.
B.
C.
D.
E. *
295.
A.
B. *
C.
D.
E.
296.
A.
B.
C. *
D.
E.
297.
A.
B. *
C.
D.
E.
298.
A.
B. *
C.
D.
E.
299.
A. *
B.
C.
D.
E.
300.
A.
B.
C.
D. *
E.
301.
A. *
B.
C.
D.
E.
302.
A.
B.
C. *
D.
E.
303.
A.
B.
C. *
D.
E.
304.
A.
B.
Nancy has a fibroid tumor
Nancy has been under much stress and has a hormone imbalance.
Result of ultrasound is not valid
Betty is in her 7th month of pregnancy. She has been complaining of nasal congestion and occasional
epistaxis. The physician suspects that:
This is a normal respiratory change in pregnancy due to elevated levels of estrogen.
This is an abnormal cardiovascular change and the nosebleeds are an ominous sign.
Betty is a victim of domestic violence and is being hit in the face by her partner.
Betty has been using cocaine intranasally.
Betty should be examined by laryngologist o rule out chronic synusitis
Juanita has just moved to the United States from Mexico. She is 3 months pregnant and has arrived
for her first prenatal visit. During her assessment interview, you discover that Juanita has not had any
immunizations. Which of the following immunizations should Juanita receive at this point of her
pregnancy?
Herpes Simplex Type 3
Chickenpox
Rubella
Hepatitis B
HIV
A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. You know
that which of the following findings are considered normal?
Dipstick assessment of trace to +1
> 300 mg/24 hours
Dipstick assessment of +2
> 300 mg/24 hours
It is impossible to use urine dipstick test
A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14.
Her expected date of birth (EDB) would be:
September 17
November 7
November 21
December 17
May 7
A pregnant woman at 10 weeks’ gestation jogs three to four times per week. She is concerned about
the effect of exercise on the fetus. The physician would inform her:
“You do not need to modify your exercising any time during your pregnancy.”
“Stop exercising because it will harm the fetus.”
“You may find that you need to modify your exercise to walking later in your pregnancy around the
seventh month.”
“Jogging is too hard on your joints; switch to walking now.”
Continue jogging to delivery time it is allows to decrease time of labour
A woman who is 14 weeks pregnant tells the physician that she always had a glass of wine with
dinner before she became pregnant. She has abstained during her first trimester and would like to
know if it is safe for her to have a drink with dinner now. You would tell her:
“Since you are in your second trimester, there is no problem with having one drink with dinner.”
“One drink every night is too much. One drink three times a week should be fine.”
C.
D. *
E.
305.
A.
B. *
C.
D.
E.
306.
A.
B.
C.
D. *
E.
307.
A. *
B.
C.
D.
E.
308.
A.
B.
C.
D. *
E.
309.
A.
B.
C. *
D.
310.
A. *
“Since you are in your second trimester, you can drink as much as you’d like.”
“Because no one knows how much or how little alcohol it takes to cause fetal problems, it is
recommended that you abstain throughout your pregnancy.”
“One glass of wine three times a week will help make you delivery easier”
A pregnant woman at 18 weeks’ gestation calls the clinic to report that she has been experiencing
occasional backaches of mild to moderate intensity. The physician would recommend that she:
Do Kegel exercises
Do pelvic rock exercises
Use a softer mattress
Stay in bed for 24 hours
Should do X-ray of spine
In her work with pregnant women of various cultures, a physician has observed various practices that
seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem
to have one purpose in common. Which of the following statements best describes that purpose?
To promote family unity
To ward off the “evil eye”
To appease the gods of fertility
To protect the mother and fetus during pregnancy
To have desired sex of the baby
Juanita has just moved to the United States from Mexico. She is 3 months pregnant and has arrived
for her first prenatal visit. During her assessment interview, you discover that Juanita has not had any
immunizations. Which of the following immunizations should Juanita receive at this point of her
pregnancy?
Tetanus
Chickenpox
Rubella
Cytomegalovirus
Herpes Simplex type I
A 22-year-old pregnant woman with a single fetus has a preconception body mass index (BMI) of 24.
When she was seen in the clinic at 14 weeks’ gestation, she had gained 1.8 kg since conception. How
would the physician interpret this?
This large weight gain indicates possible pregnancy-induced hypertension (PIH).
This small weight gain indicates that her infant is at risk for intrauterine growth restriction (IUGR).
It is impossible to evaluate this weight gain until the woman has been observed for several more
weeks.
The woman’s weight gain is appropriate for this stage of pregnancy.
The weight gain is not important during pregnancy
A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, fruits, and
vegetables. The physician would be least concerned about this woman’s intake of:
Calcium
Protein
Vitamin B12
Folic acid
A pregnant woman reports that she is still playing tennis at 32 weeks’ gestation. The physician would
be most concerned whether this woman consumes which of the following during and after tennis
matches?
Several glasses of fluid
B.
C.
D.
E.
311.
A.
B.
C. *
D.
E.
312.
A.
B.
C.
D. *
E.
313.
A.
B.
C.
D. *
E.
314.
A. *
B.
C.
D.
E.
315.
A.
B.
C. *
D.
E.
316.
A.
Extra protein sources such as peanut butter
Salty foods to replace lost sodium
Easily digested sources of carbohydrate
Avoid food 2 hours after match
A 27-year-old pregnant woman had a preconceptal BMI of 18.0. The physician would be aware that
this woman’s total recommended weight gain during pregnancy should be at least:
20 kg (44 lb)
16 kg (35 lb)
12.5 kg (27.5 lb)
10 kg (22 lb)
8 kg (17,5 lb)
A woman in her 34th week of pregnancy reports that she is very uncomfortable because of heartburn.
The physician would suggest that the woman:
Substitute other calcium sources for milk in her diet.
Lie down after each meal.
Decrease the amount of fiber that she consumes.
Eat five small meals daily.
Should be examined by gastroenterologist
A woman who has come to the clinic for preconception counseling because she wants to start trying
to get pregnant in 3 months can expect the following advice:
“Discontinue all contraception now.”
“Lose weight so that you can gain more during pregnancy.”
“You may take any medications that you have been taking regularly.”
“Make sure you include adequate folic acid in your diet.”
“Start to do additional exercise like jog”
After you complete your nutritional counseling for a pregnant woman, you ask her to reiterate your
instructions to assess her understanding of the instructions given. What statement below would
indicate that she understands the role of protein in her pregnancy?
“Protein will help my baby grow.”
“Eating protein will prevent me from becoming anemic.”
“Eating protein will make my baby have strong teeth after he is born.”
“Eating protein will prevent me from being diabetic.”
“Eating protein will prevent excessive blood lost in postpartum period”
Your client reports “unusual food cravings”. When you inquire about the specifics, she reports
eating laundry detergent and dirt. You know that this type of craving is known as ___.
anorexia
bulimia
pica
vomiting
emesis
A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is
obtained: She is 24 years old with a BMI of 17.5. She admits to having used cocaine “several times”
during the past year and drinks alcohol occasionally. Her blood pressure is 108/70 mm Hg, her pulse
rate is 72 beats per minute, and her respiratory rate is 16 breaths per minute. Family history is
positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube
defect. Which characteristics place the woman in a high-risk category?
Blood pressure, age, BMI
B.
C.
D. *
E.
317.
A. *
B.
C.
D.
E.
318.
A. *
B.
C.
D.
E.
319.
A.
B. *
C.
D.
E.
320.
A.
B.
C. *
D.
E.
321.
A.
B.
C.
D. *
E.
322.
Drug/alcohol use, age, family history
Family history, blood pressure, BMI
Family history, BMI, drug/alcohol abuse
Blood pressure, family history, BMI
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular
menstrual periods all of her life. She has a history of smoking approximately one pack of cigarettes a
day, but tells you that she is trying to cut down. Her laboratory data are within normal limits. Which
of the following diagnostic techniques could be employed with this pregnant woman at this time?
Ultrasound examination
Maternal serum alpha-fetoprotein screening
Amniocentesis
Nonstress test
Biophysical profile
The physician sees a woman for the first time when she is 30 weeks pregnant. The woman has
smoked throughout the pregnancy, and now fundal height measurements are suggestive of growth
restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool
useful in confirming the diagnosis?
Doppler blood flow analysis
Contraction stress test
Amniocentesis
Daily fetal movement counts
Vaginal examination
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would
yield more detailed information about the fetus?
Ultrasound for fetal anomalies
Biophysical profile
Maternal serum alpha-fetoprotein screening
Percutaneous umbilical blood sampling
Daily fetal movement counts
At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytics are administered
and she is placed on bed rest, she continues to experience regular uterine contractions and her cervix
is beginning to dilate and efface. What would be an important test for fetal well-being at this time?
Percutaneous umbilical blood sampling
Ultrasound for fetal size
Amniocentesis for fetal lung maturity
Nonstress test
Vaginal examination
A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest
to her at this time?
Biophysical profile
Amniocentesis
Maternal serum alpha-fetoprotein
Transvaginal ultrasound
Vaginal examination
A 30-year-old 3-2-0-0-2 is at 18 weeks' gestation. At this time, what screening test should be
suggested to her?
A.
B.
C. *
D.
E.
323.
A.
B. *
C.
D.
E.
324.
A. *
B.
C.
D.
E.
325.
A. *
B.
C.
D.
E.
326.
A.
B.
C. *
D.
E.
327.
A.
B. *
C.
D.
E.
Biophysical profile
Chorionic villi sampling
Maternal serum alpha-fetoprotein screening
Screening for diabetes mellitus
Speculum examination
A maternal serum alpha-fetoprotein test indicates an elevated level. It is repeated and again is
reported as higher than normal. What would be the next step in the assessment sequence to determine
the well-being of the fetus?
Percutaneous umbilical blood sampling
Ultrasound for fetal anomalies
Biophysical profile for fetal well-being
Amniocentesis for genetic anomalies
Doppler velocimetry
Karen is undergoing a nipple-stimulated contraction stress test. She is having contractions that
occur every three minutes. The fetal heart rate has a baseline of approximately 120 bpm without any
decelerations. The interpretation of this test is said to be:
Negative
Positive
Satisfactory
Unsatisfactory
Normal
A pregnant woman’s biophysical profile score is 8. She asks the physician to explain the results. The
physician’s best response is:
“The test results are within normal limits.”
“Immediate delivery by cesarean birth is being considered.”
“Further testing will be performed to determine the meaning of this score.”
“An obstetric specialist will evaluate the results of this profile and, within the next week, will inform
you of your options regarding delivery.”
”You should repeat this test again after 3 days”
A primigravid client visiting the antepartal clinic at 8 weeks' gestation tells the physician that she
wants an amniocentesis because there is a history of hemophilia A in her family. The physician
instructs the client that newer techniques now allow amniocentesis to be performed as early as which
of the following?
8 weeks'gestation.
10 weeks'gestation.
12 weeks' gestation.
14 weeks' gestation.
16 weeks' gestation.
A 40-year-old gravida 4 client at 10 weeks' gestation and her husband are coming into the clinic to
discuss tests that are available during the first or early second trimester to diagnose an abormality of
the fetus. Which of the following tests are appropriate?
Electrocardiogram.
Chorionic villus sampling (CVS).
External fetal monitoring (EFM).
Nonstress test
Auscultation of fetal heart rate
328.
A.
B.
C. *
D.
E.
329.
A.
B.
C.
D. *
E.
330.
A.
B. *
C.
D.
E.
331.
A.
B.
C.
D. *
E.
332.
A.
B.
C. *
D.
E.
333.
A.
B.
C.
A 40-year-old gravida 4 client at 10 weeks' gestation and her husband are coming into the clinic to
discuss tests that are available during the first or early second trimester to diagnose an abnormality of
the fetus. Which of the fol¬lowing tests are appropriate?
Electrocardiogram.
External fetal monitoring (EFM).
Amniocentesis.
Nonstress test
Vaginal examination
A primigravid adolescent client at approximately 15 weeks' gestation who is visiting the prenatal
clinic with her mother is to undergo alphafetoprotein (AFP) screen¬ing. When developing the
teaching plan for this client, the physician should include which of the following pieces of
in¬formation?
Ultrasonography usually accompanies AFP testing.
Results are usually very accurate until 20 weeks' gestation.
A clean-catch midstream urine specimen is needle
Increased levels of AFP are associated with neural tube defects.
Elevated level of alphafetoprotein is responsible for preterm labour
A 40-year-old client at 8 weeks' gestation has a 3-year-old child with Down syndrome. The physician
is dis_cussing amniocentesis and chorionic villus sampling as genetic screening methods for the
expected baby. The physician is confident that her teaching has been understood when the client
states which of the following?
“Each test identifies a different part of the infant's genetic makeup.”
”Chorionic villus sampling can be performed earlier in pregnancy.”
“The test results take the same length of time to be complete”
“Amniocentesis is a more dangerous procedure for the fetus.”
“Amniocentesis is the most safe procedure for the fetus sex”
A 27-year-old primigravid client with insulin-dependent diabetes at 34 weeks' gestation undergoes a
nonstress test, the results of which are documented as reactive. The physician tells the client that the
test results indicate which of the following?
A contraction stress test is necessary.
The nonstress test should be repeated
Chorionic villus sampling is necessary.
There is evidence of fetal well-being.
This is indication to emergency Cesarean section
A primigravid client with insulin-dependent diabetes tells the physician that the contraction stress test
performed earlier in the day was suspicious. The physician interprets this test result as indicating that
the fetal heart rate pattern showed which of the following?
Frequent late decelerations
Decreased fetal movement
Inconsistent late decelerations
Lack of fetal movement
Late acceleration
A 34-years-old woman at 36 week’s gestation has been scheduled for a biophysical profile. She asks
the physician why the test needs to be performe. The physician would tell her that the test:
Determines how well her baby will breathe after born
Evaluates the response of her baby’s heart to uterine contractions
Measures her baby’s head and length
D. *
E.
334.
A.
B. *
C.
D.
E.
335.
A.
B.
C. *
D.
E.
336.
A. *
B.
C.
D.
E.
337.
A.
B.
C.
D.
E. *
338.
A.
B.
C. *
D.
E.
339.
A.
Observes her baby’s activities to ensure that her baby is getting enough oxygen
Identify lung maturation
A 40-year-old woman at 18 week’s of gestation is having Triple Marked test performed. She is obese
and her health history reveals that she is Rh negative. The primary purpose of this test is screen for
Spina bifida
Down syndrome
Gestational diabetes
Rh antibody
Pregnancy induced hypertension
During a contraction stress test, four contractions lasting 45 to 55 seconds were recorded in a 10
minute period. A late deceleration was noted during the third contraction. The physician conducting
the test would document which of the following result
negative
positive
Suspicious
Unsatisfactory
Normal
Patient S., labor first, at term. Uterine contractions on 45-50 sec, every 2-3 min. Fetal heart rate is
rhythmic, 144 bpm, a head is in the pelvic inlet. Vaginally: cervix is effaced, opening 7 cm, amniotic
membrane is absent. What is the stage of labor?
First.
Second.
Preliminary.
Finishing.
Third.
Pregnant 24 years, the first pregnancy, I labor. Regular uterine contractions. At vaginal examination:
the cervical opening is 4 cm, an amniotic sac is whole, the fetal head is fixed in the pelvic inlet.
Sagittal suture is in a transversal size, the small fontanel is in the center of pelvis to the left. What is
the moment of the labor biomechanism?
The V moment of the labor biomechanism
The ІІ moment of the labor biomechanism
The ІІІ moment of the labor biomechanism
The IV moment of the labor biomechanism
I moment of the labor biomechanism
The first delivery, II period. The fetal lie is longitudinal. The head presents, that it can't be
determinate by external maneuvers. In internal examination: the uterine cervix is effaced, dilatation is
full, membranes are absent. The sagittal suture is in a direct size, small fontanel is under the pubis. In
the pushing the fetal head appears from a vulva. What area of pelvis a fetal head occupies?
Pelvic inlet
That is pressed to pelvic inlet plane
The area of pelvic outlet
The area of wide part of a cavity of a small pelvis
The area of narrow part of a cavity of a small pelvis
Patient S., labor first, at term. Uterine contractions on 45-50 sec, after 2-3 min.. Fetal heart rate is
rhythmic, 144 in 1 min, a head is in the pelvic inlet. Vaginally: cervix is effaced, dilating is full,
amniotic membrane is absent. What is period of labor?
First.
B. *
C.
D.
E.
340.
A.
B. *
C.
D.
E.
341.
A.
B. *
C.
D.
E.
342.
A.
B. *
C.
D.
E.
343.
A.
B.
C. *
D.
E.
344.
A.
B.
C.
D.
E. *
Second.
Preliminary.
Finishing.
Third.
Primapara N., 20 years, II pregnancy, I labor. The fetal lie is longitudinal, the fetal back is anteriorly.
The fetal heart rate is clear, rhythmic. Vaginal examination: the cervix is effaced, opening is full, an
amniotic sac is absent. Head of fetus in the plane of pelvic outlet. Sagittal suture is in a direct size,
small fontanel is under the pubis. What moment of the labor biomechanism at the anterior type of
occipital presentation is ended?
The І moment of the labor biomechanism
II moment of the labor biomechanism
The ІІІ moment of the labor biomechanism
The IV moment of the labor biomechanism
The V moment of the labor biomechanism
The patient is admitted to delivery department. In examination longitudinal lie, I position, posterior
variety of the fetus is exposed. What is the leading point at the posterior type of occipital
presentation?
Small fontanel
The middle of sagittal suture
Large fontanel
Chin
Subtongue bone
Patient II, labor first, at term. The patient’ condition is satisfactory. The new-born is just delivered.
The umbilical cord hangs down from a vagina and increases in its length. Bleeding is not present.
Uterus is in normal tonus. How do you called this positive sign of placenta separation?
Dovshenko sign
Alfeld sign
Shreder' sign
Pupil sign
Hehar sign
Patient 30 years, labor at term. A girl with the Apgar score 8 was born. The umbilical vessels do not
pulsate, the cord is clammed. Bloody excretions from the vagina are absent. What period of labor this
patient is found in?
Cervical
Pelvic
Placental
Puerperal period
Preliminary period
Pregnant N., 25 years is delivered in the maternity department with complaints about periodic pains
in lower part of abdomen and lumbal region during 7 hours. Amniotic fluid did not released. Fetal
heart rate is 136 in 1min. Vaginal examination: the cervix is effaced, opening 10 cm, the amniotic
membrane is whole. What is the doctor’ tactic?
Cesarean section
Stimulation of labor
Obstetric forceps
Conservative conducting of labor
Amniotomy
345.
A. *
B.
C.
D.
E.
346.
A.
B.
C.
D.
E. *
347.
A.
B.
C.
D. *
E.
348.
A. *
B.
C.
D.
E.
349.
A.
350.
A. *
Woman with full-term pregnancy. Uterine contractions occur every 4-5 minutes and lasts 30-35
seconds. Vaginal examination: cervix is totally effaced, dilation to 4 cm, fetal head is on -2 station.
Sagittal suture is in right oblique diameter of the pelvic inlet, posterior fontanel under the symphysis.
Amniotic sac is present. Diagnosis?
Longitudinal lie, cephalic presentation, I position, anterior. First stage of labor
Longitudinal lie, cephalic presentation, I position, posterior. First stage of labor
Longitudinal lie, cephalic presentation, II position, anterior. First stage of labor
Longitudinal lie, cephalic presentation, II position, anterior. Second stage of labor
Longitudinal lie, cephalic presentation, I position, anterior. Second stage of labor
Woman with full-term pregnancy. Uterine contractions occur every 4-5 minutes and lasts 30-35
seconds. Vaginal examination: cervix is totally effaced, dilation to 4 cm, fetus head is on -2 station.
Sagittal suture is in left oblique diameter of the pelvic inlet, posterior fontanel near sacral region.
Amniotic sac is present. Diagnosis?
Longitudinal lie, cephalic presentation, I position, anterior. First stage of labour
Longitudinal lie, cephalic presentation, II position, posterior. First stage of labour
Longitudinal lie, cephalic presentation, II position, anterior. First stage of labour
Longitudinal lie, cephalic presentation, II position, anterior. Second stage of labour
Longitudinal lie, cephalic presentation, I position, posterior. First stage of labour
Primapara R., 21 eyars old, primapara. Full term of pregnancy. The labor started 8 hours ago. The
membranes ruptured 15 minutes ago. Pelvic sizes: 25,28,31,20 cm. Fetal head rate 140 per minute
with satisfactory characteristics. Per vaginum: the cervix is dilated to 5 cm. The amniotic sac is
absent. Fetal head is palpated in plane of pelvic inlet. Which stage of labor?
Third
Second
Latent stage of first
Active stage of first
Fourth
Primipara F., 25 years old. Pregnancy at term. The labor started 6 hours ago. The membranes
ruptured one hour ago. Pelvic sizes: 23,25,29,18 cm. Fetal head rate 140 per minute with satisfactory
characteristics. Uterine contractions occur every 7-8 minutes. Per vaginum: the uterine cervix
dilatation is 2 cm. The amniotic sac is absent. One fetal foot is palpated in the vagina. Buttocks are in
the pelvic inlet. Which stage of labor?
Latent stage of first stage
Active stage of first stage
Second stage
Third
Fourth
M., 25 years old, multipara. Full term of pregnancy. Initiation of labor was 7 hours ago. The
membranes ruptured 40 minutes ago. Pelvic sizes: 25,28,31,20 cm. Fetal heart rate is 132 per
minute with satisfactory characteristics. Per vaginum: the cervix is completely dilated. The amniotic
sac is absent. Fetal head is in the plane of the greatest diameter of the true pelvis. The face line is in
the right oblique size. The chin is palpated under the symphysis. What is the moment of labor
biomechanism?
A woman in her 40th weeks of pregnancy, the second labour, has regular labour activity. Uterine
contractions take place every 3 minutes. All of criteria describe the beginning of the II labor stage
EXEPT:
Cervical dilatation by no less than 4 cm
B.
C.
D.
E.
351.
A.
B.
C.
D. *
E.
352.
A.
B.
C.
D.
E. *
353.
A.
B.
C.
D.
E. *
354.
A. *
B.
C.
Cervical dilation to 10 cm
Duration of uterine contractions over 30 seconds
Presenting part is in the lower region of small pelvis
Rupture of fetal bladder
A 17 year-old G0 sexually active woman presents to the emergency room with acute right lower
quadrant pain and nausea for 12 hours. Her periods have always been irregular, with her last one 6
weeks ago. She is otherwise completely healthy. She appears in mild distress. Physical examination:
temperature 100.2°F (37.9°C); blood pressure 110/60; heart rate 108 beats/min. She has moderate
abdominal tenderness with right greater than left pelvic tenderness. Pelvic exam reveals normal
external genitalia and pink-tinged discharge is noted on speculum examination.
Bimanual/rectovaginal exam confirms mild cervical motion tenderness and fullness in the right
adnexa with moderate tenderness and some voluntary guarding. What is the single most important
test to obtain?
Pelvic ultrasound
CT scan of the abdomen and pelvis
GC and chlamydia DNA probe
Beta-hCG
CBC with differential
An 18 year-old woman comes to the office due to vaginal spotting for the last two weeks. Her
menstrual periods were regular until last month, occurring every 28-32 days. Menarche was at age
13. She started oral contraceptives 3 months ago. On pelvic examination, the uterus is normal in size,
slightly tender with a mass palpable in the right adnexal region. No adnexal tenderness is noted.
Which of the following tests is the most appropriate next step in the management of this patient?
Endometrial biopsy
Coagulation studies
Pelvic sonography
Abdominal CT scan
Urine pregnancy test
A 26-year-old G0 woman presents to the emergency room with 8 hours of severe right lower
quadrant pain associated with nausea. She has a history of suspected endometriosis, which was
diagnosed 2 years ago, based on severe dysmenorrhea. She has been using NSAIDs with her menses
to control the pain. She is not sexually active. She is otherwise in good health. Her menstrual cycles
are normal every 28 days and her last menstrual period was 3 weeks ago. She has no history of
sexually transmitted infections. Her blood pressure is 145/70; pulse is 100; temperature is 99.2°F.
She appears uncomfortable. On abdominal exam, she has moderate tenderness to palpation in the
right lower quadrant. On pelvic exam, she has no lesions or discharge. A complete bimanual exam
was difficult to perform due to her discomfort. Labs: BHCG
MRI of the pelvis
Doppler pelvic ultrasound
CAT scan of the pelvis
Begin oral contraceptives
Surgical exploration
A 29 years old woman with a history of pelvic inflammatory disease presents to emergency with
severe left lower quadrant crampy pain, spotting and amenorrhea for the past two cycles. There is a
left adnexal mass with tenderness to palpation. The B-hcG is elevated. Further studies would most
likely reveal an implantation at which of the following locations in the fallopian tube?
Ampula
Fimbriae
Isthmus
D.
E.
355.
A.
B.
C.
D. *
E.
356.
A.
B.
C.
D. *
E.
357.
A.
B. *
C.
D.
E.
358.
A.
B.
C.
D.
E. *
359.
A.
B.
C. *
Infundibulum
Uterine segment
A 35 years old sexually active woman visits her gynecologist complaining of mild, right-sided, lower
abdominal pain but no other symptoms, there are no peritoneal signs, her surgical history is
significant for an appendectomy at age 10, her last period occurred 14 days ago, which of the
following endometrial changes corresponds to this stage of the patient's menstrual cycle?
Apical movement of secretions in the glandular cells
Tissue expansion by cellular hypertrophy
Degeneration of the glandular structures
Growth of the spinal arteries
Glandular glycogen accumulation in the functionalism
A 35 years old woman comes to the emergency with a sudden onset of severe right lower abdominal
pain, nausea, vomiting. Ultrasound shows enlarged ovary with decreased or absent blood flow, the
diagnosis might be?
PID
Ectopic pregnancy
Cyst rupture
Ovarian torsion
Endometriosis
Name a complication of PID, presents with fever, abdominal pain and a complex multiloculated
adnexal mass with thick walls and internal debris.
Mole
Tubo-ovarian abscess
Cervicitis
Bacterial vaginitis
Ovarian cancer
A 37-year-old woman comes to the emergency department because of a 3-day history of increasingly
severe abdominal pain, nausea, and vomiting. Twelve years ago, she had a hysterectomy because of
severe dysfunctional uterine bleeding. Her temperature is 37°C (98.6°F), blood pressure is 106/70
mm Hg, pulse is 110/min, and respirations are 12/min. Examination shows a distended, tympanic
abdomen with diffuse tenderness but no guarding; bowel sounds are hypoactive. Her leukocyte count
is 10,000/mm3, and hematocrit is 44%. An x-ray of the abdomen is shown. Which of the following is
the most appropriate initial step in management?
Laparotomy
Nasogastric intubation
Esophagogastroduodenoscopy
Intravenous neostigmine therapy
CT scan of the abdomen
A 25-year-old woman is brought to the emergency department 1 hour after she fainted. She has had
mild intermittent vaginal bleeding, sometimes associated with lower abdominal pain, during the past
3 days. She has had severe cramping pain in the right lower abdomen for 12 hours. She has not had a
menstrual period for 3 months; previously, menses occurred at regular 28-day intervals. Abdominal
examination shows mild tenderness to palpation in the right lower quadrant. Bimanual pelvic
examination shows a tender walnut-sized mass in the right parametrium. Which of the following is
the most likely diagnosis?
Appendicitis
Cancer of the ovary
Ectopic pregnancy
D.
E.
360.
A. *
B.
C.
D.
E.
361.
A.
B.
C. *
D.
E.
362.
A. *
B.
C.
D.
E.
363.
A. *
B.
C.
D.
E.
364.
A. *
B.
C.
D.
E.
Endometriosis
Ovarian cyst
A 23.y.old woman presents with fever and abdominal pain of 2 days duration. She has a positive
chandelier sign. Antibiotics are started. What is the next step in management?
Pelvic ultrasonography to rule out tubo-ovarian abscess
Laparoscopic investigation
Higher dose of antibiotics after 10 days
Lower dose of antibiotics after 48 hours
Emergency surgery
A 25-year-old woman is brought to the emergency department 1 hour after she fainted. She has had
mild intermittent vaginal bleeding, sometimes associated with lower abdominal pain, during the past
3 days. She has had severe cramping pain in the right lower abdomen for 12 hours. She has not had a
menstrual period for 3 months; previously, menses occurred at regular 28-day intervals. Abdominal
examination shows mild tenderness to palpation in the right lower quadrant. Bimanual pelvic
examination shows a tender walnut-sized mass in the right parametrium. Which of the following is
the most likely diagnosis?
Appendicitis
Cancer of the ovary
Ectopic pregnancy
Endometriosis
Ovarian cyst
Women, 39 year admitted to the gynecology department with complaints of severe abdominal pain,
occurring after physiological activity. In bimanual examination found sharply painful swelling in the
pelvis, the positive symptoms of peritoneal irritation on the side of the tumor. Your diagnosis?
torsion of ovary cancer stem
spontaneous miscarriage
acute salpingoophoritis
dysfunctional uterine bleeding
none of the above
In the gynecology department admitted a woman 23 year with complaints of sudden onset of pain in
one of the iliac regions, radiating pain in the shoulder, nausea, and vomiting, delayed menstruation
for 3 weeks. Pregnancy test is positive. Your diagnosis?
an ectopic pregnancy, the type of rupture of the uterine tube
torsion of ovary cancer stem
spontaneous miscarriage
acute salpingoophoritis
dysfunctional uterine bleeding
In 27 years old woman you suspect tubal abortion (without significant intra-abdominal bleeding).
With which diseases you would differentiate:
a miscarriage of small time dysfunctional uterine bleeding
acute salpingoophoritis
Endometriosis
PID
Cyst rupture
365.
A.
B.
C.
D.
E. *
366.
A.
B.
C. *
D.
E.
367.
A. *
B.
C.
D.
E.
368.
A.
B.
C.
D.
E. *
Woman, aged 22 years was admitted to gynecologic department with complaints on pains in the
lower abdomen, elevation of body temperature to 39,5*C. Objectively: heart beat rate – 108
beats/min, arterial pressure – 120/180 mm Hg., abdomen is bloated moderately, sharply painful in the
hypogastric area. Signs of peritoneal irritation are positive in the hypogastric area. Vaginal
examination: uterus and appendages are not palpable due to tension of the anterior abdominal wall,
posterior fornix overhangs, sharply painful. What is the most probable diagnosis?
Ovarian apoplexy
acute salpingoophoritis
Acute endometritis
Ectopic pregnancy
Pelvic peritonitis
Urgent admission of a patient with complaints on pain in the lower abdomen with irradiation to the
rectum, blood-tinged discharge from genital passages, dizziness. Complaints appeared suddenly. Last
menses was 2 weeks ago. Skin integuments are pale, pulse – 102 beats/min., arterial pressure – 90/60
mm Hg. Abdomen is tense, somewhat painful in the lower areas, symptoms of irritation of the
peritoneum are slightly positive. What is the most probable diagnosis?
Intestinal obstruction.
Fibroid, which is being born.
Ovarian apoplexy.
Ectopic pregnancy.
Setting out abortion.
Woman, aged 26 years was admitted to admission department with complaints on sudden pain in the
lower abdomen, malaise, loss of consciousness at home. Previous menses was absent. Hb – 106 g/l,
pulse rate – 120 beats/min, arterial pressure – 80-50 mm Hg., tenderness and symptoms of peritoneal
irritation are in the bottom in the right side. What diagnosis is the most probable?
Interrupted uterine pregnancy.
Acute appendicitis.
Right-sided acute salpingoophoritis
Torsion of the ovarian pedicle.
Intestinal obstruction
Patient, aged 20 years was admitted to gynecologic unit with complaints on acute sudden pain in the
lower abdomen in the lumbar area, moderate blood-tinged discharge from reproductive ways. Delay
of menses – 2 weeks. On bimanual examination: uterine cervix is of 3,5 cm length, soft, cyanotic,
through external os tip of the fingers passes. Uterine body is of ovoid form, large one, of softened
consistency. In the left a soft formation, movable, painful on palpation is palpable. Discharge is
blood-tinged, insignificant. Arterial pressure – 95/60 mm Hg., pulse rate – 100 beats/min. What
diagnosis is the most probable?
Incipient abortion.
Threatened abortion.
Abortion in progress.
Uterine body leiomyoma.
Ectopic pregnancy.
369.
A. *
B.
C.
D.
E.
370.
A.
B.
C.
D. *
E.
371.
A.
B. *
C.
D.
E.
372.
A.
B. *
C.
D.
E.
Patient P., aged 37 years appealed to gynecologic unit complaining of pain in the lower abdomen,
which becomes worse during 24 day period, nausea, elevation of body temperature to 38,5*C. Patient
fell ill 15 days ago after surgery for artificial abortion. Objectively: T- 38,5*C, pulse rate – 100
beats/min. Tongue is dry, abdomen is tense in the lower portions, signs of peritoneal irritation are is
positive. On bimanual examination: sharp pain develops in replacement of uterine body, contours of
the uterus and appendage are not defined clearly because of tension of the anterior abdominal wall. In
the right side through the crypt, pole of formation of ovoid form is determined, painful on palpation.
Vaginal discharge is pus-like. What diagnosis is the most probable?
Pelvic peritonitis.
Acute salpingoophoritis.
Acute appendicitis.
Parametritis.
Gonorrhea pelvic peritonitis.
Patient was admitted to gynecologic unit complaining of menstruation delay during 2 weeks, staining
blood-tinged discharge from reproductive passages, pain in the lower abdomen more expressed in the
left side, nausea, vomiting, weakness. In the past history: chronic adnexitis. On bimanual
examination: uterus body is slightly enlarged in sizes, softened, appendages in the left are enlarged,
painful on palpation, uterine cervix is conical in shape, external os is closed. Posterior crypt hangs
over, very painful. Reaction to chorionic gonadotropin is positive, By ultrasonic examination: in the
uterine cavity a fetal ovum is not determined. What diagnosis is the most probable?
Secondary amenorrhoe.
Exacerbation of chronic salpingoophoritis.
Shtein-Leventhal’s syndrome.
Ectopic pregnancy.
Endometriosis.
Patient, aged 20 years was admitted to the hospital with sharp pains in the lower abdomen in the left.
The last normal menstruation was 2 weeks ago, in time. Arterial pressure – 100/70 mm Hg., pulse
rate – 90 beats/min., body temperature is 36,9*C, patient is pale. Abdomen is painful in the lower
portions. Blumberg-Schyotkin’s symptom is slightly positive. On vaginal examination: uterine cervix
is of conical shape, external os is closed. Uterine is not enlarged, sensitive. Appendages on the right
are not palpable. On the left something painful appendages are palpable. Crypts hang over, painful
ones. What diagnosis is the most probable?
Uterine leiomyoma.
Apoplexy of the ovary.
Ectopic pregnancy.
Inflammation of the uterine appendages.
Acute appendicitis.
Patient, aged 28 years was admitted to the in-patient unit complaining of sharp pains in the lower
abdomen which developed 2 hours ago and of blood-tinged staining discharge from reproductive
ways. Last menstruation began 2 months ago. On bimanual examination: uterine body is somewhat
enlarged. Displacement along the uterine cervix is sharply painful. Uterine appendages in the left are
enlarged, painful. In the blood: Hb – 102 g/l, ESR – 32, leucocytes – 6,5x109/l, diastase – 8g/hour l.
Signs of peritoneal irritation are positive. What is the most probable diagnosis?
Uterine leiomyoma.
Disturbed uterine pregnancy.
Acute appendicitis.
Progressive ectopic pregnancy.
Abortion in progress.
373.
A.
B.
C. *
D.
E.
374.
A. *
B.
C.
D.
E.
375.
A.
B.
C.
D. *
E.
376.
A. *
B.
C.
D.
E.
377.
A.
Patient B., 22 years of age complains of aching pains in the right iliac area, lasting during a week,
nausea in the morning, gustatory changes. In the past history: menstruation delay – 3 weeks.
Objectively: arterial pressure: 110/70 mm Hg., pulse rate – 78 beats/min., body temperature – 37*C.
On bimanual examination: uterine is slightly enlarged, softened, movable, painless. Appendages: in
the left side a painful formation of 3x4 cm, dense-elastic consistency, limitedly movable is palpable.
What diagnosis should be made?
Cyst of the right ovary.
Disturbed uterine pregnancy.
Progressive uterine pregnancy.
Uterine pregnancy.
Acute appendicitis.
Ambulance delivered a patient complaining of short-term loss of consciousness, dizziness, sharp pain
in the right lower abdomen, last menstruation was 2 weeks ago. Skin integuments are pale. Pulse rate
– 110 beats/min., pulse is thread, Hb - 76 g/l, body temperature – 36,8*C, blood pressure – 80/60 mm
Hg., abdomen falls behind on respiration in the lower portions, palpation of the abdomen on the
bottom is painful. On examination: uterine cervix is within the norm, cervical canal is closed. Uterine
body is not enlarged, on palpation insignificant tenderness is noted. Appendages in the right side on
palpation are painful, ovary is enlarged. Posterior fornix of the vagina hangs over. What is the most
probable diagnosis?
Ruptured ectopic pregnancy.
Acute appendicitis.
Apoplexy of the ovary.
Acute salpingoophoritis.
Torsion of the cystoma of the right uterine appendages.
Woman, aged 28 years appealed for doctor’s advice complaining of acute pain in the left iliac area,
no menstruation delay. By the data of ultrasonic examination 2 months ago ovarian cyst in the left
was revealed. Patient refused from hospitalization. On vaginal examination: in the left side
tumor-like formation, sizes of 5x7 cm., painful one, very movable is determined. What is the most
probable diagnosis?
Ectopic pregnancy.
Apoplexy of the ovaries.
Threatening abortion.
Torsion of the ovarian cyst.
Hydatid mole.
Patient K. aged 19 years, 3 hours ago after physical culture lesson developed pain in the lower
abdomen in the left, dryness in the mouth. Menstruation was 2 weeks ago. Pulse rate – 92 beats/min.,
rhythmic one. Arterial pressure – 95/55mm Hg. Tongue is dry and coated. Abdomen “breathes”, but
painful in the right iliac area and suprapubic junction, doubtful symptoms of peritoneal irritation are
noted. What diagnosis should be made?
Apoplexy of the ovary.
Acute appendicitis.
Acute salpingoophoritis.
Disturbed uterine pregnancy.
Renal colic in the left.
Patient S., aged 41years appealed for doctor’s advice complaining of periodic pains in the lower
abdomen, painful profuse, prolonged menstruation. On bimanual examination: uterine was enlarged
to 9 weeks of pregnancy, along the posterior wall a node, sizes 3x3 cm is palpable, uterine body is
movable, painful, appendages are without peculiarities. What disease should be thought of?
Ovarian tumor.
B.
C.
D.
E. *
378.
A. *
B.
C.
D.
E.
379.
A.
B. *
C.
D.
E.
380.
A. *
B.
C.
D.
E.
381.
A.
B.
C.
Adenomyosis.
Uterine pregnancy.
Chronic endometritis.
Ischemia of fibromatous node.
Woman, aged 30 years was admitted to gynecologic unit for planned surgical intervention because of
tumor-like formation in the area of the right appendages, sizes 9x8 cm., of dense-elastic consistency,
movable, painless. While performing physical work, severe pain developed, woman lost
consciousness. During surgical intervention a thin-walled formation on the long pedicle, containing
hair and teeth was removed. What diagnosis should be made?
Torsion of the dermoid ovarian cyst.
Uterine leiomyoma.
Ovarian cancer.
Hydrosalpinx.
Pyo-ovarium.
Patient, aged 28 years complains of pain in the lower abdomen, loss of consciousness developed at
home. Menstruation is in time. Skin is pale, pulse rate – 110 beats/min., Hb. – 76 g/l., arterial
pressure is 80/60. Signs of peritoneal irritation are positive. On vaginal examination: uterine body is
not enlarged, painful on ectopia, appendages are not palpable. Posterior fornix of the vagina hangs
over, painful. On abdominal paracentesis through the posterior crypt, bright blood, which coagulates
was obtained. What is the most probable diagnosis?
Disturbed ectopic pregnancy.
Ovarian apoplexy.
Torsion of the cystoma of the right uterine appendages.
Acute salpingoophoritis.
Acute appendicitis.
Patient, aged 23 years, married. Menstruation has been since 16 years, regular one. Last menstruation
was 7 weeks ago. Regular sexual life. Patient does not use means of contraception. In the past
history: chronic adnexitis,, patient is followed up at the prenatal center, received treatment several
times due to exacerbation of the inflammatory process of the small pelvis organs. By the data of
ultrasonic examination, a formation, sizes - 7x3x4 cm in the area of the right appendages was
revealed. Diagnosis of hydrosalpinx was made. On her way to work patient experienced sharp pain in
the lower abdomen, lost consciousness. She was delivered to gynecologic unit by an ambulance in a
severe state. Skin and mucous membranes are pale, arterial pressure – 75/40 mm Hg. Pulse rate is
116 beats/min., body temperature – 38*C, symptom of irritation of the peritoneum is positive. What
is the most probable diagnosis?
Ruptured ectopic pregnancy.
Abortion in progress.
Rupture of the ovarian cyst.
Pelvioperitonitis.
Perforating gastric ulcer.
Patient with uterine fibromyoma (first revealed 4 years ago). During observation uterine sizes are
stable (correspond to 8-9 weeks of pregnancy. Patient appealed for doctor’s advice, complaining of
sharp pains in the lower abdomen. On examination: sharply positive symptoms of irritation of the
peritoneum, high leucocytosis. On vaginal examination: uterine is enlarged to 9 weeks of pregnancy
term at the expense of fibromatous nodes, one of them is movable, sharply painful. Appendages are
not palpable. Discharge is mucous, moderate one. What is treatment tactics?
Urgent surgical intervention (laparotomy).
Observation and spasmolytic therapy.
Fractional diagnostic curettage of uterine walls.
D. *
E.
382.
A.
B. *
C.
D.
E.
383.
A.
B.
C. *
D.
E.
384.
A.
B.
C.
D. *
E.
385.
A. *
B.
C.
D.
E.
386.
A. *
B.
Surgical laparoscopy.
Observation and therapy with antibiotics.
Patient, aged 28 years was admitted to the gynecologic unit complaining of sharp pain in the lower
portions of the abdomen, pain developed suddenly on the 4-th week of menstruation delay. Skin
integuments are pale, pulse rate – 110 beats/min., arterial pressure – 90/60. Abdomen is sharply
painful on palpation in the lower portions, positive symptom of irritation of the peritoneum. On
vaginal examination: uterine is enlarged, deviated to the right, on the left – oblong formation, painful
on palpation is revealed, posterior fornix is sharply painful, hangs over. What is the most informative
method of investigation?
Diagnostic laparoscopy.
Paracentesis of the posterior fornix.
Test for chorionic gonadotropin.
Ultrasonic investigation.
Dynamics of total blood analysis.
Patient, aged 43 years complains of constant dull pains in the lower abdomen, mostly in the left side,
elevation of body temperature up to 38*C. During the last 5 years patient is followed up due to
subserous uterine fibromyoma. On bimanual examination: uterine is enlarged to 10 weeks of
gestation term, solid, tuberous one. In the left side of the uterine, formation coming out of the uterine,
size 6x8 cm., of elastic consistency, sharply painful on palpation is observed. What is the most
probable diagnosis?
Pyosalpinx.
Extrauterine pregnancy.
Necrosis of myomatous node.
Cyst of the left ovary, which became suppurated.
Uterine sarcoma.
Patient, aged 37 years was admitted to the gynecologic unit complaining of intensive cramp-like
pains in the lower abdomen, bleeding from reproductive passages. Over the period of the last 4 years
patient experienced profuse menstruation, sometimes transitory into bleeding. Patient was not
followed up at gynecologist. On bimanual examination: uterine cervix is smoothened, external os is
opened up to 4 cm., in the cervical canal a dense tumor-like formation is palpable. Uterine is
enlarged, dense. What is the most probable diagnosis?
Necrosis of fibromatous node.
Abortion in progress.
Hydatid mole.
Protruding myoma.
Uterine cancer.
A patient with acute pelvic pain has a low grade fever, nontender uterus and negative beta hCG test.
The most probable diagnosis would be:
Salpingitis
Appendicitis
Missed abortion
Ectopic pregnancy
Rupted ovarian cyst
At the vaginal examination of the patient you revealed the following: the exernal os of cervix is
closed, the uterus is slightly enlarged, soft, the right of the appendages is soft and painful. There is
pain with movement of the cervix. Possible diagnosis:
progressive tubal pregnancy.
apoplexy of the right ovary.
C.
D.
E.
387.
A.
B.
C.
D. *
E.
388.
A.
B.
C. *
D.
E.
389.
A. *
B.
C.
D.
E.
390.
A.
B.
C. *
chronic inflammation of the right adnexa.
Appendicitis.
All answers are correct.
Patient 29 years, delivered by the emergency, complains about acute pains in lower parts of an
abdomen. Pains arose up suddenly, at getting up of weight. The last menstruation was 10 days ago, in
the term. Labors — 2, abortions — 2. The last time visited gynecologist half-year ago, ovarian cyst
was definite. Pulse - 100 in a minute, rhythmic, breathing 22 in a minute. Abdomen is tense, acutely
painful, especially on the left. Objectively: the uterine cervix is cylinder, deformed by old postnatal
ruptures, clean. The uterine body is not determined due to tension of abdominal wall. Right adnexa
not palpated. A tumor without clear contours is palpated in the region of the left adnexa, elastic
consistency; the mobile is limited, painful. Parametriums are free. What most reliable diagnosis?
The ruptured ectopic pregnancy.
Torsion of pedicle of ovarian cyst.
Apoplexy of ovary.
Rupture the cysts of ovary.
Appendicitis
The patient 36 years complains on pain in lower parts of abdomen on the left side, which arose up
suddenly. Objectively: external genital organs without pathology, the uterine cervix is cylindric,
clean. The body of uterus is enlarged to 12—13 weeks of pregnancy, the mobile is limited. One of
fibroids on the left near a fundus acutely painful. Adnexa are not determined, its region is unpainful.
Parametrium is free. Excretions serous. Blood test: Haemoglobin — 120 g/l, leucocytes — 12x109
/л. What is the most reliable diagnosis?
Chorionepithelioma.
Spontaneous rupture of pregnant uterus.
Necrosis of fibroid.
The interrupted pregnancy in the interstitsial region of fallopian tube.
Destructive form of the molar pregnancy.
The patient 36 years complains about pain in lower parts of abdomen, that reminds the labor
contractions, weakness. The menstruations last 2 years are more abundant, of long duration. The last
menstruation began 2 days ago. Objectively: A skin and mucous membranes are pale, pulse 88 in 1
min. Abdomen is soft, unpainful. Gynecological status: external genital organs without pathology,
the uterine cervix is cylinder, a canal freely skips 2 fingers. From a cervix a tumor 3x6 cm hangs
down to the vagina, pedicle by thickness to 1 cm enters to the cavity of uterus. The tumor is a
dark-purple color, at contact bleeds. The body of uterus is enlarged to 7-8 weeks of pregnancy,
unequal surface, mobile, not painful. Adnexa are not determined. What is the most reliable
diagnosis?
The protruding fibroid
Endophytic growth of cancer of uterine cervix
Chorionepithelioma, metastasis in the uterine cervix
Inevitable abortion in 7-8 weeks of pregnancy
Exophytic growth of cancer of uterine cervix
In the gynecological department a woman 25 years appealed with complaints about the rise of
temperature of body to 38,60С, pain in lower parts of abdomen, dysuria. Became ill 3 days to that,
when the indicated complaints appeared after artificial abortion. At gynecological examination: the
uterine cervix is cylinder, external os is closed. Body of uterus a few enlarged, painful, soft. The
adnexa of uterus are not palpated. Excretions festering-bloody. In the blood test leycocytosis with
displacement of formula of blood to the left, speed-up ESR. What diagnosis is most credible?
Acute endocervicitis
Acute salpingoophoritis
Acute endometritis
D.
E.
391.
A.
B.
C.
D. *
E.
392.
A.
B. *
C.
D.
E.
393.
A.
B.
C. *
D.
E.
394.
A.
B. *
C.
D.
E.
Acute cystitis
Piosalpinx
Patient delivered in the gynecological department by the emergency. Two hours ago suddenly the
acute pain in an abdomen, nausea, vomits began. The last menstruation was two weeks ago. Patient is
pale, pulse 116, soft, AP 70/40 mm Hg. An abdomen does not take part in breathing. Vaginally: the
posterior fornix of vagina is painful, uterus of normal sizes, mobile, painful at palpation. Adnexa are
not palpated through the tension of abdominal wall. Blood test: leucocytes 8x109/l. A pregnancy test
is negative. Diagnosis?
Acute appendicitis
The ruptured ectopic pregnancy
Necrosis of subserosal fibroid
Ovarian apoplexy
Acute bilateral adnexitis
Patient D., 30 years, delivered with complaints about pain in lower parts of abdomen of periodic
character which arose up suddenly, irradiate in sacrum and anus, and also on spotting bloody
excretions. The last menstruation - 6 weeks ago. In anamnesis there are 1 labor, 2 abortions. After the
last abortion - acute bilateral adnexitis. Objectively: the patient’ condition is satisfactory, t-36,8o. The
symptoms of irritation of peritoneum are not exposed. Vaginal examination: uterine cervix of
cyanotic, the uterus is enlarged in sizes, sensible at palpation; right adnexa - without changes. In the
projection of the left adnexa – tumor which mobile is limited, consistency elastic, shape egg-like by
sizes 4х4х5 cm, acutely painful at palpation; discharges are bloody, moderate. Diagnosis?
Cyst of the left ovary with violation of blood supply
The ruptured left-side ectopic pregnancy
Acute left-side adnexitis
Subserosal leyomyoma with violation of blood supply
Apoplexy of the left ovary
A woman, 26 years, appealed to the doctor of female dispensary with complaints about absence of
menstruation (delay on 26 days) and feeling of nausea, mostly in the morning. A test on pregnancy is
positive. Earlier a menstrual cycle was regular. Pregnancies were not present before. It is set at the
objective inspection: mucous membrane the cervix is cyanotic, uterine consistency is soft, some
enlarged in uterine sizes is present. Ultrasonography – a fetal sac in the uterine cavity is not exposed.
The most credible diagnosis?
Violation of menstrual cycle
Uterine pregnancy
Unruptured ectopic pregnancy
Ruptured ectopic pregnancy
Ovarian insufficiency
Patient 34 years. The uterine myoma is exposed 2 years ago. Growth is not present. There is pain in
lower parts of abdomen. Leucocytosis 17х109 /L. The symptoms of irritation of peritoneum are
positive. At vaginal examination: the uterus is enlarged to 10 weeks of pregnancy, one of fibroids is
mobile, painful. Excretions are mucous. Diagnosis?
Cyst of ovary
Fibroid’ torsion
Acute adnexitis
Rupture of piosalpinx
Acute appendicitis
395.
A. *
B.
C.
D.
E.
396.
A. *
B.
C.
D.
E.
397.
A. *
B.
C.
D.
E.
398.
A.
B.
C.
D.
E. *
399.
A. *
B.
C.
D.
E.
Women, 39 year admitted to the gynecology department with complaints of severe abdominal pain,
occurring after physiological activity. In bimanual examination found sharply painful swelling in the
pelvis, the positive symptoms of peritoneal irritation on the side of the tumor. Your diagnosis?
torsion of ovary cancer stem
spontaneous miscarriage
acute salpingoophoritis
dysfunctional uterine bleeding
none of the above
In the gynecology department admitted a woman 23 year with complaints of sudden onset of pain in
one of the iliac regions, radiating pain in the shoulder, nausea, and vomiting, delayed menstruation
for 3 weeks. Pregnancy test is positive. Your diagnosis?
an ectopic pregnancy, the type of rupture of the uterine tube
torsion of ovary cancer stem
spontaneous miscarriage
acute salpingoophoritis
Uterine pregnancy
In 27 years old woman you suspect tubal abortion (without significant intra-abdominal bleeding).
With which diseases you would differentiate:
a miscarriage of small time
acute salpingoophoritis
Ovarian apoplexy
Acute appendicitis
All answers are correct
Patient 22 years, complains about absence of pregnancy during 5 years of marriage. For the last 3
years conducted medical and resort treatment. Two months ago metrosalpingography was done —
tubes’ permeability is normal. The last menstruation was with the delay on 2 weeks, painful. 2 days
ago bloody excretions in a small amount and pain in lower parts of abdomen appeared again.
Objectively: the uterine cervix is cyanotic, external os is closed. The uterus in normal position,
enlarged to 5 weeks of pregnancy, is soft, mobile. Right adnexa are not determined. The left adnexa
are enlarged in sizes to 6x3 cm, painful at palpation. Parametriums are free. Discharges are bloody, in
a little quantity. Blood test: Haemoglobin — 90g/l, red cells — 3,0 h 10 /l, leucocytes— 8,6 h 10 /l.
What is the most reliable diagnosis?
Pregnancy 6-5 weeks. Initial abortion. Cyst of the left ovary.
Pyosalpinx after metrosalpingography
The molar pregnancy
Violation of menstrual cycle
Ectopic pregnancy, tubal abortion
A 23 years old primigravida presents with abdominal pain, syncope and vaginal spotting, assessment
reveals that she has an ectopic pregnancy, the most common site of pregnancy is:
Ampula
Isthmus
Fimbrial end
Abdomen
Cervix
400.
A.
B. *
C.
D.
E.
401.
A. *
B.
C.
D.
E.
402.
A.
B.
C.
D. *
A 31-year-old woman comes to the physician for follow-up after an abnormal Pap test and cervical
biopsy. The patient's Pap test showed a high-grade squamous intraepithelial lesion (HGSIL). This
was followed by colposcopy and biopsy of the cervix. The biopsy specimen also demonstrated
HGSIL. The patient was counseled to undergo a loop electrosurgical excision procedure (LEEP).
Which of the following represents the potential long-term complications from this procedure?
Abscess and chronic pelvic inflammatory disease
Cervical incompetence and cervical stenosis
Constipation and fecal incontinence
Hernia and intraperitoneal adhesions
Urinary incontinence and urinary retention
A 40-year-old woman comes to the physician for an annual examination. She has no complaints. She
has menses every 28-30 days that last for 3 days. She has no intermenstrual bleeding. She has
asthma, for which she uses an occasional inhaler. She had a tubal ligation 10 years ago. She has no
known drug allergies. Examination is unremarkable, including a normal pelvic examination. One of
her friends was recently diagnosed with endometrial cancer, and the patient wants to know when and
if she needs to be screened for this. Which of the following is the most appropriate response?
Screening for endometrial cancer is not cost effective or warranted
Screening is with endometrial biopsy and starts at age 40
Screening is with endometrial biopsy and starts at age 50
Screening is with ultrasound and starts at age 40
Screening is with ultrasound and starts at age 50
A 21-year-old G0 woman has her first Pap smear, and it shows a high-grade squamous intraepithelial
lesion (HSIL.) Colposcopy is performed, and three biopsies and an endocervical curettage are
obtained. The biopsy and endocervical curettage were read as normal. Which of the following would
be the most appropriate next step in the management of this patient?
Pap smear in 6 months
Colposcopy with directed biopsies in 3-6 months
Cryotherapy
Cervical conization
E.
403.
Treat for presumed infection and repeat Pap in 4-6 weeks
An 88 year-old G2P2 nursing home resident is brought in for evaluation of blood found in her
diapers. She has a long-standing history of incontinence. This is the first time that her caregivers have
noted blood. They describe it as “quarter size.” Her nurses think that she may have been itching, as
they frequently find her scratching through the diaper. On review of her medical record, biopsy
documented lichen sclerosus of the vulva was diagnosed fifteen years ago. She has not been on any
therapy for this condition for years. Examination of the external genitalia reveals an elevated, firm
irregular lesion arising from the left labia. The lesion measures 2.5 cm in greatest dimension. The
remainder of the external genitalia shows evidence of excoriation of thin, white skin with a wrinkled
parchment appearance. The vagina and cervix are atrophic. No masses are noted on bimanual or
rectovaginal exam and a sample of her stool is negative for blood. No nodularity is noted in her
groin. Which of the following is the most appropriate next step in the management of this patient?
A.
B.
C. *
D.
E.
Begin steroids for her lichen sclerosis
Benadryl and xylocaine jelly for symptomatic relief
Biopsy the lesion
Exam under anesthesia with colposcopy and CO2 laser ablation
Complete vulvectomy and lymph node dissection
404.
A.
B. *
C.
D.
E.
405.
A.
B. *
C.
D.
E.
406.
A.
B.
C.
D.
E. *
407.
A. *
B.
C.
D.
E.
408.
A.
B.
C.
D. *
E.
A 57 year-old G2P2 woman is seen for a routine visit. She states she and her 75 year-old husband
stopped having sexual intercourse 3 years ago when he had an operation for prostate cancer.
Menopause occurred at age 50 and she denies taking hormones. Her husband now wishes to resume
intercourse and is able to get an erection with sildenafil (Viagra). Attempts at intercourse have been
unsuccessful due to the pain she experiences when insertion is attempted. Examination is normal
except for a narrowed vagina with atrophic mucosa. Which of the following is the most appropriate
recommendation at this time?
Progesterone cream
Estrogen cream
Oral estrogen
testosterone cream
Vaginal dilators
A 39 year-old G1P1 woman comes to see you because of increased bleeding due to her known
uterine fibroids, especially during her menses. She reports that her bleeding is so heavy that she has
to miss two days of work every month. She has been using oral contraceptives and NSAIDs. Her
most recent hematocrit was 27%. She is undecided about having more children. You discuss with her
short and long-term options to decrease her bleeding. What is the next best step in the management of
this patient?
Blood transfusion
Gonadotropin-releasing hormone agonists
Endometrial ablation
Hysterectomy
Uterine artery embolization
A 28-year-old G0 woman has her first abnormal Pap, which was read as high-grade squamous
intraepithelial lesion (HSIL.) She has no complaints. She smokes one pack of cigarettes per day. Her
pelvic exam is normal. Colposcopy is performed. The cervix is noted to have an ectropion and there
is abundant aceto-white epithelium. Mosaicism, punctations and several disorderly, atypical vessels
are noted. Several biopsies are obtained and sent to pathology. Which of the findings on this patient’s
colposcopy is most concerning?
Ectropion
Acetol-white epithelium
Mosaicism
Punctations
Disorderly, atypical vessels
The patient K, 48 years old, came for regular check-up. Which process the type I does reflects in
Pap smear test?
Normal epithelium.
Moderate dysplasia.
Cancer.
Inflammation.
Malignization suspect.
The patient C, 38 years old, complains on excessive with odor discharge from the vagina lately.
Which process does the type IIA reflect in Pap smear test?
Normal epithelium.
Moderate dysplasia.
Cancer.
Inflammation.
Malignization suspect.
409.
A.
B. *
C.
D.
E.
410.
A.
B. *
C.
D.
E.
411.
A.
B. *
C.
D.
E.
412.
A. *
B.
C.
D.
E.
A 76-year-old G3P3 presents to the office with worsening stress urinary incontinence for the last 3
months. She reports an increase in urinary frequency, urgency and nocturia. On exam, she has a
moderate size cystocele and rectocele. A urine culture is negative. A post-void residual is 50 cc. A
cystometrogram shows two bladder contractions while filling. Which of the following is the most
likely diagnosis in this patient?
Genuine stress incontinence
Urge incontinence
Overflow incontinence
Functional incontinence
Continuous incontinence
An 81 year-old G3P3 woman presents to your office with a history of light vaginal spotting. She
states this has occurred recently and in association with a thin yellow discharge. She never
experienced any vaginal bleeding since menopause at the age of 52, and denies ever having been on
hormone replacement therapy. She is otherwise reasonably healthy, except for osteoporosis,
well-controlled hypertension, and diabetes. She is physically active and still drives to all her
appointments. She is no longer sexually active since the death of her husband 2 years ago. On
examination, she is noted to have severe atrophic changes affecting her vulva and vagina. A small
Pederson speculum allows for visualization of a normal multiparous cervix, and the bimanual
examination is notable for a small, mobile uterus. Rectovaginal exam confirms no suspicious adnexal
masses or nodularity. Which of the following is the most appropriate management for this patient?
Pelvic transvaginal ultrasound
Office endometrial biopsy
Reassurance and observation for further bleeding
Vaginal estrogen therapy
Dilation and curettage
A 35 year-old G3P3 comes to the office to discuss tubal ligation as she desires permanent
sterilization. What are the non-contraceptive health benefits of female sterilization?
Reduced risk of endometriosis
Reduced risk of ovarian cancer
Protection against endometrial cancer
Reduction in menstrual blood flow
Reduced risk of sexually transmitted infections
A 38 year-old G1P1 woman comes to the office for an annual exam. She has noticed some urinary
frequency over the past month. She has no dysuria, hematuria, urgency or incontinence. She has
normal cycles, no history of abnormal Pap smears or sexually transmitted infections and is sexually
active, with 1 partner. She smokes a quarter of a pack of cigarettes daily, and drinks one glass of
wine per day. Her mother had breast cancer at age 30. Her general examination is normal. On pelvic
exam, she has normal external genitalia; vagina and cervix are without lesions. Her uterus is normal
size, anteverted and nontender. Her left adnexa is normal, right adnexa has a mobile, slightly tender 4
cm mass. Laboratory results show a normal urinalysis, a negative urine pregnancy test and a normal
Pap smear. What is the most appropriate next step in the management of this patient?
Perform a transvaginal ultrasound
Perform a diagnostic laparoscopy
Recommend a CT-guided drainage of the mass
Order a KUB plain film
Perform an exploratory laparotomy
413.
A.
B.
C. *
D.
E.
414.
A.
B.
C.
D. *
E.
415.
A. *
B.
C.
D.
E.
416.
A. *
B.
C.
D.
E.
417.
A.
B.
C. *
D.
E.
A 52 year-old nulliparous woman presents with long-standing vulvar and vaginal pain and burning.
She has been unable to tolerate intercourse with her husband because of introital pain. She had
difficulty sitting for prolonged periods of time or wearing restrictive clothing because of worsening
vulvar pain. She recently noticed that her gums bleed more frequently. She avoids any topical
over-the-counter therapies because they intensify her pain. Her physical examination is remarkable
for inflamed gingiva and a whitish reticular skin change on her buccal mucosa. A fine papular rash is
present around her wrists bilaterally. Pelvic examination reveals white plaques with intervening red
erosions on the labia minora as shown in picture below. A speculum cannot be inserted into her
vagina because of extensive adhesions. The cervix cannot be visualized. Which of the following is
the most likely diagnosis in this patient?
Squamous cell hyperplasia
Lichen sclerosus
Lichen planus
Genital psoriasis
Vulvar cancer
You are collecting data from a 37-year-old client who you suspect may have fibroid tumors. You
expect her subjective data to include which of the following symptoms?
Urinary urgency
Difficult defecation
Cyclic migraine headaches
Deep pelvic paindyspareunia
All of the above
History of obesity, nulliparity, chronic anovulation, irregular intermenstrual bleeding, non tender
uterus in 47-year-old woman gives indication for?
Endometrial cancer/ hyperplasia
Hormonal changes
Sexual transmitted disease
Pelvic Inflammatory disease
Fibroids
A 52-year-old woman comes to the physician because of a 1-month history of headache, weakness,
tingling of her extremities, muscle cramping, and fatigue. Her blood pressure is 170/110 mm Hg.
Physical examination shows no other abnormalities. Laboratory studies show a decreased serum
potassium concentration, metabolic alkalosis, and decreased plasma renin activity; serum sodium
concentration is within the reference range. Urine catecholamine concentrations are within the
reference range. Which of the following is the most likely diagnosis?
Adrenal adenoma
Focal segmental glomerulosclerosis
Hypothalamic tumor
Juxtaglomerular cell tumor
Renal artery stenosis
A twenty year old is found to have moderate dysplasia (high grade SIL) on a routine PAP. Moderate
inflammation is noted on the PAP. The next appropriate step in management is?
repeat PAP in 3 months
treat inflammation and repeat PAP in 3 months
colposcopy and biopsies
wire loop excision of the transformation zone
cold knife conization
418.
A. *
B.
C.
D.
E.
419.
A.
B.
C.
D. *
E.
420.
A. *
B.
C. *
D.
E.
421.
A.
B.
C. *
D.
E.
Which treatment is followed by a 40 years patient with cervical dysplasia with the deformation of the
cervical canal:
diatermoconization of cervix
diathermocoagulation of cervical
laser
treatment by solkovagin
hysterectomy without appendages
A 29-year-old woman comes to the physician for follow-up of a right breast lump. The patient first
noticed the lump 4 months ago. It was aspirated at that time, and cytology was negative, but the cyst
recurred about 1 month later. The cyst was re-aspirated 2 months ago and, again, the cytology was
negative. The lump has recurred. Examination reveals a mass at 10 o'clock, approximately 4 cm from
the areola. Ultrasound demonstrates a cystic lesion. Which of the following is the most appropriate
next step in management?
Mammography in 1 year
Ultrasound in 1 year
Tamoxifen therapy
Open biopsy
Mastectomy
A 43-year-old African American woman comes to the physician because of her concern regarding
breast cancer. She has no complaints at present. In past years, she had noted bilateral breast
tenderness prior to her menses, but this has since abated. She has no medical problems. She had two
cesarean deliveries, but no other surgeries. She takes a low-dose oral contraceptive pill and has no
known drug allergies. She does not smoke, and her family history is negative. Physical examination
is normal. All mammograms (yearly since age 40) have been negative to date. She wants to know
whether BRCA1 and BRCA2 screening would be appropriate for her. Which of the following is the
correct response?
BRCA1 and 2 screening is not recommended
BRCA1 and 2 screening should be performed after age 50
BRCA1 and 2 screening should be performed if breast pain recurs
BRCA1 screening is recommended
BRCA2 screening is recommended
A 50 year-old G4P4 woman presents for her yearly checkup. She states her menses are of normal
flow every 32 days, with minimal cramping and 5-day duration. Review of systems is negative. She
has no medical problems. She had a bilateral tubal ligation following her last child, and a
laparoscopic cholecystectomy 5 years ago. She has a history of LGSIL Pap smear with colposcopy
and cryotherapy 15 years ago; her Paps have been normal since then. She does not smoke, drink
alcohol or use any drugs. She is sexually active with one partner with no problems. Her general
exam, including a breast exam and pelvic exam, is normal. In addition to performing a Pap smear,
which of the following is the most appropriate screening test for this patient?
Pelvic ultrasound
Endometrial biopsy 1% C. 94% D. 2% E.
Mammogram
DEXA scan
Colposcopy
422.
A.
B. *
C.
D.
E.
423.
A.
B.
C.
D. *
E.
424.
A. *
B.
C.
D.
E.
425.
A.
B.
C.
D. *
E.
426.
A.
B.
C. *
D.
A 25 year-old G1P1 comes to the office due to left breast pain and fever. She is breast feeding her 2
1/2- week old infant. The symptoms began earlier in the day and are not relieved by acetaminophen.
Blood pressure 120/60; pulse 64; temperature 99.9° F, 37.7° C. On exam, she has erythema on the
upper outer quadrant of the left breast, which is tender to touch; there are no palpable masses. In
addition to starting oral antibiotics, what is the most appropriate next step in the management of this
patient?
Discontinue breastfeeding
Add ibuprofen for pain relief
Obtain a breast ultrasound
Use a topical antifungal
Admission to the hospital
A 23 year-old G1P1 delivered her first baby two days ago after an uncomplicated labor and vaginal
delivery. She wants to breast feed and has been working with the lactation team. Prior to discharge,
her temperature was 100.4°F, 38°C (other vitals were normal). She denies urinary frequency or
dysuria and her lochia is mild without odor. On examination, her lungs are clear, cardiac exam
normal, and abdomen and uterine fundus are nontender. Her breasts are firm and tender throughout,
without erythema and nipples are intact. Which of the following is the most likely cause of her fever?
Endomyometritis
Septic pelvic thrombophlebitis
Mastitis
Breast engorgement
Vaginitis
A 61 years old woman comes to the office because of an enlarging breast mass. Exam reveals a firm,
fixed, 3 cm mass in the right upper outer quadrant, the biopsy of mass reveals loss of cell
differentiation and lack of tissue organization, which if the following term best corresponds to this
finding?
Anaplasia
Desmoplasia
Dysplasia
Hyperplasia
Metaplasia
A 67 years old woman with advanced metastatic breast cancer comes to the clinic for follow-up visit,
her chief complaint at this time is weight loss and a reduced appetite. Which of the following is
thought to be a major contributor to her chief complaint?
Clathrin
Histamin
Interferon
Tumor necrosis factor (TNF)
Interleukin
45 years old woman presents with blood tinged discharge from the right nipple. The nipple appears
slightly retracted and subareolar nodule can be felt on palpation. Mammographic exam shows linear
shadows attributable to calcification. The lesion consists of dilated ducts and are surrounded by
fibrosis and chronic inflammation, focal calcium deposition is present, which of the following is the
diagnosis?
Mondor disease
Adenocarcinoma
Mammary duct Eurasia
Fat necrosis
E.
427.
A.
B.
C.
D. *
E.
428.
A.
B.
C.
D.
E. *
429.
A.
B.
C.
D. *
E.
430.
A.
B. *
C.
D.
E.
431.
A.
B. *
C.
D.
E.
Abscess
A 61 years old woman comes to the office because of an enlarging breast mass. Exam reveals a firm,
fixed, 3 cm mass in the right upper outer quadrant, the biopsy of mass reveals loss of cell
differentiation and lack of tissue organization, which if the following term best corresponds to this
finding?
Metaplasia
Hyperplasia
Dysplasia
Anaplasia
Desmoplasia
A 67 years old woman with advanced metastatic breast cancer comes to the clinic for follow-up visit,
her chief complaint at this time is weight loss and a reduced appetite. Which of the following is
thought to be a major contributor to her chief complaint?
Clathrin
Histamin
Interferon
Interleukin-2
Tumor necrosis factor (TNF)
A 30 years old woman complains of breast tenderness that becomes worse during the premenstrual
period, multiple small masses are appreciable on palpation, cytologic exam of a fine needle aspirate
reveals no malignant cells, biopsy shows multifocal cyst formation, areas of fibrosis, calcification
and apocrine metaplasia, this condition is associated with an increased risk of cancer if:
Apocrine Metaplasia is marked
Calcification is prominent
Cysts are larger than 0.5 cm
Epithelial hyperplasia is florid
Fibrosis is predominant
An 18 years old girl whose grandmother was recently diagnosed with breast cancer discovers a large,
round, movable nodule in her left breast, she visits the physician with concern about the nodule.
Which of the diagnosis should rank highest on the physician’s differential?
Cystosarcoma phyllodes
Fibroadenoma
Infiltrating ductal carcinoma
Intraductal papilloma
Fibrocystic breast disease
You are counseling a 40-year-old client who has come to the clinic because she fund a “lump” in
her breast last night. She is frantic because she believes she has cancer. The clinical breast
examination reveals firm, smooth, discrete masses in both breast. You reinforce the physicisn’s
impression that she is feeling is most likely a noncancerous “lump” and that she should have which
of the following evaluation procedures first?
Lumpectomy
Mammogram
Excisional biopsy
Stereotactic biopsy
All of the above
432.
A.
B.
C.
D.
E. *
433.
A.
B.
C.
D.
E. *
434.
A.
B.
C. *
D.
E.
435.
A. *
B.
C.
D.
E.
436.
A.
B. *
C.
D.
E.
437.
A.
A 19-year-old woman noticed a mass in her left breast 2 weeks ago while doing monthly breast
self-examination. Her mother died of metastatic breast cancer at the age of 40 years. Examination
shows large dense breasts; a 2-cm, firm, mobile mass is palpated in the upper outer quadrant of the
left breast. There are no changes in the skin or nipple, and there is no palpable axillary adenopathy.
Which of the following is the most likely diagnosis?
Lobular carcinoma
Intraductal papilloma
Infiltrating ductal carcinoma
Fibrocystic changes of the breast
Fibroadenoma
39 year old woman has been sent to the lab for evaluation of CA-125 level, this onco-marker is to
indicate?
Colon cancer
Cervical cancer
Vaginal cancer
Metastasis from lung cancer
Ovarian carcinoma
The patient C, 45 years old, complains on dull abdominal pain, weakness, loss of appetite and
weight loss for the last 5 months. Which process does the type V reflect in Pap smear test?
Normal epithelium
Moderate dysplasia.
Cancer.
Inflammation.
Malignization suspect.
You are completing the chief complaint interview with a client who states that she has a continuous
dysmenorrhea. Based on her subjective data, you suspect which of the following medical diagnoses?
Cervical cancer
Hypermenorrhea
Pelvic relaxation
Polycystic ovary disease
Moderate dysplasia.
The patient C, 55 years old, complains on dull abdominal pain, weakness, bloody-serous, such as
"meat slops"discharge from the vagina. Which additional diagnostic methods should be applied to
refine the diagnosis of cancer of uterine body?
An ultrasound scan.
Endometrectomy.
Colposcopy.
Laparoscopy.
Pap smear test
A 45-year-old G4P3 woman presents with vaginal bleeding. Last week, she performed a home
pregnancy test that was positive. She thinks her last menstrual period was four months ago. The last
time she saw her doctor was 8 years ago, with the birth of her last child. She has no serious medical
problems, has smoked a pack of cigarettes a day since the age of 20, occasionally has a beer and does
not exercise. Her vitals are normal. Abdominal examination reveals a soft abdomen and the fundus
palpable just below the umbilicus. Pelvic ultrasound reveals a fundal placenta and a fetus measuring
18 weeks with normal cardiac activity. Vaginal examination reveals a 3-centimeter lesion arising off
the posterior lip of the cervix. It easily bleeds with palpation and is hard in consistency. Which of the
following is the most likely cause of the bleeding?
Trauma
B.
C.
D. *
E.
438.
A.
B.
C. *
D.
E.
439.
A.
B.
C. *
D.
E.
440.
A. *
B.
C.
D.
E.
441.
A.
B.
C. *
Cervicitis
Threatened abortion
Cervical cancer
Nabothian cyst
A 16-year-old nulligravid woman comes to the emergency department because of heavy vaginal
bleeding. She states that she normally has heavy periods every month but missed a period last month
and this period has been unusually heavy with the passage of large clots. She has no medical
problems, has no history of bleeding difficulties, and takes no medications. Her temperature is 37 C
(98.6 F), blood pressure is 110/70 mm Hg, pulse is 96/minute and respirations are 12/minute. Pelvic
examination shows a moderate amount of blood in the vagina, a closed cervix, and a normal uterus
and adnexae. Hematocrit is 30%. Urine hCG is negative. Which of the following is the most
appropriate management?
Expectant management.
Hysteroscopy
Oral contraceptive pills
Laparoscopy
Laparotomy
A 12-year-old female comes to the physician because of a vaginal discharge. The discharge started
about 2 months ago and is whitish in color. There is no odor. The patient has no complaints of
itching, burning, or pain. The patient started breast development at 9 years of age and her pubertal
development has proceeded normally to this point. She has not had her first menses and she is not
sexually active. She has no medical problems. Examination is normal for a 12-year-old female.
Microscopic examination of the discharge shows no evidence of pseudohyphae, clue cells, or
trichomonas. Which of the following is the most likely diagnosis?
Bacterial vaginosis
Candida vulvovaginitis
Physiologic leucorrhea
Syphilis
Trichomoniasis
A 34-year-old woman comes the physician because of lower abdominal cramping. The cramping
started 2 days ago. Examination is unremarkable except for a pelvic examination that reveals a
10-week sized uterus. Urine hCG is positive, and pelvic ultrasound reveals a 10-week intrauterine
pregnancy with a fetal heart rate of 160. The patient states that she is not sure whether to keep the
pregnancy. Which of the following is the most appropriate next step in management?
Counsel the patient or refer to an appropriate counselor
Notify the patient's parents
Notify the patient's partner
Schedule a termination of pregnancy
Tell the patient that she is likely to have a miscarriage
A 67-year-old woman comes to the physician because of pain with urination and frequent urination.
She has hypertension for which she takes a beta-blocker, but no other medical problems. She states
that she is not sexually active. She does not smoke and drinks cranberry juice daily. Examination
shows mild suprapubic tenderness and genital atrophy but is otherwise unremarkable. Urinalysis
shows 50 to 100 leukocytes/high powered field (hpf) and 5 to 10 erythrocytes/hpf. Which of the
following is the most likely cause of the infection?
Cardiac disease
Cranberry juice ingestion
Hypoestrogenism
D.
E.
442.
A.
B.
C. *
D.
E.
443.
A.
B.
C.
D. *
E.
444.
A.
B.
C.
D. *
E.
445.
A.
B.
C.
D. *
Nephrolithiasis
Sexual intercourse
A 14-year old G0 adolescent reports menarche six months ago, with increasingly heavy menstrual
flow causing her to miss several days of school. Three months ago, her pediatrician started her on
oral contraceptives to control her menstrual periods, but she continues to bleed heavily. Her previous
medical history is unremarkable. The patient has a normal body habitus for her age. Appropriate
breast and pubic hair development is present. Her hemoglobin is 9.1 mg/dl, hematocrit 27.8%, urine
pregnancy test negative. Which of the following etiologies for menorrhagia is most likely the cause
of her symptoms?
Uterine leiomyoma
Thyroid disorder
Coagulation disorder
Endometrial hyperplasia
Chronic Endometritis
A 32 year-old G0 presents with amenorrhea for the last 3 months. She has a long history of irregular
cycles, 26 to 45 days apart, for the last two years. She is otherwise in good health and is not taking
any medications. She is sexually active with her husband and uses condoms for contraception. She is
5 feet 4 inches tall and weighs 140 pounds. On exam, she has a slightly enlarged, non-tender uterus.
There are no adnexal masses. What is the most appropriate next step in the management of this
patient?
Perform a pelvic ultrasound
Check a TSH level
Check progesterone and estrogen levels
Perform a urine pregnancy test
Check FSH and LH levels
A 20-year-old G1P0 woman has vaginal spotting and mild cramping for the last 3 days. She had her
last normal menstrual period approximately 6-1/2 weeks ago. She had a positive home pregnancy
test. Her medical and gynecologic histories are negative and non-contributory. On physical exam:
blood pressure 120/72; pulse 64; respirations 18; temperature 98.6°F (37°C). On pelvic exam, she has
scant old blood in the vagina, with a normal appearing cervix and no discharge. On bimanual exam,
her uterus is nontender and small, and there are no adnexal masses palpable. Pertinent labs:
Quantitative Beta-hCG is 750 mIU/ml 48 hours ago; today, the level is 760 mIU/ml; progesterone
level = 3.2 ng/ml; hematocrit is 37%. Transvaginal ultrasound shows a fluid collection in the uterus
and no fetal pole, no masses and no free fluid in the pelvis. Which of the following is the most
appropriate next step in the management of this patient?
Exploratory surgery
Treat with Methotrexate
Treat with Mifepristone
Dilatation and Curettage
Repeat hCG level in one week
An obese 30 year-old G3P1 Asian woman undergoes an uncomplicated dilation and curettage for a
first trimester miscarriage. Pathology reveals a molar pregnancy. The patient’s medical history is
significant for chronic hypertension. She has a history of a previous uncomplicated term pregnancy,
and termination of a pregnancy at 16 weeks gestation for trisomy 18. What aspect of the patient’s
history places her at increased risk for a molar pregnancy?
Obesity
Previous history of fetal aneuploidy
Chronic hypertension
Asian race
E.
Prior term pregnancy
446.
A 17 year-old G0 presents with a 3-year history of severe dysmenorrhea shortly after menarche at age
14. Her menstrual cycles are regular with heavy flow. She has been treated with NSAIDs and oral
contraceptives for the last year without significant improvement. She misses 2-3 days of school each
month due to her menses. She has never been sexually active. Physical examination is remarkable for
Tanner: Stage IV breasts and pubic hair. Pelvic examination is normal, as is a pelvic ultrasound. Both
the patient and her mother are concerned. What is the next best step in the management of this
patient?
Empiric treatment with GnRH agonist
CT scan of the pelvis
Diagnostic laparoscopy
MRI of the pelvis
Hysterosalpingography
A 22-year old G0 presents with 5 months of amenorrhea since discontinuing her oral contraceptive
pills. She had been on the pill for the last 6 years and had normal menses every 28 days while taking
them. She is in good health and not taking any medications. She is 5 feet 4 inches tall and weighs 140
pounds. Her examination, including a pelvic examination, is normal. Which of the following history
elements would be most useful in determining the cause of amenorrhea in this patient?
Age at first intercourse
History of sexually transmitted infections
Parity
Recent history of weight loss
History of oligo-ovulatory cycles
A 15 year-old G0 presents with severe menstrual pain for the past 12 months. The pain is severe
enough for her to miss school. The pain is not relieved with ibuprofen 600 mg every 4 hours. She is
not sexually active and the workup reveals no pathology. The most appropriate next step in the
management of this patient is to begin combination oral contraceptives. How do oral contraceptives
relieve primary dysmenorrhea?
Creating endometrial atrophy
Decreasing inflammation
Increasing prolactin levels
Decreasing inhibin levels
Thickening cervical mucous
A 18 year-old woman, married, has regular unprotected sex, presents with low appetite, insomnia and
amenorrhea for 3 months. What is the most likely diagnose and how to confirm it?
Hypothyroidism/Free T4 level
Hypethyroidism/TsH level
Cervical cancer/PAP Smear test
Syphylis/VDRL
Pregnancy/BhcG
A woman who recently gave birth has elevated prolactin levels, the gland responsible for secretion of
this hormone is derived from which of the following structures?
Anterior Pituitary
Cerebral vesicles
Infundibulum
Neurohypophysis
Proctodeum
A.
B.
C. *
D.
E.
447.
A.
B.
C.
D.
E. *
448.
A. *
B.
C.
D.
E.
449.
A.
B.
C.
D.
E. *
450.
A. *
B.
C.
D.
E.
451.
A 55 year old woman stopped menstruating about 3 months ago, worried that she may be pregnant,
she decided to have a pregnancy test, the result is negative, which of the following series of test
results will confirm that the woman is postmenopausal?
A.
Increased LH, increased FSH, increased estrogen
Decreased LH, decreased FSH, increased estrogen
Decreased LH, increased FSH, decreased estrogen
Increased LH, decreased FSH, decreased estrogen
Increased LH, increased FSH, decreased estrogen
Crampy lower abdominal and back pain during menses in 21 year old woman and normal
examination would suggest?
Trauma
Cancer
Primary dysmenorrhea
Fibrosis
PID
Choose the most exact method for determination of pathological reason for uterine bleeding in
woman 35 years old:
measurement of the basal temperature of the body
diagnostic curettage of the mucous membrane of the uterus
hysteroscopy
measurement of the concentration of estrogens in the blood serum
Measurement of the concentration of progesterone in the blood serum
You are counseling a perimenopausal client regarding prevention of osteoporosis. You recommend
that she increase her dietary intake of which of the following?
Milk and iron
Calcium and vitamin D
Magnesium and vitamin C
Magnesium and phosphorus
All of the above
You are completing the chief complaint interview for a 17-year-old with dysmenorrhea. You will
assess for which of the following symptoms?
Food cravings
Heart palpitations
Abnormal bleeding
Duration of her pain
All of the above
You are explaining the intervention strategies for PMS to a 28-year-old client. You recommend that
during the latter part of her cycle she limit which of the following?
Exercise
Fluid intake
Fruits and vegetables
Salt and caffeine intake
All of the above
B.
C.
D.
E. *
452.
A.
B.
C. *
D.
E.
453.
A.
B. *
C.
D.
E.
454.
A.
B. *
C.
D.
E.
455.
A.
B.
C.
D. *
E.
456.
A.
B.
C.
D. *
E.
457.
A. *
B.
C.
D.
E.
458.
A. *
B.
C.
D.
E.
459.
A. *
B.
C.
D.
E.
460.
A. *
B.
C.
D.
E.
A 42-year-old woman comes to the physician because of a 1-year history of vaginal bleeding for 2 to
5 days every 2 weeks. The flow varies from light to heavy with passage of clots. Menses previously
occurred at regular 25- to 29day intervals and lasted for 5 days with normal flow. She has no history
of serious illness and takes no medications. She is sexually active with one male partner, and they use
condoms inconsistently. Her mother died of colon cancer, and her maternal grandmother died of
breast cancer. She is 163 cm (5 ft 4 in) tall and weighs 77 kg (170 lb); BMI is 29 kg/m2. Her
temperature is 36.6°C (97.8°F), pulse is 90/min, respirations are 12/min, and blood pressure is 100/60
mm Hg. The uterus is normal sized. The ovaries cannot be palpated. The remainder of the
examination shows no abnormalities. Test of the stool for occult blood is negative. Which of the
following is the most appropriate next step in diagnosis?
Endometrial biopsy
Barium enema
Progesterone challenge test
Colposcopy
Cystoscopy
A 14-year-old girl is brought to the physician by her mother because of a 2-month history of heavy
vaginal bleeding during menstrual periods. She has had episodes of excessive periodontal bleeding
while brushing her teeth and easy bruising for 6 years. She also had an episode of extended bleeding
after a tooth extraction 4 years ago. Her mother and brother have had similar symptoms. Physical
examination shows patchy ecchymosis over the upper and lower extremities. Laboratory studies
show: Platelet count 234,000/mm3 Bleeding time 17 min Prothrombin time 12 sec (INR=1) Partial
thromboplastin time 46 sec Which of the following is the most likely diagnosis?
von Willebrand disease
Factor X (Stuart factor) deficiency
Factor XII (Hageman factor) deficiency
Hemophilia A
Vitamin K deficiency
A 36-year-old woman has been trying to conceive for the past 2 years. Her menses occur every 19 to
45 days. She has a past history of some type of sexually transmitted disease, but says she was treated
and cured. She is 163 cm (5 ft 4 in) tall and weighs 109 kg (240 lb); BMI is 41 kg/m2. Physical
examination including a pelvic examination is unremarkable. An endometrial biopsy is performed
based on the menstrual history and a negative pregnancy test. The biopsy shows stromal breakdown
associated with proliferative glands. Which of the following is the most likely cause of her infertility?
Anovulation
Chronic endometritis
Endometrial polyps
Endometriosis
All of the above
Patient, aged 22 years complains of delay of menses during 2 months. Taste qualities changed.
Nullipara, no abortions in the past history. Vaginal examination: mucous membrane and uterine
cervix are cyanotic, uterus of ovoid form, enlarged to 7-8 weeks of pregnancy, soften consistency.
Appendages are without peculiarities. Isthmus of the uterus is softened. Crypts of the vagina are free.
What diagnosis is the most probable?
Uterine pregnancy.
Uterine leiomyoma.
Disorder of ovarian-menstrual cycle.
Hydatid mole.
Choryonepithelioma.
461.
A. *
B.
C.
D.
E.
462.
A. *
B.
C.
D.
E.
463.
A.
B.
C. *
D.
E.
464.
A. *
B.
C.
D.
E.
465.
A. *
B.
C.
D.
E.
466.
A 48-year-old patient was delivered to a hospital in-patient unit with uterine bleeding that occurred
after the 2-week-long delay of menstruation. Anamnesis states single birth. Examination of the
uterine cervix with mirrors revealed no pathologies. On bimanual examination: uterus is of normal
size, painless, mobile; uterine appendages have no changes. Discharge is bloody and copious. What
primary hemostatic measure should be taken in the given case?
Fractional curettage of uterine cavity
Hormonal hemostasis
Hemostatics
Uterine tamponade
Uterotonic
A 13-year-old girl was admitted to the gynecology department for having a signifi-cant bleeding
from the genital tract for 10 days. The patient has a history of irregular menstrual cycle since
menarche. Menarche occurred at the age of 11. Recto-abdominal examination revealed no pathology.
What is the provisional diagnosis?
Juvenile uterine bleeding
Adenomyosis
Injury of the external genitalia
Werlhof’s disease
Endometrial polyp
A 20-year-old female consulted a gynecologist about not having menstrual period for 7 months.
History abstracts: early childhood infections and frequent tonsillitis, menarche since 13 years, regular
monthly menstrual cycle of 28 days, painless menstruation lasts 5-6 days. 7 months ago the patient
had an emotional stress. Gynecological examination revealed no alterations in the uterus. What is the
most likely diagnosis?
Algomenorrhea
Primary amenorrhea
Secondary amenorrhea
Spanomenorrhea
Cryptomenorrhea
A 28-year-old patient complains of infertility. The patient has been married for 4 years, has regular
sexual life and does not use contraceptives but has never got pregnant. Examination revealed normal
state of the genitals, tubal patency. Basal body temperature recorded over the course of 3 consecutive
menstrual cycles appeared to have a single phase. What is the most likely cause of infertility?
Anovulatory menstrual cycle
Immunological infertility
Genital endometriosis
Chronic salpingoophoritis
Ovulatory menstrual cycle
3 months after the first labor a 24- year-old patient complained of amenorrhea. Pregnancy ended in
Caesarian section because of premature detachment of normally positioned placenta which resulted
in blood loss at the rate of 2000 ml due to disturbance of blood clotting. Choose the most suitable
investigation:
Estimation of gonadotropin rate
US of small pelvis
Progesteron assay
Computer tomography of head
Estimation of testosteron rate in blood serum
A 28-year old woman presents with secondary amenorrhea of six month duration. After a history and
physical and after pregnancy has been excluded, the next step should be:
A. *
B.
C.
D.
E.
467.
A. *
B.
C.
D.
E.
468.
A.
B. *
C.
D.
E.
469.
A. *
B.
C.
D.
E.
470.
A. *
B.
C.
D.
E.
471.
A.
B.
C.
D.
E. *
Measurement of a TSH and prolactin and administer progestational challenge
Measurement of gonadotropin assay and progestational challenge
Measurement of gonadotropin assay followed by a 21-day cycle of estrogen and progestin
Measurement of chromosomes and gonadotropin level
Measurement of gonadotropins and a coronal CT scan
A 22-year-old patient complains of 8-month delay of menstruation. Anamnesis: menarche since the
age of 12,5. Since the age of 18 menstruations are irregular. No pregnancies. Mammary glands have
normal development; when the nipples are pressed, milk drops are discharged. On gynecological
examination: moderate uterus hypoplasia. On hormonal examination: prolactin level exceeds the
norm two times. On computed tomogram of the sellar region: a space-occupying lesion 4 mm in
diameter is detected. The most likely diagnosis is:
Pituitary tumor
Lactation amenorrhea
Stein-Leventhal syndrome
Sheehan’s syndrome
Cushing’s disease
A 24 year-old G0 presents with a one-year history of introital and deep thrust dyspareunia. She also
has a 2- year history of severe dysmenorrhea, despite the use of oral contraceptives. She underwent a
diagnostic laparoscopy 6 months ago that showed minimal endometriosis with small implants in the
posterior cul de sac only, which were ablated with a CO2 laser. On further questioning, she reports
significant urinary frequency, urgency and nocturia. A recent urine culture was negative. What is the
most likely diagnosis in this patient?
Acute cystitis 5%
Interstitial cystitis
Acute urethral syndrome
Acute urethritis
Salpingitis
Pain peaks before menses, dyspareunia and infertility in 22 year old woman are the signs of?
Endometriosis
Sexually Transmitted Disease
Pelvic congestion
Malignancy
Fibrosis
Dysmenorrhea, pelvic pain, menorrhea (bulky, globular, tender uterus) in 25 year old woman are
indicative of?
Adenomyosis
Pelvic Inflammatory Disease
Malignancy
Fibrosis
None of them
Dull and ill-defined pelvic ache that worsens with standing plus dyspareunia in 35 year old woman
are indications for?
Endometriosis
Cancer
Vaginitis
Cervicitis
Pelvic congestion
472.
A 33 year old woman comes to the clinic on examination, there is an immobile uterus and posterior
cul-de-sac, the patient has suffered from a chronic pelvic pain as well, the diagnosis might be:
A.
B.
C.
D. *
E.
473.
Vaginitis
Mittelschmerz
Cervical cancer
Endometriosis
Ovarian cyst
A 36-year-old nulligravid woman with primary infertility comes for a follow-up examination. She
has been unable to conceive for 10 years; analysis of her husband's semen during this period has
shown normal sperm counts. Menses occur at regular 28-day intervals and last 5 to 6 days. She is
asymptomatic except for severe dysmenorrhea. An endometrial biopsy specimen 5 days before
menses shows secretory endometrium. Hysterosalpingography 1 year ago showed normal findings.
Pelvic examination shows a normal vagina and cervix. Bimanual examination shows a normal-sized
uterus and no palpable adnexal masses. Rectal examination is unremarkable. Which of the following
is the most likely diagnosis?
Endometriosis
Tubal obstruction
Male factor
Intrauterine synechiae
Anovulation
A 28-year-old woman has bursting pain in the lower abdomen during menstruation; chocolate-like
discharges from vagina are observed. It is known from the anamnesis that the patient suffers from
chronic adnexitis. Bimanual examination revealed a tumour-like formation of heterogenous
consistency 7х7 cm large to the left from the uterus. The formation is restrictedly movable, painful
when moved. What is the most probable diagnosis?
Endometrioid cyst of the left ovary
Follicular cyst of the left ovary
Fibromatous node
Exacerbation of chronic adnexitis
Tumour of sigmoid colon
A 28-year-old female patient has been admitted to the gynecology department for abdominal pain,
spotting before and after menstruation for 5 days. The disease is associated with the abortion which
she had 2 years ago. Anti-inflammatory treatment had no effect. Bimanual examination findings: the
uterus is enlarged, tight, painful, smooth. Hysteroscopy reveals dark red holes in the fundus with dark
blood coming out of them. What diagnosis can be made on the grounds of these clinical
presentations?
Inner endometriosis
Polymenorrhea
Hypermenorrhea
Submucous fibromatous node
E Dysfunctional uterine bleeding
A 35-year-old woman addressed a gynecological in-patient department with complaints of regular
pains in her lower abdomen, which increase during menstruation, and dark-brown sticky discharge
from the genital tracts. On bimanual examination: the uterine body is slightly enlarged, the
appendages are not palpated. Mirror examination of the uterine cervix reveals bluish spots. What
diagnosis is most likely?
Cervical endometriosis
Cervical erosion
A. *
B.
C.
D.
E.
474.
A. *
B.
C.
D.
E.
475.
A. *
B.
C.
D.
E.
476.
A. *
B.
C.
D.
E.
477.
A.
B. *
C.
D.
E.
478.
A.
B.
C.
D. *
E.
479.
A.
B.
C. *
D.
E.
480.
A. *
B.
C.
D.
Cervical polyp
Cervical cancer
Cervical fibroid
A 16-year-old female comes to the physician because of an increased vaginal discharge. She
developed this symptom 2 days ago. She also complains of dysuria. She is sexually active with one
partner and uses condoms intermittently. Examination reveals some erythema of the cervix but is
otherwise unremarkable. A urine culture is sent which comes back negative. Sexually transmitted
disease testing is performed and the patient is found to have gonorrhea. While treating this patient's
gonorrhea infection, treatment must also be given for which of the following?
Bacterial vaginosis
Chlamydia
Herpes
Syphilis
Trichomoniasis
A 23 year-old G0 reports having a solitary, painful vulvar lesion that has been present for three days.
This lesion has occurred twice in the past. She states that herpes culture was done by her doctor
during her last outbreak and was negative. She is getting frustrated in that she does not know her
diagnosis. She has no significant previous medical history. She uses oral contraceptives and
condoms. She has had four sexual partners in her lifetime. On physical examination, a cluster of three
irregular erosions with a superficial crust is noted on the posterior fornix. Urine pregnancy test is
negative. You suspect recurrent genital herpes. How do you explain the negative culture?
Cultures were taken too early
The more definitive test would be serum herpes antibody testing
The cultures were refrigerated prior to transport to the lab
Herpes cultures have a 10-20% false negative rate
The herpes virus cannot be recovered with recurrent infections
A 22 year-old P0 presents with a one-month history of profuse vaginal discharge with mild odor. She
has a new sexual partner with whom she has had unprotected intercourse. She reports mild to
moderate irritation, pruritus and pain. She thought she had a yeast infection, but had no improvement
after using an over-the counter antifungal cream. She is concerned about sexually transmitted
infections. Her medical history is significant for lupus and chronic steroid use. Pelvic examination
shows normal external genitalia, an erythematous vagina with a copious, frothy yellow discharge and
multiple petechial on the cervix. Vaginal pH is 7. Saline wet mount reveals motile, flagellated
organisms and multiple white blood cells. Which of the following is the most appropriate treatment
for this patient?
Clindamycin
Azithromycin
Metronidazole
Ampicillin
Doxycycline
A 26 year-old G2P2 reports that she is sexually active with a new male partner. She is using oral
contraception for birth control and, as such, did not use a condom. She reports the new onset of
vulvar burning and irritation. She thought she had a cold about 10 days ago. Given her history, which
of the following is the most likely diagnosis in this patient?
Herpes simplex virus
Primary syphilis
Secondary syphilis
Human immunodeficiency virus
E.
Trichomonas
481.
A 39 year-old G0 presents to the clinic reporting non-tender spots on her vulva for about a week. No
pruritus or pain is present. She also notes a brownish rash on the palms of her hands. She admits to
IV drug abuse. She was diagnosed as HIV-positive two years ago, but has not been compliant with
suggested treatment. On examination, three elevated plaques with rolled edges are noted on the
vulva. They are non-tender. A brown macular rash is noted on the palms of her hands and the soles of
her feet. What is the most appropriate next step in the management of this patient?
Obtain a treponemal-specific test
Biopsy of the lesion
Colposcopic evaluation of the vulvar lesions
Culture the base of the lesion
Perform a wet prep
A 20 year old woman presents with a 2-day history of dysuria and increased urinary frequency, she is
recently married and was not sexually active prior to the marriage, gynecologic exam reveals no
evidence of discharge, vaginitis or cervicitis, urinalysis reveals 14 white blood cells per
high-powered field with many gram-negative rods, which of the following is the most appropriate
pharmacotherapy?
Trimethropim-Sulfamethoxazole
Ceftriaxone
Fluconazole
Gentamicin
Metronidazole
Woman with large, deep ulcers on genital with gray/yellow exudate, the ulcers are well-demarcated
borders and soft, the patient also has severe lymphadenopathy, which of the following could be the
case?
Haemophilus (chancroid)
HSV-vesicles
Lymphogranuloma venerum
HPV (wart)
None of them
A 37 years old woman has been examined and a fishy-odor discharge is noted, itching/ burning and
inflamed vagina not to see, what is the diagnosis?
Candida vaginitis
Cancer
Bacterial vaginosis
Cervicitis
HPV
The chief complaint interview on a client reveals vaginal discharge with itching and burning. The
client also reveals she experiences dyspareunia. If her diagnosis is monilial vulvovaginitis, you would
expect the wet mount slide to contain which of the following?
Bacteria
Clue cells
Trichomonads
Budding hyphae
All of the above
A. *
B.
C.
D.
E.
482.
A. *
B.
C.
D.
E.
483.
A. *
B.
C.
D.
E.
484.
A.
B.
C. *
D.
E.
485.
A.
B.
C.
D. *
E.
486.
A. *
B.
C.
D.
E.
487.
A.
B.
C.
D.
E. *
488.
A. *
B.
C.
D.
E.
489.
A. *
B.
C.
D.
E.
490.
A.
B. *
C.
D.
E.
491.
A.
B.
C.
D. *
A 20.y.old woman is diagnosed with trichomonas and prescribed an antibiotic. She calls her
physician complaining of the flushing, nausea, and emesis. What antibiotic was the patient prescribed
and what should she have been warned of?
Metronidazole - alcohol
Metronidazole - sunlight
Metronidazole – smoking
Azithromycin – spicy food
Azithromycin – oral contraceptive
The patient complains of feeling of itching, pain in the vagina, large selection of white disharge. On
examination: vaginal mucosa edematous flushed, in the lateral fornices - the accumulation of white
layers, similar to the chees. What is the previous diagnosis?
Trichomonas colpitis
chlamydial colpitis
urogenital mycoplasmosis
bacterial vaginosis
candidiasis vaginitis
The patient D, 22 years old was diagnosed Trichomonas colpitis. Select a product for the treatment of
this patient
tinidozol
ciprofloxacin
ampicillin
Biseptol
Diflucan
A 27 year-old G0 woman comes to the clinic as she has been unable to conceive for the last year. She
is in good health and has not used any hormonal contraception in the past. She had normal cycles in
the past every 28 days until about 6 months ago. At that time, she began to have irregular menses
every 2-3 months, with some spotting in between. She is not taking any medications. She has no
history of abnormal Pap smears or sexually transmitted infections. Her physical examination is
normal. Laboratory tests show: Results Normal Values TSH 10 mIU/ml 0.5-4.0 mIU/ml Free T40.2
ng/dl 0.8-1.8 ng/dl Prolactin 40 ng/ml
Begin combined oral contraceptive
Begin bromocriptine
Order a Clomid ovulation challenge test
Obtain a brain MRI
Order a thyroid gland ultrasound
25 year old woman comes to the physician for the regular check-up, during meeting, she asks the
physician about the direct role of hcG in pregnancy, which of the following is the best reply?
Egg producing
Maintenance of the corpus luteum
Uterine contraction
Ovaries relaxant
Maintenance of placenta
A 35-year-old woman is considered infertile after ____ of trying to conceive
1 month
2 months
4 months
6 months
E.
12 months
492.
Patient 22 years, complains about absence of pregnancy during 5 years of marriage. For the last 3
years conducted medical and resort treatment. Two months ago metrosalpingography was done —
tubes’ permeability is normal. The last menstruation was with the delay on 2 weeks, painful. 2 days
ago bloody excretions in a small amount and pain in lower parts of abdomen appeared again.
Objectively: the uterine cervix is cyanotic, external os is closed. The uterus in normal position,
enlarged to 5 weeks of pregnancy, is soft, mobile. Douglas punch isn’t painfull. Right adnexa are not
determined. The left adnexa are enlarged in sizes to 6x3 cm, painful at palpation. Parametriums are
free. Excretions are bloody, in a little quantity. Blood test: Haemoglobin — 90g/l, red cells — 3,0 h
10 /l, leucocytes— 8,6 h 10 /l. What is the most reliable diagnosis?
Pregnancy 6-5 weeks. Abortion, that began. Cyst of the left ovary.
Pyosalpinx after metrosalpingography
The molar pregnancy
Violation of menstrual cycle
Ectopic pregnancy, that was ruptured on the type of tube abortion
The patient 25 years old, diagnosed with endocrine form of infertility. Which drug stimulates
ovulation of patients with endocrine form of infertility?
progesterone
Clomiphene Citrate
androkur
femoston
dufaston
The patient 29 years old, complains of infertility. Sexual life has been leading in marriage for 4 years,
hasn’t been preventing pregnancy. She didn’t have any pregnancy yet. An examination of women is
established: the development of genital organs were normal; The fallopian tubes are passable. Basal
[rectal] temperature for three menstrual cycles had single phase. The most probable cause of
infertility?
Anovulatory menstrual cycle
Chronic adnexitis
Anomalies of genital organs
Immunological infertility
Genital endometrioses
The patient complains about infertility. Menstruations started at 16 years, are not regular, 5-6 days
after 28-35 days, to marriage - painful. Sexual life during 4 years. Did not use contraceptives,
become not pregnant. In childhood was ill on a measles, scarlet fever. Vaginally: the uterus is of
normal size, mobile, unpainful, adnexa are not palpated. In speculum: the uterine cervix is normal.
Analysis of sperm of husband - 55 mln of spermatozoa in 1 ml, 75% of them are mobile. Shuvarscy
test is positive. A basal temperature during 2 cycles is monotonous. Diagnosis?
Infertility I, tubal genesis
Infertility I, tubal-peritoneal genesis
Infertility I, anovulatory cycles
Infertility I, masculine genesis
Infertility I, anomaly of development of privy parts
The woman, suffering from infertility came to the gynecologist with complain of delayed
menstruation. Which pregnancy test will be the most reliable in the early stages?
Measurement of human chorionic gonadotropin in the blood
Immune hemagglutination inhibition test.
Reaction Galey Maynini
A. *
B.
C.
D.
E.
493.
A.
B. *
C.
D.
E.
494.
A. *
B.
C.
D.
E.
495.
A.
B.
C. *
D.
E.
496.
A. *
B.
C.
D.
E.
497.
A.
B.
C. *
D.
E.
498.
A.
B.
C.
D.
E. *
499.
A.
B.
C. *
D.
E.
500.
A.
B. *
C.
D.
E.
501.
A. *
B.
C.
D.
E.
502.
A. *
B.
C.
Measurement of the concentration of estrogen in the blood
Measurement of concentration of progesterone in the blood
While discussing reproductive health with a group of female adolescents, one of the adolescents asks
the doctor, "Where is the ovum fertilized?" The doctor responds by stating that fertilization normally
occurs at which of the following sites?
Uterus.
Vagina.
Fallopian tube.
Cervix.
Ovary
A female patient, aged 25, suffers endocrine form of infertility for 5 years. What should be included
in investigations of this patient?
Ultrasonic monitoring of growth of follicles during the menstrual cycle.
Measuring basal temperature.
Determine the level of hormones in the blood.
Smears on the "hormonal mirror."
All answers are correct.
A couple visiting the infertility clinic for the first time asks the doctor, "What causes infertility in a
woman?" Which of the following would the doctor include in the response as one of the most
common factors?
Absence of uterus.
Overproduction of prolactin.
Anovulation.
Immunologic factors.
Genetic factors.
25-year-old patient notes the absence of pregnancy within 5 years. Operations were performed twice
at the tubal pregnancy. What method can solve the problem of the generative function in this woman?
Correction factors of ovarian
In Vitro Fertilization (IVF) and embryo transplantation
Intrauterine artificial insemination
Intracervical artificial insemination
Insemination sperm donor
What is not included in the complex examination of patients with endocrine form of infertility?
definition of the Fallopian tubes
basal body temperature
determine the level of hormones in the blood
smears on the "hormonal mirror"
ultrasound control the growth of follicles during the menstrual cycle
A 26-year-old woman has attended maternity center complaining of her inability to become pregnant
despite 3 years of regular sex life. Examination revealed the following: increased body weight;
male-type pubic hair; excessive pilosis of thighs; ovaries are dense and enlarged; basal body
temperature is monophasic. The most likely diagnosis is:
Ovaries sclerocystosis
Inflammation of uterine appendages
Adrenogenital syndrome
D.
E.
503.
A. *
B.
C.
D.
E.
504.
A. *
B.
C.
D.
E.
505.
A.
B.
C. *
D.
E.
506.
A. *
B.
C.
D.
E.
507.
A.
B.
C. *
D.
E.
Premenstrual syndrome
Gonadal dysgenesis
A 31-year-old female patient complai-ns of infertility, amenorrhea for 2 years after the artificial
abortion that was complicated by endometritis. Objectively: examination of the external genitalia
revals no pathology, there is female pattern of hair distribution. According to the functional tests, the
patient has biphasic ovulatory cycle. What form of infertility is the case?
Uterine
Ovarian
Pituitary
Hypothalamic
Immunologica
The patient 29 years old, complains of infertility. Sexual life has been leading in marriage for 4 years,
hasn’t been preventing pregnancy. She didn’t have any pregnancy yet. An examination of women is
established: the development of genital organs were normal; The fallopian tubes are passable. Basal
[rectal] temperature for three menstrual cycles had single phase. The most probable cause of
infertility?
Anovulatory menstrual cycle
Chronic adnexitis
Anomalies of genital organs
Immunological infertility
Genital endometriosis
The patient complains about infertility. Menstruations started at 16 years, are not regular, 5-6 days
after 28-35 days, to marriage - painful. Sexual life during 4 years. Did not use contraceptives,
become not pregnant. In childhood was ill on a measles, scarlet fever. Vaginally: the uterus is of
normal size, mobile, unpainful, adnexa are not palpated. In speculum: the uterine cervix is normal.
Analysis of sperm of husband - 55 mln of spermatozoa in 1 ml, 75% of them are mobile. Shuvarscy
test is positive. A basal temperature during 2 cycles is monotonous. Diagnosis?
Infertility I, tubal genesis
Infertility I, tubal-peritoneal genesis
Infertility I, anovulatory cycles
Infertility I, masculine genesis
Infertility I, anomaly of development of privy parts
The woman, suffering from infertility came to the gynecologist with complain of delayed
menstruation. Which pregnancy test will be the most reliable in the early stages?
Measurement of human chorionic gonadotropin in the blood
Immune hemagglutination inhibition test.
Reaction Galey Maynini
Measurement of the concentration of estrogen in the blood
Measurement of concentration of progesterone in the blood
A client is scheduled to have in vitro fertilization (IVF) as an infertility treatment. Which of the
following client statements about IVF indicates that the client understands this procedure?
"IVF requires supplemental estrogen to enhance the implantation process."
"The pregnancy rate with IVF is higher than that with gamete intrafallopian transfer."
"IVF involves bypassing the blocked or absent fallopian tubes."
"Both ova and sperm are instilled into the openened of a fallopian tube."
Nothing of the above
508.
A.
B.
C.
D.
E. *
509.
A.
B. *
C.
D.
E.
510.
A.
B.
C.
D. *
E.
511.
A.
B. *
C.
D.
E.
512.
A. *
B.
C.
D.
E.
A female patient, aged 25, suffers endocrine form of infertility for 5 years. What should be included
in investigations of this patient?
Ultrasonic monitoring of growth of follicles during the menstrual cycle.
Measuring basal temperature.
Determine the level of hormones in the blood.
Smears on the "hormonal mirror."
All answers are correct.
25-year-old patient notes the absence of pregnancy within 5 years. Operations were performed twice
at the tubal pregnancy. What method can solve the question of the generative function in this
woman?
Correction factors of ovarian
In Vitro Fertilization (IVF) and embryo transplantation
Intrauterine artificial insemination
Intracervical artificial insemination
Insemination sperm donor
A 19-year-old Hispanic woman who is a regular patient comes to the office for her annual physical
examination and cervical cytology. She tells you that she has not had a menstrual period for the past
6 months. She is a college student who is in good health, has not had any medical illnesses or
surgery, and has never been pregnant. She is currently sexually active and uses barrier contraception.
She reports that during the past year her menses had become very irregular prior to complete
cessation 6 months ago. She also notes that she has gained about 9 kg in the past 6 months and has
had an increasing problem with acne and a troublesome growth of hair on her thighs and abdomen.
She has been somewhat depressed about this, and her grades have declined. She reports that one of
her sisters also had this problem prior to getting married. Physical examination shows a mildly obese
young woman who has scattered facial acne, mild male pattern hair growth on the abdomen, and an
essentially normal pelvic examination except for slight enlargement of the uterus and both ovaries.
This patient's history is most consistent with which of the following?
Androgen-producing ovarian tumor.
Cushing syndrome.
Hypothyroidism.
Polycystic ovarian syndrome.
Prolactinoma.
An obese patient with Body Mass Index (BMI) of 38 is diagnosed with polycystic ovary syndrome,
what is the very first-line treatment of choice?
Protein diet
Weight loss
Warm bath
Aspirin
Laxatives
A 60 years old woman comes to the office with complaints of vaginal bleeding, pelvic pressure on
examination, the vulvovaginal dryness, irritation, pruritus to mention the mucosa is pale with low
elasticity and low rugae. What might be the diagnosis?
Genitourinary syndrome of menopausal
Candida vaginitis
Dermatitis
Bacterial vaginitis
Vaginal cancer
513.
A.
B.
C.
D. *
E.
514.
A. *
B.
C.
D.
E.
515.
A.
B. *
C.
D.
E.
516.
A.
B.
C.
D.
E. *
517.
A.
B. *
C.
D.
E.
518.
A.
B.
C.
D. *
E.
Massive hemorrhage complicated with hypotension, low prolactin, fatigue, bradycardia, vaginal
atrophy, are suggestive for?
Bacterial vaginitis
Ovarian torsion
Ovarian cancer
Sheehan syndrome
Cancer
A 22 years old first time mother 9 days after delivery develops inability to void or small-volume
voids, incomplete bladder emptying and dribbling of urine, what might be the diagnosis?
Postpartum urinary retention
Cervicitis
Vaginitis
UTI
Sheehan syndrome
A 56 y.old woman presents with complaints of insomnia, vaginal dryness and lack of menses for 13
months. What is the most likely diagnosis?
Sheehan syndrome
Menopause
Hypothyroidism
Hyperthyroidism
Ovarian cancer
A 16 y.old girl presents with low appetite, insomnia and amenorrhea for 3 months. What is the most
likely diagnosis and how will you confirm it?
Hypothyroidism/Free T4 levels
Hyperthyroidism/TSH level
Cervical cancer/Pap smear test
Syphilis/VDRL
Pregnancy/BhcG
You are counseling a perimenopausal client regarding prevention of osteoporosis. You recommend
that she increase her dietary intake of which of the following?
Milk and iron
Calcium and vitamin D
Magnesium and vitamin C
Magnesium and phosphorus
Calcium and iron
You are explaining the intervention strategies for PMS to a 28-year-old client. You recommend that
during the latter part of her cycle she limit which of the following?
Exercise
Fluid intake
Fruits and vegetables
Salt and caffeine intake
Alcohol
519.
A.
B. *
C.
D.
E.
520.
A. *
B.
C.
D.
E.
521.
A. *
B.
C.
D.
E.
522.
A.
B.
C.
D. *
E.
523.
A.
B.
C.
A 62-year-old woman comes to the physician for a routine health maintenance examination. On
questioning, she has had fatigue, constipation, and a 9-kg (20-lb) weight gain during the past year.
She receives estrogen replacement therapy. Serum lipid studies were within the reference range 5
years ago. She is 157 cm tall and weighs 77 kg; BMI is 31 kg/m2. Physical examination shows no
other abnormalities. Serum lipid studies today show: Total cholesterol 269 mg/dL, HDL-cholesterol
48 mg/dL, LDL-cholesterol 185 mg/dL, Triglycerides 180 mg/dL. Which of the following is the most
likely cause?
Thiazide diuretic therapy
Hypothyroidism
Estrogen replacement therapy
Estrogen deficiency
Diabetes mellitus
A 28.y.old woman comes to clinic for a wellness exam. She describes that approximately 2 weeks
after her menses, she experiences intense, sharp lower quadrant abdominal pain that lasts couple of
hours. The pain varies from the right to the left side each cycle. What is the name of this
phenomenon?
Mittelschmerz
Ovarian cancer
Polycystic ovarian syndrome
None of them
Pelvic Inflammatory Disease
A 15-year-old girl who is a ballet dancer has not had a menstrual period for the past 3 months.
Menses were previously regular at 29-day intervals. She has lost weight over the past year; her
weight is 70% of that expected for her height. She is afebrile and has purpuric lesions on her
extremities and trunk. Platelet, absolute neutrophil, and lymphocyte counts are below the reference
range. She has macrocytic anemia. The most likely cause of these symptoms is a deficiency of which
of the following nutrients?
Folic acid
Iron
Linoleic acid
Magnesium
Niacin
A 16-year-old girl has hirsutism, deepening of the voice, and cessation of menses. She swims in
competitions. Which of the following drugs is most likely to have caused these findings?
Ethinyl estradiol
Leuprolide
Medroxyprogesterone
Nandrolone
Tamoxifen
22-year-old woman appealed to the doctor complaining of a two-year increase in body hair growth
and weight gain of 3.2 kg. Menarche from 15 years, irregular menstruation in the range of 4 - to 6
months from the time. Not treated. Objectively: height - 160 cm, weight - 74 kg. Body mass index 29 kg / m. Blood pressure, pulse, respiratory rate and temperature within normal limits. In the study
revealed hirsutism and strongly pigmented skin on the neck and axillary area. What is the correct
diagnosis?
Edison disease
hypothyroidism
punched hymen
D. *
E.
524.
A. *
B.
C.
D.
E.
525.
A. *
B.
C.
D.
E.
526.
A. *
B.
C.
D.
E.
527.
A. *
B.
C.
D.
E.
528.
A. *
B.
Polycystic Ovarian Syndrome
Syndrome of premature ovarian failure
28-year-old woman complains of increased intermenstrual periods up to 2 months, hirsutism.
Gynecological examination revealed that the ovaries were enlarged, painless, and compact, uterus
had no peculiarities. Pelvic ultrasound revealed that the ovaries were 4-5 cm in diameter and had
multiple enlarged follicles on periphery. X-ray of skull base showed that sellar region was dilated.
What is the most probable diagnosis?
Stein-Leventhal syndrome (Polycystic ovary syndrome)
Algodismenorrhea
Sheehan’s syndrome
Premenstrual syndrome
Morgagni-Stewart syndrome
A woman consulted a therapeutist about fatigability, significant weight loss, weakness, loss of
appetite. She has been having amenorrhea for 8 months. A year ago she delivered a full-term child.
Hemorrhage during labor made up 2 She got blood and blood substitute transfusions. What is the
most probable diagnosis?
Sheehan’s syndrome
Stein-Leventhal syndrome
Shereshevsky-Turner’s syndrome
Homological blood syndrome
Vegetovascular dystonia
A 22-year-old patient complains of 8-months-long delay of menstruation. Anamnesis: menarche
since the age of 12,5. Since the age of 18 menstruations are irregular. No pregnancies. Mammary
glands have normal development; when the nipples are pressed, milk drops are discharged. On
gynecological examination: moderate uterus hypoplasia. On hormonal examination: prolactin level
exceeds the norm two times. On computed tomogram of the sellar region: a space-occupying lesion 4
mm in diameter is detected. The most likely diagnosis is:
Pituitary tumor
Lactation amenorrhea
Stein–Leventhal syndrome (Polycystic ovary syndrome)
Sheehan’s syndrome
Cushing’s disease
A 30-year-old woman complains of infertility during her 10-year-long married life. Menstruations
occur since she was 14 and are irregular, with delays up to a month and longer. Body mass is
excessive. Hirsutism is observed. On bimanual examination: uterine body is decreased in size;
ovaries are increased in size, dense, painless, and mobile. The most likely diagnosis is:
Stein–Leventhal syndrome (Polycystic ovary syndrome)
Follicular cyst of ovaries
Genital endometriosis
Genital tuberculosis
Inflammatory tumor of ovaries
A 39-year-old female patient complains of dyspnea when walking, palpitation, edema in the evening.
The patient’s height is 164 cm, weight - 104 kg. Objectively: overnutrition. Heart sounds are weak,
and tachycardia is present. The menstrual cycle is not broken. Blood sugar is 5,6 mmol/l,
ACTH-response tests revealed no alterations. X-ray of the Turkish saddle revealed no pathology.
What disease is it?
Alimentary obesity
Climax
C.
D.
E.
529.
A. *
B.
C.
D.
E.
530.
A. *
B.
C.
D.
E.
531.
A. *
B.
C.
D.
E.
532.
A.
B.
C.
D. *
E.
533.
A.
B.
C.
D. *
E.
Pituitary obesity
Diabetes mellitus
Cushing’s syndrome (primary hypercortisizm)
An 18-year-old girl complains of breast pain and engorgement, headaches, irritability, swelling of the
lower extremities. These symptoms have been observed since menarche and occur 3-4 days before
the regular menstruation. Gynecological examination revealed no pathology. Make a diagnosis:
Premenstrual syndrome
Neurasthenia
Renal disease
Mastopathy
Cardiovascular disorder
A 25-year-old female presented to a women’s welfare clinic and reported the inability to get pregnant
within 3 years of regular sexual activity. Examination revealed increased body weight, male pattern
of pubic hair growth, dense enlarged ovaries, monophasic basal temperature. What is the most likely
diagnosis?
Polycystic ovarian syndrome
Adnexitis
Adrenogenital syndrome
Premenstrual syndrome
Gonadal dysgenesis
A 49-year-old female patient complains of itching, burning in the external genitals, frequent
urination. The symptoms have been present for the last 7 months. The patient has irregular
menstruation, once every 3-4 months. Over the last two years she has had hot flashes, sweating, sleep
disturbance. Examination revealed no pathological changes of the internal reproductive organs.
Complete blood count and urinalysis showed no pathological changes. Vaginal smear contained
20-25 leukocytes per HPF, mixed flora. What is the most likely diagnosis?
Menopausal syndrome
Cystitis
Trichomonas colpitis
Vulvitis
E Bacterial vaginosis
A 35-year old woman presents with no menses for six months. Her serum prolactin is normal. She
does not have withdrawal bleeding after progesterone. She does have bleeding after a combined
estrogen and progestin treatment and her serum FSH is 100. The most likely diagnosis is
Outflow tract obstruction
Asherman’s Syndrome
Hyperprolactinemia
Premature menopause
Hypogonadotrophic hypogonadism
A 18-year old presents with primary amenorrhea. Physical exam reveals a lack of secondary sex
characteristics and the presence of a uterus. Which of the following is NOT a possible diagnosis?
Sawyer’s Syndrome
17 hydroxylase deficiency
Turner’s Syndrome
Rokitansky Custer Hauser Syndrome
Pure XY gonadal dysgenesis
534.
A. *
B.
C.
D.
E.
535.
A. *
B.
C.
D.
E.
536.
A.
B.
C.
D. *
E.
537.
A.
B. *
C.
D.
E.
An 18-year-old woman complains of mammary glands swelling, headaches, tearfulness, abdominal
distension occurring the day before menstruation. The symptoms disappear with the beginning of
menstruation. Menstruations are regular, last for 5-6 days with interval of 28 days in between.
Gynecological examination revealed no changes of internal genitals. What is your diagnosis?
Premenstrual syndrome
Sheehan syndrome
Stein-Leventhal syndrome
Asherman’s syndrome
Adrenogenital syndrome
A 25-year-old woman complains of menstruation retention lasting for 3 years. The patient explains it
by a difficult childbirth complicated with profuse hemorrhage, weight loss, brittleness and loss of
hair, loss of appetite, depression. Objective examination reveals no pathologic changes of uterus and
uterine appendages. What pathogenesis is characteristic of this disorder?
Decreased production of gonadotropin
Hyperproduction of estrogen
Hyperproduction of androgen
Decreased production of progesterone
Hyperproduction of prolactin
A 15-year-old girl is brought to the office by her mother because of abdominal pain and constipation
for the past several weeks. Her mother says, "She is getting almost all A's in school and she is on the
track team." You ask the patient about her diet and she responds, "I'm kind of a picky eater." She
requests a laxative to help with her constipation. She is 158 cm tall and weighs 43 kg; BMI is 18
kg/m2. Pulse is 65/min. Specific additional history should be obtained regarding which of the
following?
Color, caliber, and frequency of bowel movements
Exposure to sexually transmitted diseases.
Family history of irritable bowel syndrome.
Menstrual history.
Use of illicit drugs.
An 18 year-old college student is seen in the emergency room, claiming she was raped by a 29
year-old janitor in her dorm 4 hours ago. He threatened her with a knife and she did not resist. She
appears calm and has a flattened affect when the history is taken. Currently, she is sexually active
with a fellow student and is taking birth control pills. The alleged attacker used a condom, which she
helped him put on. The student is 173cm tall and weighs 82kg. She is a cheerleader for the college
football team. Examination reveals no bruising and gynecologic examination reveals no apparent
injuries. Which of the following statements is the most likely explanation for this patient’s
presentation?
The attack was not emotionally traumatic
The student is in shock
The attack never happened
The student cooperated with the attacker
The student suffers from chronic depression
538.
A.
B. *
C.
D.
E.
539.
A. *
B.
C.
D.
E.
540.
A. *
B.
C.
D.
E.
541.
A. *
B.
C.
D.
E.
542.
A 32 year-old G0 woman comes to the office due to the inability to conceive for last two years. She
reports having been on oral contraceptives for 8 years prior. She had menarche at age 14 and has had
irregular cycles about every 3 months until she started oral contraceptives, which regulated her
cycles. In the last year, she has had about 5 cycles in total; her last menstrual period was 6 weeks ago.
She is otherwise in good health and has not had any surgeries. She has no history of abnormal Pap
smears or sexually transmitted infections. She is 176cm and weighs 90kg. On general appearance,
she seems to be hirsute on the face and the abdomen. The rest of her exam is otherwise normal.
Which of the following is most likely to help identify the underlying cause of this woman’s
infertility?
Lutenizing hormone levels
Testosterone levels
Follicle stimulating hormone levels
Thyroid function tests
Progesterone levels
A 34 year-old woman comes to you for a chief complaint of hirsutism. She states that this has been
present since menarche, but has gotten worse in the past two years. Her menses have become more
irregular, now every 28-45 days apart. She states that she quit smoking and gained approximately
thirty pounds in the past three years. Her mother is obese, diabetic and has hirsutism. There is no hair
seen on her chin, but she shaves every few days. TSH, prolactin, 17-hydroxyprogesterone and
DHEAS are normal. Testosterone is mildly elevated. Which of the following is the most likely
etiology of her hirsutism?
Polycystic ovarian syndrome
Ovarian neoplasm
Diabetes
Cushing’s syndrome
Adrenal tumor
A 52 year-old G3P3 woman presents to your office with severe hot flashes and vaginal dryness for 6
months. Her last menstrual period was 15 months ago. After discussing the risks and benefits of
hormone therapy with this patient, she decides to begin treatment. This patient is most likely to stop
hormone therapy secondary to what side effect?
Vaginal bleeding
Development of breast cancer
Hirsutism
Nausea
Relief of menopausal symptoms
A 22 year-old G0 college student returns for follow-up of mood swings and difficulty concentrating
on her schoolwork the week before her menses for the past 12 months. Her past medical history is
unremarkable and physical examination is normal. Which of the following would be an appropriate
treatment option for this patient?
Oral contraceptive pills
Reassurance and observation
Methylphenidate (Ritalin
Gabapentin
Ginkgo
A 16 year-old girl comes to the doctor to discuss contraception. She recently became sexually active
and states she has never had a menstrual cycle. She regularly attends school and participates in the
band. On physical examination, she is 175cm and weighs 84kg. She has no secondary sexual
characteristics with normal appearing external genitalia. The physician suspects Kallmann syndrome.
Which of the following diagnostic tests will help confirm the diagnosis?
A.
B. *
C.
D.
E.
543.
A.
B. *
C.
D.
E.
544.
A.
B. *
C.
D.
E.
545.
A.
B. *
C.
D.
E.
546.
A.
B.
C.
D. *
E.
An MRI of the pituitary
Olfactory challenge
Measurement of testosterone levels
Pelvic ultrasound
Cortisol levels
An 18 year-old G0 comes in for an annual exam with her mother. Her mother comments that she had
severe PMS symptoms in her twenties and thirties. She would like to know if her daughter will
inherit this as well. Which of the following has the strongest association with premenstrual
syndrome?
Obesity
Positive family history
Insulin dependent diabetes mellitus
History of early menarche
Vitamin K deficiency
A 28 year-old G1P1 presents to your office. She delivered 4 days ago and tearfully reports that
yesterday and the day before she had trouble sleeping, felt anxious and was irritable. She feels
somewhat better today, but is still concerned. What is the most likely diagnosis?
Hypothyroidism
Blues
Depression
Normal postpartum state
Anxiety
A 24 year-old woman comes to her physician for help with her premenstrual syndrome symptoms.
She complains of “not being herself” for 3 to 4 days before her period and has episodes of crying and
irritability. She denies depressive symptoms and notes she is a stay-at-home mother for her three
children. After a complete history and physical examination, the patient is prescribed a selective
serotonin reuptake inhibitor but, after three months, she returns as there is no change in her
symptoms. Upon further discussion, the patient admits that her husband has a bad temper at times.
Physical examination is normal with the exception of some bruising on the patient’s arms. She claims
that she fell and that she is often clumsy. Which of the following is the most appropriate next step in
the management of this patient?
Report the injuries to the police
Offer domestic violence resources to the patient
Refer the patient for a psychiatric consultation
Arrange for a home visit by a women’s shelter counselor
Arrange for security to escort her to a women’s shelter
A mother brings her 16 year-old daughter to the doctor because she has not begun menses and has
not kept up in growth with her friends. She performs well in school and participates in extracurricular
activities. On physical examination, she is171cm tall, 78kg and has Tanner stage 1 breast and pubic
hair growth. Her breast nipples are widely spaced with a shield chest and neck is thickened. No
genital tract abnormalities are noted on exam. Which of the following is the most likely cause of her
delayed sexual maturation?
Partial deletion of the long arm of the X chromosome
Mullerian agenesis
Down Syndrome
Turner syndrome
Rokitansky-Kuster-Hauser Syndrome
547.
A. *
B.
C.
D.
E.
548.
A.
B.
C.
D. *
E.
549.
A.
B. *
C.
D.
E.
550.
A.
B.
C. *
D.
E.
551.
A.
B.
C.
D. *
E.
A 21 year-old woman comes to the office because of acne, irregular menses and hirsutism. She
initially was evaluated 6 months ago. At that time, she was diagnosed with idiopathic hirsutism. She
was started on oral contraceptive pills to improve her symptoms. Menstrual periods now occur every
month, but her hirsutism has not significantly improved. In addition to the oral contraceptives, which
of the following would be an appropriate treatment for hirsutism?
Spironolactone
Lupron
Danazol
Depo-Provera
Steroids
Postmenopausal woman should be routinely screened after age 65 for which of the following:
Cirrhosis
Ovarian cancer
Small cell carcinoma
Osteoporosis
Dementia
A 56 year-old woman presents with complains of insomnia, vaginal dryness and amenorrhea for 13
months. What is the most likely diagnose?
Sheehan syndrome
Menopause
Hypothyroidism
Hypethyroidism
Ovarian cancer
A 90-year-old G7P7 woman presents with severe vaginal prolapse. The entire apex, anterior and
posterior wall are prolapsed beyond the introitus. She cannot urinate without reduction of the
prolapse. Hydronephrosis was noted on ultrasound of the kidneys and it is thought to be related to the
prolapse. She has a long-standing history of diabetes and cardiac disease. She is not a candidate for
general or regional anesthesia. She has failed a trial of pessaries. Which of the following is the next
best step in the management of this patient?
Do nothing and observe.
Anterior and posterior repair
Colpocleisis
Sacrospinous fixation
Sacrocolpopexy
A 48-year-old G0 woman comes to the office for a health maintenance exam. She is healthy and not
taking any medications. She has no history of abnormal Pap smears or sexually transmitted diseases.
She is not currently sexually active. Her menstrual cycles are normal and her last cycle was three
weeks ago. She smokes one pack of cigarettes per day. Her mother was diagnosed with endometriosis
and had a hysterectomy and removal of the ovaries at age 38. She is 5 feet 4 inches tall and weighs
130 pounds. On pelvic examination, the patient had a palpable left adnexal mass. An ultrasound was
obtained, which showed a 4 cm complex left ovarian cyst and a 2 cm simple cyst on the right ovary.
What is the most appropriate next step in the management of this patient?
CAT scan of the abdomen and pelvis
MRI of the pelvis
Abdominal hysterectomy and bilateral salpingoophorectomy (TAH/BSO)
Repeat ultrasound in 2 months
Oral contraceptives
552.
A.
B.
C. *
D.
E.
553.
A.
B.
C.
D.
E. *
554.
A.
B.
C.
D.
E.
555.
A.
B.
C.
D.
E. *
556.
A.
B.
C.
A 45 year-old G5P5 premenopausal woman was initially seen in your office for work-up and
evaluation of a FIGO grade 2 endometrial cancer that was diagnosed by her gynecologist. Which of
the following is the most appropriate treatment for this patient?
Total laparoscopic hysterectomy with bilateral salpingoophorectomy
Vaginal hysterectomy with bilateral salpingoophorectomy
Total abdominal hysterectomy, bilateral salpingoophorectomy, bilateral pelvic and
paraaorticlymphadenectomy, pelvic washings
Supracervical abdominal hysterectomy with ovarianpreservation
Megace (megestrol acetate)
A 31 year-old G0 woman has been diagnosed with uterine fibroids. A fluid contrast ultrasound
confirmed the presence of two intramural fibroids measuring 5 x 6 cm and 2 x 3 cm that appear to be
distorting the patient’s uterine cavity. The patient has a two-year history of infertility. She has had a
thorough infertility work up. No etiology for her infertility has been identified. Which of the
following treatments is most appropriate for this patient?
Hysteroscopy
Uterine curettage
Gonadotropin-releasing hormone agonist
Uterine artery embolization
Myomectomy
A 72 year-old G3P2 postmenopausal woman is referred to your office by her internist after a work-up
for abdominal bloating revealed a large pelvic mass on transvaginal ultrasound and an elevated
CA-125. She has no significant medical history and only a prior appendectomy. The CT scan showed
a large heterogenous pelvic mass measuring 20 x 13 x 10 cm. There was a moderate amount of
ascites and likely “omental caking.” There was no significant pelvic or abdominal lymphadenopathy,
and the chest x-ray showed only a small right pleural effusion. On pelvic examination, there is
minimal cul-de-sac nodularity and the mass is readily palpable and somewhat mobile. There is an
obvious fluid wave. Which of the following is the most appropriate next step in the management of
this patient?
Thoracentesis
Exploratory laparotomy and tumor debulking (cytoreduction)
Paracentesis
Diagnostic laparoscopy and tissue biopsies
Neoadjuvant chemotherapy
Which of the following is the risk factor for vesicovaginal fistula?
Child birth trauma
Prolonged labour
Pelvic irradiation
Pelvic surgery
All of them
A previously healthy 27-year-old nulligravid woman comes to the emergency department because of
a 2-day history of moderate-to-severe pain and swelling of the left labia. She is sexually active and
uses condoms inconsistently. Her temperature is 37.2°C (99°F), pulse is 92/min, respirations are
18/min, and blood pressure is 115/75 mm Hg. Pelvic examination shows a 4 x 3-cm, tender, fluctuant
mass medial to the left labium majus compromising the introital opening. Which of the following is
the most appropriate next step in management?
Vulvectomy
Ultrasound-guided needle aspiration of the mass
Administration of intravenous penicillin G
D.
E.
557.
A. *
B.
C.
D.
E.
558.
Administration of intravenous metronidazole
Incision and drainage
26 years old patient has formed formation of purulent inflammation of the appendages of the uterus.
What would you recommend?
puncture through the posterior vaginal vault, draining pus cavity and the introduction of antibiotics
into it
surgery
pirogenal therapy
electrophoresis of zinc
Nothing above
Woman I., aged 38 years was admitted to gynecologic department with complaints on cramp-like
pains in the lower abdomen and moderate blood-tinged discharge from vagina. In past-history: labor
1, medical abortions – 2. Patient notes delay of menstruation, instantaneous loss of consciousness.
Objectively: skin integuments are pale, covered with cold perspiration. Arterial pressure – 90/50 mm
Hg., pulse rate – 120 beats/min. On vaginal examination: somewhat enlarged uterine, in the right –
movable formation of ovoid form, soft consistency is palpable. What treatment should be carried out?
A. *
B.
C.
D.
Surgical intervention.
Treatment with estrogens.
Treatment with androgens.
Symptomatic treatment.
E.
559.
Treatment with gestagens.
Patient, aged 32 years was admitted to gynecologic department with complaints on sharp pain in the
lower abdomen. Menses were 2 weeks ago, timely. On bimanual vaginal examination: vagina and
uterine cervix are without peculiarities. Examination of the uterine body and appendages is
impossible to perform due to tenderness and tension of the anterior abdominal wall. Posterior fornix
overhangs, painful. Apoplexy of the ovary is suspected. What should be done to precise diagnosis?
To perform bimanual examination again under narcosis.
Paracentesis of the abdominal cavity through posterior fornix of vagina.
Ultrasonic investigation.
Symptomatic treatment
Hysteroscopic examination.
Patient, aged 23 years was admitted to the gynecologic unit complaining of pain in the lower
abdomen, general weakness, collaptoid state, blood-tinged discharge from the reproductive passages.
In the past history: patient had chronic adnexitis; last 2 months – no menstruation, sometimes bloody
discharge was noted. Objectively: skin and mucous membranes are pale. Arterial pressure – 90/60,
pulse rate – 100 beats/min. Abdomen is swelled a little, painful in the lower portions. Shchyotkin’s
symptom is positive. Vaginal examination: uterine is enlarged up to 5-6 weeks, soft, painful one on
palpation. Appendages are not palpable clearly due to a sharp tension of the anterior abdominal wall.
Posterior fornix hangs over, painful one. Dark blood-tinged discharge continues. What method of
investigation is the most informative?
Hysteroscopy.
Laparoscopy.
Ultrasonic investigation.
Abdominal paracentesis.
Dopplerometry.
A.
B. *
C.
D.
E.
560.
A.
B.
C.
D. *
E.
561.
A. *
B.
C.
D.
E.
562.
A.
B.
C. *
D.
E.
563.
A. *
B.
C.
D.
E.
564.
A. *
B.
C.
D.
E.
565.
A.
B. *
C.
D.
E.
A 30-year-old woman complains of irregular copious painful menstruations, pain irradiates to the
rectum. Anamnesis states 10- year-long infertility. On bimanual examination: uterus is of normal
size; uterine appendages on the both sides are corded, with rectricted mobility, painful; there are
dense nodular painful growths detected in the posterior fornix. A doctor suspects endometriosis.
What method allows to verify this diagnosis?
Laparoscopy
Diagnostic curettage of uterine cavity
Paracentesis of posterior fornix
Uterine probing
Hysteroscopy
Which treatment is followed by a 48 years patient with severe cervical dysplasia and ovarian cyst:
diatermokonization of cervix
diathermocoagulation of cervix
hysterectomy with appendages
treatment by solkovagin
hysterectomy without appendages
Patient 22 years. Complains about pain in a right labia pudenda majora, rise of body temperature to
38.0°C. At the review of genital organs the considerable increasing of right large sexual lip definites,
especially in the lower third. Erythema, edema, at palpation acutely painful, fluctuation is
determined. To conduct vaginal examination due to acute pain is impossible. Blood test: Leucocytes
— 10,0 x 109 per cu mm. What method is main?
The dissection and drainage of abscess.
To withdraw a bartolin gland within the limits of healthy tissue.
To appoint physical therapy procedures.
To appoint compresses with liniment.
To expect a spontaneous regeneration of abscess.
26 years old patient has formed formation of purulent inflammation of the appendages of the uterus.
What would you recommend?
puncture through the posterior vaginal vault, draining pus cavity and the introduction of antibiotics
antibiotics into it
surgery
pirogenal therapy
electrophoresis of zinc
A 16-year-old female comes to the physician because of an increased vaginal discharge. She
developed this symptom 2 days ago. She also complains of dysuria. She is sexually active with one
partner and uses condoms intermittently. Examination reveals some erythema of the cervix but is
otherwise unremarkable. A urine culture is sent which comes back negative. Sexually transmitted
disease testing is performed and the patient is found to have gonorrhea. While treating this patient's
gonorrhea infection, treatment must also be given for which of the following?
Bacterial vaginosis
Chlamydia
Herpes
Syphilis
Trichomoniasis
566.
A.
B.
C.
D. *
E.
567.
A.
B.
C. *
D.
E.
568.
A. *
B.
C.
D.
E.
569.
A. *
B.
C.
D.
E.
A 23 year-old G0 reports having a solitary, painful vulvar lesion that has been present for three days.
This lesion has occurred twice in the past. She states that herpes culture was done by her doctor
during her last outbreak and was negative. She is getting frustrated in that she does not know her
diagnosis. She has no significant previous medical history. She uses oral contraceptives and
condoms. She has had four sexual partners in her lifetime. On physical examination, a cluster of three
irregular erosions with a superficial crust is noted on the posterior fornix. Urine pregnancy test is
negative. You suspect recurrent genital herpes. How do you explain the negative culture?
Cultures were taken too early
The more definitive test would be serum herpes antibody testing
The cultures were refrigerated prior to transport to the lab
Herpes cultures have a 10-20% false negative rate
The herpes virus cannot be recovered with recurrent infections
A 22 year-old P0 presents with a one-month history of profuse vaginal discharge with mild odor. She
has a new sexual partner with whom she has had unprotected intercourse. She reports mild to
moderate irritation, pruritus and pain. She thought she had a yeast infection, but had no improvement
after using an over-the counter antifungal cream. She is concerned about sexually transmitted
infections. Her medical history is significant for lupus and chronic steroid use. Pelvic examination
shows normal external genitalia, an erythematous vagina with a copious, frothy yellow discharge and
multiple petechial on the cervix. Vaginal pH is 7. Saline wet mount reveals motile, flagellated
organisms and multiple white blood cells. Which of the following is the most appropriate treatment
for this patient?
Clindamycin
Azithromycin
Metronidazole
Ampicillin
Doxycycline
A 26 year-old G2P2 reports that she is sexually active with a new male partner. She is using oral
contraception for birth control and, as such, did not use a condom. She reports the new onset of
vulvar burning and irritation. She thought she had a cold about 10 days ago. Given her history, which
of the following is the most likely diagnosis in this patient?
Herpes simplex virus
Primary syphilis
Secondary syphilis
Human immunodeficiency virus
Trichomonas
A 39 year-old G0 presents to the clinic reporting non-tender spots on her vulva for about a week. No
pruritus or pain is present. She also notes a brownish rash on the palms of her hands. She admits to
IV drug abuse. She was diagnosed as HIV-positive two years ago, but has not been compliant with
suggested treatment. On examination, three elevated plaques with rolled edges are noted on the
vulva. They are non-tender. A brown macular rash is noted on the palms of her hands and the soles of
her feet. What is the most appropriate next step in the management of this patient?
Obtain a treponemal-specific test
Biopsy of the lesion
Colposcopic evaluation of the vulvar lesions
Culture the base of the lesion
Perform a wet prep
570.
A. *
B.
C.
D.
E.
571.
A. *
B.
C.
D.
E.
572.
A.
B.
C. *
D.
E.
573.
A.
B.
C.
D. *
E.
574.
A. *
B.
C.
D.
E.
575.
A.
B.
C.
A 20 year old woman presents with a 2-day history of dysuria and increased urinary frequency, she is
recently married and was not sexually active prior to the marriage, gynecologic exam reveals no
evidence of discharge, vaginitis or cervicitis, urinalysis reveals 14 white blood cells per
high-powered field with many gram-negative rods, which of the following is the most appropriate
pharmacotherapy?
Trimethropim-Sulfamethoxazole
Ceftriaxone
Fluconazole
Gentamicin
Metronidazole
Woman with large, deep ulcers on genital with gray/yellow exudate, the ulcers are well-demarcated
borders and soft, the patient also has severe lymphadenopathy, which of the following could be the
case?
Haemophilus (chancroid)
HSV-vesicles
Lymphogranuloma venerum
HPV (wart)
None of them
A 37 years old woman has been examined and a fishy-odor discharge is noted, itching/ burning and
inflamed vagina not to see, what is the diagnosis?
Candida vaginitis
Cancer
Bacterial vaginosis
Cervicitis
HPV
The chief complaint interview on a client reveals vaginal discharge with itching and burning. The
client also reveals she experiences dyspareunia. If her diagnosis is monilial vulvovaginitis, you would
expect the wet mount slide to contain which of the following?
Bacteria
Clue cells
Trichomonads
Budding hyphae
All of the above
A 20.y.old woman is diagnosed with trichomonas and prescribed an antibiotic. She calls her
physician complaining of the flushing, nausea, and emesis. What antibiotic was the patient prescribed
and what should she have been warned of?
Metronidazole - alcohol
Metronidazole - sunlight
Metronidazole – smoking
Azithromycin – spicy food
Azithromycin – oral contraceptive
The patient complains of feeling of itching, pain in the vagina, large selection of white disharge. On
examination: vaginal mucosa edematous flushed, in the lateral fornices - the accumulation of white
layers, similar to the chees. What is the previous diagnosis?
Trichomonas colpitis
chlamydial colpitis
urogenital mycoplasmosis
D.
E. *
576.
A. *
B.
C.
D.
E.
577.
A. *
B.
C.
D.
E.
578.
A.
B.
C.
D. *
E.
579.
A. *
B.
C.
D.
E.
580.
A. *
B.
C.
D.
E.
581.
A.
B.
C. *
D.
E.
bacterial vaginosis
candidiasis vaginitis
The patient D, 22 years old was diagnosed Trichomonas colpitis. Select a product for the treatment of
this patient
tinidozol
ciprofloxacin
ampicillin
Biseptol
Diflucan
When performing a clinical breast examination on a client, a physician palpates a thickened area
where the skin folds under the breast. What is the physician’s best action?
Proceed with the examination.
Determine if the thickness is bilateral.
Ask the client how long the thickness has been present.
Attempt to elicit the same response with the client in a different position.
Schedule for MRI
The client who has discovered a lump in one breast is very upset when calling to schedule a
mammogram. What is the physician’s best response?
“It is a good thing you called. All lumps are considered cancerous until proven otherwise.”
“Unless you have a relative with breast cancer, this lump is most likely benign.”
“Diagnosing cancer at this early stage is most likely to result in a cure.”
“Many women have breast lumps, and 90% of the lumps are benign.”
“Routine mammogram allows you rule out cancer”
During the visit for a school physical, the 13-year old girl being examines questions the asymmetry
of her breasts. The best response is
One breast may grow faster than the other during development
I will give you a referral for a mammogram
You will probably have fibrocystic disease when you are older
This may be an indication of hormonal imbalance. We will check again in 6 month
It is first symptom of cancer
This is the first visit for a woman, age 38. The physician instructs her that a baseline mammogram is
recommended for woman between the age of 35 and 39 and that the clinical exam schedule would be
based on age. The recommendation for women 40 to 49 is:
every year
every 2 years
twice a year
only the baseline exam is needed unless the woman has symptoms
woman of this age have no any need in mammogram examination
The client is 45 years old and has just been diagnosed with fibrocystic breast disease. She asks what
this means in terms of her health. What is the physician’s best response?
“This problem greatly increases your risk for breast cancer, so be sure to schedule yearly
mammograms.”
“This problem progressively increases as you age, especially if you have never been pregnant.”
“This problem will probably diminish with menopause if you don't take replacement hormones.”
“This problem is genetic and you should teach your daughters about it.”
“This first symptom od cancer”
582.
A. *
B.
C.
D.
E.
583.
A.
B.
C.
D. *
E.
584.
A.
B.
C. *
D.
E.
585.
A.
B.
C.
D. *
E.
586.
A.
B.
C. *
D.
E.
587.
A.
B.
C. *
D.
E.
The client who has just been diagnosed with invasive infiltrating ductal carcinoma asks what this
means. What is the physician’s best response?
“The cancer has spread from the breast ducts into surrounding breast tissue.”
“The cancer has spread from the breast into local lymph nodes and channels.”
“The cancer has spread from the breast into surrounding tissues and organs.”
“The cancer has spread from the breast into distant tissues and organs.”
“The cancer has spread from the breast into the ducts from surrounding breast tissue
Which comment made by the client with breast cancer indicates correct understanding regarding
cancer causes and prevention?
“I will cure my cancer by eating a low-fat diet from now on.”
“If I had breast-fed my children, this would not have happened to me.”
“I hope this doesn't increase my risk for bone cancer or lung cancer.”
“I will have regular mammograms on my other breast to detect cancer early.”
“Regular physical exercise is good method of prevention of cancer in future”
The client frequently finds lumps in her breasts, especially around her period. Which info should the
physician teach the client about breast self care?
This is a benign process that does not need follow up.
Eliminate chocolate and caffeine from diet.
Practice breast self exam monthly.
This is how breast cancer starts and she needs surgery.
Do additional physical exercise to decrease size of lump
The physician is teaching a class on breast health to a group of ladies at the senior center. Which is
the most important risk factor to emphasize to this group?
Find out about family history of Breast Cancer
Men at this age can get breast cancer and should also be screened
Monthly self-exam is the key to early detection.
The older a woman gets, the greater the chance of developing Breast Cancer.
Men and women have same chance to have Breast Cancer if they are married
While the physician is obtaining a nursing history from a 52-year-old patient who has found a small
lump in her breast, which question is most pertinent?
"Do you currently smoke cigarettes?"
"Have you ever had any breast injuries?"
"Is there any family history of fibrocystic breast changes?"
"At what age did you start having menstrual periods?"
“Do you know somebody who have breast cancer
A 62-year-old patient complains to the physician that mammograms are painful and a source of
radiation exposure. She says she does breast self-examination (BSE) monthly and asks whether it is
necessary to have an annual mammogram. The physician's best response to the patient is:
"If your mammogram was painful, it is especially important that you have it done annually."
"An ultrasound examination of the breasts, which is not painful or a source of radiation, can be
substituted for a mammogram."
"Because of your age, it is even more important for you to have annual mammograms."
"Unless you find a lump while examining your breasts, a mammogram every 2 years is recommended
after age 60."
"If you will have two normal result of mammogram you can stop to do this procedure"
588.
A.
B. *
C.
D.
E.
589.
A.
B.
C. *
D.
E.
590.
A.
B. *
C.
D.
E.
591.
A.
B. *
C.
D.
E.
592.
A.
B. *
C.
D.
E.
593.
A patient with a small breast lump is advised to have a fine needle aspiration biopsy. The physician
explains that an advantage to this procedure is that
only a small incision is necessary, resulting in minimal breast pain and scarring.
if the specimen is positive for malignancy, the patient can be told at the visit.
if the specimen is negative for malignancy, the patient's fears of cancer can be put to rest.
fine needle aspiration is guided by a mammogram, ensuring that cells are taken from the lesion.
after this procedure there are no any risk for septic complication
A 33-year-old patient tells the physician that she has fibrocystic breasts but reducing her sodium and
caffeine intake and other measures have not made a difference in the fibrocystic condition. An
appropriate patient outcome for the patient is
calls the mammologist if any lumps are painful or tender.
states the reason for immediate biopsy of new lumps.
monitors changes in size and tenderness of all lumps in relation to her menstrual cycle.
has genetic testing for BRCA-1 and BRCA-2 to determine her risk for breast cancer.
increases your physical activity
A 20-year-old student comes to the student health center after discovering a small painless lump in
her right breast. She is worried that she might have cancer because her mother had cervical cancer.
The physician's response to the patient is based on the knowledge that the most likely cause of the
breast lump is
fibrocystic complex.
fibroadenoma.
breast abscess.
adenocarcinoma.
Lactostasis
A 51-year-old woman at menopause is considering the use of hormone replacement therapy (HRT)
but is concerned about the risk of breast cancer. When discussing this issue with the patient, the
physician explains that
HRT does not appear to increase the risk for breast cancer unless there are other risk factors.
She and her health care provider must weigh the benefits of HRT against the possible risks of breast
cancer.
HRT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes.
Alternative therapies with herbs and natural drugs are as effective as estrogen in relieving the
symptoms of menopause.
Additional physical exercises are as effective as estrogen in relieving the symptoms of menopause
At a routine health examination, a woman whose mother had breast cancer asks the physician about
the genetic basis of breast cancer and the genes involved. The physician explains that
her risk of inheriting BRCA gene mutations is small unless her mother had both ovarian and breast
cancer.
changes in BRCA genes that normally suppress cancer growth can be passed to offspring, increasing
the risk for breast cancer.
because her mother had breast cancer, she has inherited a 50% to 85% chance of developing breast
cancer from mutated genes.
genetic mutations increase cancer risk only in combination with other risk factors such as obesity.
Avoiding caffeine and fatty food allows to decrease risk of breast cancer related to inheriting BRCA
gene mutations
When assessing a patient for breast cancer risk, the physician considers that the patient has a
significant family history of breast cancer if she has a
A.
B. *
C.
D.
E.
594.
A.
B. *
C.
D.
E.
595.
A.
B.
C. *
D.
E.
596.
A.
B. *
C.
D.
E.
597.
A. *
B.
C.
D.
E.
598.
A.
B.
C.
D. *
E.
599.
A. *
B.
C.
cousin who was diagnosed with breast cancer at age 38.
mother who was diagnosed with breast cancer at age 42.
sister who died from ovarian cancer at age 56.
grandmother who died from breast cancer at age 72.
daughter who was diagnosed lung cancer at age 16
A 32-week-pregnant client is upset and thinks she has breast disease because she has a yellowish
discharge coming from her breasts. What can the physician say or do for this client?
Refer the client for a mammogram
This is normal toward the end of pregnancy and is called colostrum.
Notify the mammologist
Ask history questions about previous breast infections.
Refer the client for a sonography
The physician notes the presence of gynecomastia in a 15-year-old client. The physician knows:
This is an abnormal finding for a client at this age.
This condition is abnormal if it is of recent onset.
This is a temporary condition in puberty.
The client may be at increased risk for the development of breast cancer.
This is a normal finding for a client at this age.
The physician is planning a focused breast/axillae interview and wants to include a general health
question. Which of the following questions would fit these criteria?
"Has your mother or sister had breast cancer?"
"Are you still menstruating?"
"Have you ever had a mammogram?"
"Have you had any breast trauma?
"When was your last visit to gynecologist?"
A 14-year-old female client is upset because her breast development is not equal. What can the
physician say to this client?
"It is normal for breast tissue development to be unequal during puberty. It will even out as you get
older."
"Don't worry; most girls have breasts that are slightly unequal in size."
"Did your mother experience the same thing when she was your age?"
"Your breasts appear equal in size."
"You should do sonography to rule out breast cancer"
A 65-year-old female client wants to know if she still should continue to perform self breast
assessments. The most appropriate response by the physician is:
"Women can stop breast self exams after menopause."
"Self exam is not necessary if you get yearly mammograms."
"After age 60, it is not really necessary."
"Breast cancer can still develop when you get older."
"In your age self breast assessments should be performed 2 times per month"
When gathering breast history information on a client, the client states that she has noticed a few
drops of clear discharge from her nipples over the past few months. Which of the following actions is
most appropriate in this situation?
Ask additional history questions about the discharge and medications she is currently taking.
Refer the client for a mammogram.
Notify the mammologist.
D.
E.
600.
A.
B. *
C.
D.
E.
601.
A.
B. *
C.
D.
E.
602.
A.
B. *
C.
D.
E.
603.
A.
B.
C. *
D.
E.
604.
A.
B.
C. *
D.
E.
605.
A.
B. *
C.
D.
E.
Document the presence of the discharge.
Refer the client for a sonography.
A 20-year-old client with benign breast disease says she has increased breast pain and tenderness
with menses. What should the physician do in this situation?
Discuss the relationship of benign breast disease to breast cancer.
Discuss how reducing caffeine and salt intake and wearing a support bra might help.
Explain that a breast biopsy may be indicated.
Tell the client that this condition will soon go away
Explain that the additional physical exercises can reduce this pain
The physician is performing a breast examination. Which of the following reflect abnormal findings
during the inspection phase of breast examination?
A woman whose left breast is slightly larger than her right
A woman whose nipples are pointing in different directions
A woman whose skin is marked with linear striae
A pregnant woman whose breasts have a fine blue network of veins visible under the skin
A woman who wear bra size 3
A client asks the physician, "Why do I need to examine my underarms when I perform my breast
exam?" Which of the following is the most appropriate response for the physician to make to this
client?
This is the least likely area for breast cancer to occur.
Breast tissue extends into the axilla.
This is the hardest area to feel for changes.
It is easier to detect abnormalities in this area than in the breast tissue.
There are no any another need to examine this area
Physician is teaching a client who suspects that she has a lump in her breast. The physician instructs
the client that a diagnosis of breast cancer is confirmed by:
breast self-examination.
mammography.
fine needle aspiration.
chest X-ray.
sonography
Physician is teaching a group of women to perform breast self-examination. The physician should
explain that the purpose of performing the examination is to discover:
cancerous lumps.
areas of thickness or fullness.
changes from previous self-examinations.
fibrocystic masses.
mastitis
Physician is speaking to a group of women about early detection of breast cancer. The average age of
the women in the group is 47. Following the American Cancer Society guidelines, the physician
should recommend that the women:
perform breast self-examination annually.
have a mammogram annually.
have a hormonal receptor assay annually.
have a physician conduct a clinical examination every 2 years.
visit to gynecologist annually
606.
A.
Physician is providing breast cancer education at a community facility. The American Cancer Society
recommends that women get mammograms:
yearly after age 40.
after the birth of the first child and every 2 years thereafter.
after the first menstrual period and annually thereafter.
every 3 years between ages 20 and 40 and annually thereafter.
in menopause
A 34-year-old female client is requesting information about mammograms and breast cancer. She
isn’t considered at high risk for breast cancer. What should the physician tell this client?
She should have had a baseline mammogram before age 30.
She should eat a low-fat diet to further decrease her risk of breast cancer.
She should perform breast self-examination during the first 5 days of each menstrual cycle.
When she begins having yearly mammograms, breast self-examinations will no longer be necessary.
She should do additional physical exercise
Nina, an oncology educator, is speaking to a women’s group about breast cancer. Questions and
comments from the audience reveal a misunderstanding of some aspects of the disease. Various
members of the audience have made all of the following statements. Which one is accurate?
Mammography is the most reliable method for detecting breast cancer.
Breast cancer is the leading killer of women of childbearing age.
Breast cancer requires a mastectomy.
Men can develop breast cancer.
Breast self examination is the first step in an early detection of Brest cancer
Physician is instructing a premenopausal woman about breast self-examination. The physician should
tell the client to do her self-examination:
at the end of her menstrual cycle.
at the same day each month.
at the 1st day of the menstrual cycle.
immediately after her menstrual period.
Any time when remind
Gio, a community health physician, is instructing a group of female clients about breast
self-examination. The physician instructs the client to perform the examination:
At the onset of menstruation
Every month during ovulation
Weekly at the same time of day
1 week after menstruation begins
Any time during the cycle
A 70 year old woman has a palpable lesion on clinical breast examination done during a physical
examination. The hard, painless left breast mass measures approximately 5 cm. The patient has no
palpable abnormalities of the contralateral breast or either axilla, and has no additional symptoms
(such as bone pain or weight loss). It has been just over a year since the patient had a screening
mammogram. Of the following options, which is the best first step in further evaluation of this
patient’s breast lesion?
no further work-up is required
B.
C. *
D.
E.
CT of the breast
diagnostic mammography
MR imaging of both breasts
Sonography of both breasts
A. *
B.
C.
D.
E.
607.
A.
B. *
C.
D.
E.
608.
A.
B.
C.
D. *
E.
609.
A.
B.
C.
D. *
E.
610.
A.
B.
C.
D. *
E.
611.
612.
A. *
B.
C.
D.
E.
613.
A.
B.
C.
D. *
E.
614.
A.
B.
C.
D. *
E.
615.
A. *
B.
C.
D.
E.
616.
A.
B.
C.
D. *
E.
GK is a 46-year-old woman who presents to your office for a well-woman examination. She informs
you that her 51-year-old friend was diagnosed with breast cancer one month ago and that she is
worried about getting breast cancer. On further inquiry, you learn that she delivered her only child
when she was 32 years of age and has no family history for breast cancer. She does not perform
breast self-examinations and has never had a mammogram. GK asks for your advice on breast cancer
screening. Which one of the following options is best for this patient?
Discuss the harms and benefits of screening, and offer screening because she is older than age 40.
Do not offer screening because she is younger than age 50.
Offer screening to obtain a baseline examination, and begin routine screening at age 50.
Discuss the harms and benefits of screening, and offer screening because she is older than age 40;
continue screening every one to two years until age 70.
Screening is not indicated because she is at low risk for developing breast cancer.
GK is a 46-year-old woman who presents to your office for a well-woman examination. She informs
you that her 51-year-old friend was diagnosed with breast cancer one month ago and that she is
worried about getting breast cancer. On further inquiry, you learn that she delivered her only child
when she was 32 years of age and has no family history for breast cancer. She does not perform
breast self-examinations and has never had a mammogram. GK asks for your advice on breast cancer
screening. Which one of the following strategies is best to screen for breast cancer?
Monthly breast self-examinations combined with an annual clinical breast examination.
Monthly breast self-examinations and mammography every one to two years.
Clinical breast examination every one to two years.
Mammography with or without clinical breast examination every one to two years.
Routine breast self-examinations and mammography with or without clinical breast examinations
every one to two years.
A dilatation and curettage (D&C) is scheduled for a primigravid client admitted to the hospital at 10
weeks' gestation with abdominal cramping, bright red vaginal spotting, and passage of some of the
products of conception. What is the most appropriate diagnosis?
recurrent abortion
threatened abortion
septic abortion
incomplete abortion
complete abortion
Patient S., labor first, at term. Uterine contractions on 45-50 sec, every 2-3 min. Fetal heart rate is
rhythmic, 144 bpm, a head is in the pelvic inlet. Vaginally: cervix is effaced, opening 7 cm, amniotic
membrane is absent. What is the stage of labor?
First.
Second.
Preliminary.
Finishing.
Third.
A primigravid client admitted to the hospital at 10 weeks' gestation with abdominal cramping, bright
red vaginal spotting, and passage of some of the products of conception. What is the most appropriate
tactic in this situation?
Hemostatic drugs
Blood transfusion
Spasmolytic
A dilatation and curettage (D&C)
Bed rest and Vitamin supplements
617.
A.
A 22-year-old Gravida 2, Para 2 client who has disseminated intravascular coagulation after
delivering a dead fetus. Which of the following laboratory or assessment findings are the highest
priority to report?
Activated partial thromboplastin time (APTT) of 30 seconds.
Hemoglobin of 11.5g/dl.
Urinary output of 25 ml in the past hour
Platelets at 149,000/mm.
Hematocrite 0,37
A 24-year old client, G 3, P 1, at 32 weeks' gestation, is admitted to the hospital because of vaginal
bleeding. After reviewing the client's history, which of the following factors might lead the physician
to suspect placentae abruptio?
Several hypotensive episodes.
Previous low transverse cesarean delivery.
One induced abortion.
History of cocaine use.
Chronic hypertension
On arrival at the emergency department, a client tells that she suspects that she may be pregnant but
has been having a small amount of bleeding and has severe pain in the lower abdomen. The client's
blood pressure is 70/50 mm Hg and her pulse rate is 120 bpm. which of the following is suspected?
Ectopic pregnancy.
placentae abruptio.
Gestational trophoblastic disease.
Complete abortion.
Hydatiform mole
A multigravid client seen in the emergency department complaining of sharp abdominal pain and
vaginal spotting is diagnosed with an ectopic pregnancy. What is the most common site of
implantation of fertilized egg outside the uterus?
Fallopian tube.
Intestine.
Interstitial lining.
Ovary.
Uterine cervix
Pregnant 24 years, the first pregnancy, I labor. Regular uterine contractions. At vaginal examination:
the cervical opening is 4 cm, an amniotic sac is whole, the fetal head is fixed in the pelvic inlet.
Sagittal suture is in a transversal size, the small fontanel is in the center of pelvis to the left. What is
the moment of the labor biomechanism?
The V moment of the labor biomechanism
The ІІ moment of the labor biomechanism
The ІІІ moment of the labor biomechanism
The IV moment of the labor biomechanism
I moment of the labor biomechanism
A multigravid client at 8 weeks' gestation is admitted with a diagnosis of probable ectopic pregnancy.
Before surgery to remove an ectopic pregnancy and the fallopian tube, which of the following would
alert to the possibility of tubal rupture?
Amount of vaginal bleeding and discharge.
B.
C. *
Falling hematocrit and hemoglobin levels.
Slow, bounding pulse rate of 80 bpm.
A.
B.
C. *
D.
E.
618.
A.
B.
C.
D. *
E.
619.
A. *
B.
C.
D.
E.
620.
A. *
B.
C.
D.
E.
621.
A.
B.
C.
D.
E. *
622.
D.
E.
623.
A.
B.
C. *
D.
E.
624.
A.
B.
C. *
D.
E.
625.
A.
B.
C. *
D.
E.
626.
A.
B.
C. *
D.
E.
627.
A.
B.
C.
D. *
E.
628.
A.
Marked abdominal edema.
Uterine cramping
The first delivery, II period. The fetal lie is longitudinal. The head presents, that it can't be
determinate by external maneuvers. In internal examination: the uterine cervix is effaced, dilatation is
full, membranes are absent. The sagittal suture is in a direct size, small fontanel is under the pubis. In
the pushing the fetal head appears from a vulva. What area of pelvis a fetal head occupies?
Pelvic inlet
That is pressed to pelvic inlet plane
The area of pelvic outlet
The area of wide part of a cavity of a small pelvis
The area of narrow part of a cavity of a small pelvis
A multigravid client diagnosed with a probable ruptured ectopic pregnancy is scheduled for
emergency surgery. In addition to monitoring the client's blood pressure before surgery, which of the
following would the nurse assess?
Uterine cramping.
Abdominal distention.
Hemoglobin and hematocrit.
Pulse rate.
Vaginal discharge
A 36-year-old multigravid client is admitted to the hospital with possible ruptured ectopic pregnancy.
When obtaining the client's history, which of the following would the most important to identify as a
predisposing factor?
Urinary tract infection.
Marijuana use during pregnancy.
Episodes of pelvic inflammatory disease.
Use of estrogen-progestin contraceptives.
Constipation
A multigravid client is admitted to the hospital with a diagnosis of ectopic pregnancy. The nurse
antidotes that, because the client's fallopian tube has not yet ruptured, which of the following may be
ordered?
Progestin contraceptives
Medroxyprogesterone (Depo-Provera).
Methotrexate.
Betamethasone
Oxytocin
A pregnant client at 15 weeks' gestation is admitted with dark brown vaginal bleeding and continuous
nausea and vomiting. Her blood pressure is 142/98 mm Hg and fundal height is 19 cm. Based on
these findings, the client is most likely suffering from which obstetrical problem?
Preeclampsia.
Ectopic pregnancy.
Hyperemesis gravidarum.
Hydatidiform mole.
Multiple pregnancy
A 38-year-old client at about 14 weeks' gestation is admitted to the hospital with a diagnosis of
complete hydatidiform mole. Which of the following signs and symptoms would the physician
assesses for?
Pregnancy-induced hypertension.
B.
C.
D. *
E.
629.
A.
B. *
C.
D.
E.
630.
A.
B. *
C.
D.
E.
631.
A.
B. *
C.
D.
E.
632.
A.
B. *
C.
D.
E.
633.
A. *
B.
C.
D.
E.
634.
Gestational diabetes.
Hypothyroidism.
Polycythemia.
Thrombophilia
After a dilatation and curettage (D&C) to evacuate a molar pregnancy, assessing the client for signs
and symptoms of which of the following would be most important?
Urinary tract infection.
Hemorrhage.
Abdominal distention.
Chorioamnionitis.
Vaginal infection
When preparing a multigravid client who has undergone evacuation of a hydatidiform mole for
discharge, the physician explains the need for follow-up care because this the client is at risk for
developing which of the following?
Ectopic pregnancy.
Choriocarcinoma.
Multifetal pregnancies.
Infertility.
Septic abortion
Patient S., labor first, at term. Uterine contractions on 45-50 sec, after 2-3 min.. Fetal heart rate is
rhythmic, 144 in 1 min, a head is in the pelvic inlet. Vaginally: cervix is effaced, dilating is full,
amniotic membrane is absent. What is period of labor?
First.
Second.
Preliminary.
Finishing.
Third.
After suction and evacuation of a complete hydatidiform mole, the 28-year-old multigravid client
asks the nurse when she can become pregnant again. The nurse would advise the client not to become
pregnant again for at least which of the following time spans?
6 months.
12 months.
18 months.
24 months.
30 months
Upon assessment the physician found the following: fundus at 2 fingerbreadths above the umbilicus,
last menstrual period (LMP) 4 months ago, fetal heart beat (FHB) not appreciated. Which of the
following is the most possible diagnosis of this condition?
Hydatidiform mole
Missed abortion
Pelvic inflammatory disease
Ectopic pregnancy
Multifetal pregnancy
A woman presents to the emergency department complaining of bleeding and cramping. Initial
history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the
physician finds that the cervix is closed. The anticipated plan of care for this woman would be based
on a probable diagnosis of which type of spontaneous abortion?
A.
B.
C. *
D.
E.
635.
A.
B.
C. *
D.
E.
636.
A.
B. *
C.
D.
E.
637.
A.
B.
C.
D. *
E.
638.
A.
B.
C. *
D.
E.
639.
A.
B.
C.
D. *
E.
640.
A. *
B.
C.
D.
Incomplete
Inevitable
Threatened
Septic
Recurrent
A woman arrives for evaluation of her symptoms, which include: a missed period, adnexal fullness,
tenderness, and dark red vaginal bleeding. Upon examination, the physician notices an ecchymotic
blueness around the woman’s umbilicus. The physician recognizes this assessment finding as:
Normal integumentary changes associated with pregnancy
Turner sign associated with appendicitis
Cullen’s sign associated with a ruptured ectopic pregnancy
Chadwick sign associated with early pregnancy
Ortner's sign associated with cholecystitis
A woman who is 9 weeks pregnant is experiencing heavy bleeding and cramping. She reports passing
some tissue. Cervical dilation is noted on examination. This woman most likely had:
An inevitable abortion
An incomplete abortion
A complete abortion
A missed abortion
A recurrent abortion
A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding
accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. The statement
that indicates that the woman understands the explanation of an ectopic pregnancy is:
The chorionic villi develop vesicles within the uterus.
The placenta develops in the lower part of the uterus.
The fetus dies in the uterus during the first half of the pregnancy.
The embryo is implanted in the fallopian tube.
The cervical os is not closed well.
The 28-year-old primigravid client admitted to the hospital because she thinks that she is pregnant.
Which of the following findings on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
Complaint of frequent mild nausea
Blood pressure of 120/80
Fundal height measurement of 18 cm
History of bright red spotting for 1 day weeks ago
Low abdominal cramping
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Management is based
on the knowledge that:
bed rest and analgesics are the recommended treatment.
she will be unable to conceive in the future.
a D&C will be performed to remove the products of conception.
hemorrhage is the major concern.
urinary tract infection is the main predisposing factor for development of this problem
A primigravida at 10 weeks' gestation reports mild uterine cramping and slight without passage of
tissue. When she is examined, no cervical dilation is noted. The physician would:
Sent the woman home and placed on bed rest with instructions to avoid stress or orgasm
Prepare the woman for a dilation and curettage
Notify a grief counsellor to assist the woman with the imminent loss of her fetus
Tell the woman that cerclage performing help her maintain her pregnancy
E.
641.
A.
B. *
C.
D.
E.
642.
A.
B. *
C.
D.
E.
643.
A.
B. *
C.
D.
E.
644.
A. *
B.
C.
D.
E.
645.
A.
B.
C.
D. *
E.
646.
A.
B.
C.
Prepare the woman for a methotrexate therapy
Primapara N., 20 years, II pregnancy, I labor. The fetal lie is longitudinal, the fetal back is anteriorly.
The fetal heart rate is clear, rhythmic. Vaginal examination: the cervix is effaced, opening is full, an
amniotic sac is absent. Head of fetus in the plane of pelvic outlet. Sagittal suture is in a direct size,
small fontanel is under the pubis. What moment of the labor biomechanism at the anterior type of
occipital presentation is ended?
The І moment of the labor biomechanism
II moment of the labor biomechanism
The ІІІ moment of the labor biomechanism
The IV moment of the labor biomechanism
The V moment of the labor biomechanism
Jill Pangborn, age 20, has just had an incomplete abortion. While caring for her, the physician
withholds ergot products until the uterus is empty. Why?
to prevent intrauterine infection
to avoid placental fragment retention
to reduce the risk of hypertension
to allow hormone levels to return to normal
to avoid future infertility
The patient is admitted to delivery department. In examination longitudinal lie, I position, posterior
variety of the fetus is exposed. What is the leading point at the posterior type of occipital
presentation?
Small fontanel
The middle of sagittal suture
Large fontanel
Chin
Mid fontanel
Katherine Holden is admitted to the hospital with suspected ectopic pregtancy. Which health history
finding places Ms. Holden at risk for an ectopic pregnancy?
history of pelvic inflammatory disease
grand multiparity (five or more births)
use of an intrauterine device for 1 year
use of an oral contraceptive for 5 years
use of an condoms for 3 years
Katherine Holden is admitted to the hospital with suspected ectopic pregnancy. The physician
assesses Ms. Holden for signs and symptoms of ectopic pregnancy. What is the most common
finding associated with this antepartum complication?
temperature elevation
vaginal bleeding
nausea and vomiting
abdominal pain
uterine enlargement
Katherine Holden is admitted to the hospital with suspected ectopic pregnancy. The physician orders
diagnostic tests for Ms. Holden. Which three tests typically are ordered to identify ectopic
pregnancy?
serum test for beta-hCG, ultrasonography, and amniocentesis
serum test for progesterone, laparoscopy, and culdocentesis
serum test for estrogen, ultrasonography, and nitrazine paper test
D. *
serum test for beta-hCG, ultrasonography, and laparoscopy
E.
647.
serum test for beta-hCG, nitrazine paper test, and colposcopy
Denise Sorley comes to the prenatal clinic for a routine visit. She is 12 weeks pregnant, but the size
of her uterus approximates that in an 18-to 20 week pregnancy. She is diagnosed as having
gestational trophoblastic disease. For Ms. Sorley, what ultrasonography findings should the physician
expect to see?
empty gestational sac
grapelike clusters
severely malformed fetus
ectopic pregnancy
two babies
Sixteen weeks pregnant, Nicole Evans sees her physician for a regular prenatal visit. Although Ms.
Evans reports no pain or uterine contractions, the physician detects cervical dilation of 1 cm during
the physical assessment. What is the most appropriate diagnosis?
cervical incompetence
preterm delivery
spontaneous abortion
premature rupture of the membranes
placenta previa
The physician uses nitrazine paper when examining Sarah Wilder, age 24, for premature rupture of
the membranes (PROM). If Ms. Wilder has PROM, the paper will have which the color?
pink
blue
yellow
green
red
Jessica Arnold, 28 weeks pregnant, is admitted to the labor and delivery area in preterm labor. The
physician prescribes an I.V. infusion of the tocolytic drug ritodrine. The physician monitors Ms.
Arnold for adverse effects of ritodrine. Which of the following is a common adverse effect of
ritodrine?
tachycardia
pohuria
hypertension
hyporeflexia
hypotermia
Patient II, labor first, at term. The patient’ condition is satisfactory. The new-born is just delivered.
The umbilical cord hangs down from a vagina and increases in its length. Bleeding is not present.
Uterus is in normal tonus. How do you called this positive sign of placenta separation?
Dovshenko sign
Alfeld sign
Shreder' sign
Pupil sign
Hehar sign
Robert Crane, 11 weeks pregnant, is admitted with hyperemesis gravidarum. She characterizes her
condition by saying she has never known anyone to have such severe morning sickness. What is the
cause of hyperemesis gravidarum?
neurotogic disorders
A.
B. *
C.
D.
E.
648.
A. *
B.
C.
D.
E.
649.
A.
B. *
C.
D.
E.
650.
A. *
B.
C.
D.
E.
651.
A.
B. *
C.
D.
E.
652.
A.
B.
C. *
D.
E.
653.
A.
B. *
C.
D.
E.
654.
A.
B.
C. *
D.
E.
655.
A.
B.
C. *
D.
E.
656.
A.
B. *
C.
D.
E.
657.
A. *
B.
C.
D.
E.
inadequate nutrition
unknown cause
hemolysis of fetal RBCs
pure nutrition
A woman's obstetric history indicates that she is pregnant for the fourth time and all her children
from prior pregnancies are living. One was born at 39 weeks' gestation, twins at 34 weeks' gestation,
and another at 35 weeks' gestation. What is her gravity and parity using the GTPAL system?
3-1-1-1-3
4-1-2-0-4
3-0-3-0-3
4-2-1-0-3
4-0-2-1-3
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks' gestation
and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravity and
parity using the GTPAL system?
2-0-0-1-1
2-1-0-1-0
3-1-0-1-0
3-0-1-1-0
3-2-1-1
Patient 30 years, labor at term. A girl with the Apgar score 8 was born. The umbilical vessels do not
pulsate, the cord is clammed. Bloody excretions from the vagina are absent. What period of labor this
patient is found in?
Cervical
Pelvic
Placental
Puerperal period
Preliminary period
Nancy is a 31-year-old woman who believes she may be pregnant. She took an over-the-counter
pregnancy test one week after a missed period test that turned positive. During her assessment
interview, the physician inquires about Nancy’s LMP and if she is taking any medications. Nancy
states that she takes medicine for epilepsy. She has been under much stress lately at work and has not
been sleeping well. She also has a history of irregular periods. Nancy’s physical exam does not
indicate that she is pregnant. Nancy has an ultrasound that reveals she is not pregnant. What is the
most likely cause for obtaining false-positive pregnancy test results?
Nancy took the pregnancy test too early
Nancy takes anticonvulsants
Nancy has a fibroid tumor
Nancy has been under much stress and has a hormone imbalance.
Result of ultrasound is not valid
Betty is in her 7th month of pregnancy. She has been complaining of nasal congestion and occasional
epistaxis. The physician suspects that:
This is a normal respiratory change in pregnancy due to elevated levels of estrogen.
This is an abnormal cardiovascular change and the nosebleeds are an ominous sign.
Betty is a victim of domestic violence and is being hit in the face by her partner.
Betty has been using cocaine intranasally.
Betty should be examined by laryngologist o rule out chronic synusitis
658.
Juanita has just moved to the United States from Mexico. She is 3 months pregnant and has arrived
for her first prenatal visit. During her assessment interview, you discover that Juanita has not had any
immunizations. Which of the following immunizations should Juanita receive at this point of her
pregnancy?
A.
B.
Herpes Simplex Type 3
Chickenpox
Rubella
Hepatitis B
HIV
A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. You know
that which of the following findings are considered normal?
Dipstick assessment of trace to +1
> 300 mg/24 hours
Dipstick assessment of +2
> 300 mg/24 hours
It is impossible to use urine dipstick test
A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14.
Her expected date of birth (EDB) would be:
September 17
November 7
November 21
December 17
May 7
A pregnant woman at 10 weeks’ gestation jogs three to four times per week. She is concerned about
the effect of exercise on the fetus. The physician would inform her:
“You do not need to modify your exercising any time during your pregnancy.”
“Stop exercising because it will harm the fetus.”
“You may find that you need to modify your exercise to walking later in your pregnancy around the
seventh month.”
“Jogging is too hard on your joints; switch to walking now.”
Continue jogging to delivery time it is allows to decrease time of labour
A woman who is 14 weeks pregnant tells the physician that she always had a glass of wine with
dinner before she became pregnant. She has abstained during her first trimester and would like to
know if it is safe for her to have a drink with dinner now. You would tell her:
“Since you are in your second trimester, there is no problem with having one drink with dinner.”
“One drink every night is too much. One drink three times a week should be fine.”
“Since you are in your second trimester, you can drink as much as you’d like.”
“Because no one knows how much or how little alcohol it takes to cause fetal problems, it is
recommended that you abstain throughout your pregnancy.”
“One glass of wine three times a week will help make you delivery easier”
Pregnant N., 25 years is delivered in the maternity department with complaints about periodic pains
in lower part of abdomen and lumbar region during 7 hours. Amniotic fluid did not released. Fetal
heart rate is 136 in 1min. Vaginal examination: the cervix is effaced, opening 10 cm, the amniotic
membrane is whole. What is the doctor’ tactic?
Cesarean section
Stimulation of labor
Obstetric forceps
C.
D. *
E.
659.
A. *
B.
C.
D.
E.
660.
A.
B.
C. *
D.
E.
661.
A.
B.
C. *
D.
E.
662.
A.
B.
C.
D. *
E.
663.
A.
B.
C.
D.
664.
A.
B. *
C.
D.
E.
665.
A. *
B.
C.
D.
E.
666.
A.
B.
C.
D. *
E.
667.
A. *
B.
C.
D.
E.
668.
A.
B.
C.
D. *
E.
669.
A. *
Conservative conducting of labor
A pregnant woman at 18 weeks’ gestation calls the clinic to report that she has been experiencing
occasional backaches of mild to moderate intensity. The physician would recommend that she:
Do Kegel exercises
Do pelvic rock exercises
Use a softer mattress
Stay in bed for 24 hours
Should do X-ray of spine
Woman with full-term pregnancy. Uterine contractions occur every 4-5 minutes and lasts 30-35
seconds. Vaginal examination: cervix is totally effaced, dilation to 4 cm, fetal head is on -2 station.
Sagittal suture is in right oblique diameter of the pelvic inlet, posterior fontanel under the symphysis.
Amniotic sac is present. Diagnosis?
Longitudinal lie, cephalic presentation, I position, anterior. First stage of labor
Longitudinal lie, cephalic presentation, I position, posterior. First stage of labor
Longitudinal lie, cephalic presentation, II position, anterior. First stage of labor
Longitudinal lie, cephalic presentation, II position, anterior. Second stage of labor
Longitudinal lie, cephalic presentation, I position, anterior. Second stage of labor
In her work with pregnant women of various cultures, a physician has observed various practices that
seemed strange or unusual. She has learned that cultural rituals and practices during pregnancy seem
to have one purpose in common. Which of the following statements best describes that purpose?
To promote family unity
To ward off the “evil eye”
To appease the gods of fertility
To protect the mother and fetus during pregnancy
To have desired sex of the baby
Juanita has just moved to the United States from Mexico. She is 3 months pregnant and has arrived
for her first prenatal visit. During her assessment interview, you discover that Juanita has not had any
immunizations. Which of the following immunizations should Juanita receive at this point of her
pregnancy?
Tetanus
Chickenpox
Rubella
Cytomegalovirus
Herpes Simplex type I
A 22-year-old pregnant woman with a single fetus has a preconception body mass index (BMI) of 24.
When she was seen in the clinic at 14 weeks’ gestation, she had gained 1.8 kg since conception. How
would the physician interpret this?
This large weight gain indicates possible pregnancy-induced hypertension (PIH).
This small weight gain indicates that her infant is at risk for intrauterine growth restriction (IUGR).
It is impossible to evaluate this weight gain until the woman has been observed for several more
weeks.
The woman’s weight gain is appropriate for this stage of pregnancy.
The weight gain is not important during pregnancy
A pregnant woman reports that she is still playing tennis at 32 weeks’ gestation. The physician would
be most concerned whether this woman consumes which of the following during and after tennis
matches?
Several glasses of fluid
B.
C.
D.
E.
670.
A.
B.
C. *
D.
E.
671.
A.
B.
C.
D. *
E.
672.
A.
B.
C.
D.
E. *
673.
A.
B.
C.
D. *
E.
674.
A.
B.
C.
D. *
E.
675.
Extra protein sources such as peanut butter
Salty foods to replace lost sodium
Easily digested sources of carbohydrate
Avoid food 2 hours after match
A 27-year-old pregnant woman had a preconceptal BMI of 18.0. The physician would be aware that
this woman’s total recommended weight gain during pregnancy should be at least:
20 kg (44 lb)
16 kg (35 lb)
12.5 kg (27.5 lb)
10 kg (22 lb)
8 kg (17,5 lb)
A woman in her 34th week of pregnancy reports that she is very uncomfortable because of heartburn.
The physician would suggest that the woman:
Substitute other calcium sources for milk in her diet.
Lie down after each meal.
Decrease the amount of fiber that she consumes.
Eat five small meals daily.
Should be examined by gastroenterologist
Woman with full-term pregnancy. Uterine contractions occur every 4-5 minutes and lasts 30-35
seconds. Vaginal examination: cervix is totally effaced, dilation to 4 cm, fetus head is on -2 station.
Sagittal suture is in left oblique diameter of the pelvic inlet, posterior fontanel near sacral region.
Amniotic sac is present. Diagnosis?
Longitudinal lie, cephalic presentation, I position, anterior. First stage of labour
Longitudinal lie, cephalic presentation, II position, posterior. First stage of labour
Longitudinal lie, cephalic presentation, II position, anterior. First stage of labour
Longitudinal lie, cephalic presentation, II position, anterior. Second stage of labour
Longitudinal lie, cephalic presentation, I position, posterior. First stage of labour
A woman who has come to the clinic for preconception counseling because she wants to start trying
to get pregnant in 3 months can expect the following advice:
“Discontinue all contraception now.”
“Lose weight so that you can gain more during pregnancy.”
“You may take any medications that you have been taking regularly.”
“Make sure you include adequate folic acid in your diet.”
“Start to do additional exercise like jog”
Primapara R., 21 eyars old, primapara. Full term of pregnancy. The labor started 8 hours ago. The
membranes ruptured 15 minutes ago. Pelvic sizes: 25,28,31,20 cm. Fetal head rate 140 per minute
with satisfactory characteristics. Per vaginum: the cervix is dilated to 5 cm. The amniotic sac is
absent. Fetal head is palpated in plane of pelvic inlet. Which stage of labor?
Third
Second
Latent stage of first
Active stage of first
Fourth
After you complete your nutritional counseling for a pregnant woman, you ask her to reiterate your
instructions to assess her understanding of the instructions given. What statement below would
indicate that she understands the role of protein in her pregnancy?
A. *
B.
C.
D.
E.
676.
A.
B.
C. *
D.
E.
677.
A.
B.
C.
D. *
E.
678.
A. *
B.
C.
D.
E.
679.
A. *
B.
C.
D.
E.
680.
A.
B. *
C.
“Protein will help my baby grow.”
“Eating protein will prevent me from becoming anemic.”
“Eating protein will make my baby have strong teeth after he is born.”
“Eating protein will prevent me from being diabetic.”
“Eating protein will prevent excessive blood lost in postpartum period”
Your client reports “unusual food cravings”. When you inquire about the specifics, she reports
eating laundry detergent and dirt. You know that this type of craving is known as ___.
anorexia
bulimia
pica
vomiting
emesis
A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is
obtained: She is 24 years old with a BMI of 17.5. She admits to having used cocaine “several times”
during the past year and drinks alcohol occasionally. Her blood pressure is 108/70 mm Hg, her pulse
rate is 72 beats per minute, and her respiratory rate is 16 breaths per minute. Family history is
positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube
defect. Which characteristics place the woman in a high-risk category?
Blood pressure, age, BMI
Drug/alcohol use, age, family history
Family history, blood pressure, BMI
Family history, BMI, drug/alcohol abuse
Blood pressure, family history, BMI
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular
menstrual periods all of her life. She has a history of smoking approximately one pack of cigarettes a
day, but tells you that she is trying to cut down. Her laboratory data are within normal limits. Which
of the following diagnostic techniques could be employed with this pregnant woman at this time?
Ultrasound examination
Maternal serum alpha-fetoprotein screening
Amniocentesis
Nonstress test
Biophysical profile
The physician sees a woman for the first time when she is 30 weeks pregnant. The woman has
smoked throughout the pregnancy, and now fundal height measurements are suggestive of growth
restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool
useful in confirming the diagnosis?
Doppler blood flow analysis
Contraction stress test
Amniocentesis
Daily fetal movement counts
Vaginal examination
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would
yield more detailed information about the fetus?
Ultrasound for fetal anomalies
Biophysical profile
Maternal serum alpha-fetoprotein screening
D.
E.
681.
A. *
B.
C.
D.
E.
682.
A.
B.
C. *
D.
E.
683.
A.
B.
C.
D. *
E.
684.
A.
B.
C. *
D.
E.
685.
A.
B. *
C.
D.
E.
686.
A. *
B.
Percutaneous umbilical blood sampling
Daily fetal movement counts
Primipara F., 25 years old. Pregnancy at term. The labor started 6 hours ago. The membranes
ruptured one hour ago. Pelvic sizes: 23,25,29,18 cm. Fetal head rate 140 per minute with satisfactory
characteristics. Uterine contractions occur every 7-8 minutes. Per vaginum: the uterine cervix
dilatation is 2 cm. The amniotic sac is absent. One fetal foot is palpated in the vagina. Buttocks are in
the pelvic inlet. Which stage of labor?
Latent stage of first stage
Active stage of first stage
Second stage
Third
Fourth
At 35 weeks of pregnancy, a woman experiences preterm labor. Although tocolytics are administered
and she is placed on bed rest, she continues to experience regular uterine contractions and her cervix
is beginning to dilate and efface. What would be an important test for fetal well-being at this time?
Percutaneous umbilical blood sampling
Ultrasound for fetal size
Amniocentesis for fetal lung maturity
Nonstress test
Vaginal examination
A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest
to her at this time?
Biophysical profile
Amniocentesis
Maternal serum alpha-fetoprotein
Transvaginal ultrasound
Vaginal examination
A 30-year-old 3-2-0-0-2 is at 18 weeks' gestation. At this time, what screening test should be
suggested to her?
Biophysical profile
Chorionic villi sampling
Maternal serum alpha-fetoprotein screening
Screening for diabetes mellitus
Speculum examination
A maternal serum alpha-fetoprotein test indicates an elevated level. It is repeated and again is
reported as higher than normal. What would be the next step in the assessment sequence to determine
the well-being of the fetus?
Percutaneous umbilical blood sampling
Ultrasound for fetal anomalies
Biophysical profile for fetal well-being
Amniocentesis for genetic anomalies
Doppler velocimetry
Karen is undergoing a nipple-stimulated contraction stress test. She is having contractions that
occur every three minutes. The fetal heart rate has a baseline of approximately 120 bpm without any
decelerations. The interpretation of this test is said to be:
Negative
Positive
C.
D.
E.
687.
A. *
B.
C.
D.
E.
688.
A.
B.
C. *
D.
E.
689.
A.
B. *
C.
D.
E.
690.
A.
B.
C. *
D.
E.
691.
A.
692.
A. *
Satisfactory
Unsatisfactory
Normal
A pregnant woman’s biophysical profile score is 8. She asks the physician to explain the results. The
physician’s best response is:
“The test results are within normal limits.”
“Immediate delivery by cesarean birth is being considered.”
“Further testing will be performed to determine the meaning of this score.”
“An obstetric specialist will evaluate the results of this profile and, within the next week, will inform
you of your options regarding delivery.”
”You should repeat this test again after 3 days”
A primigravid client visiting the antepartal clinic at 8 weeks' gestation tells the physician that she
wants an amniocentesis because there is a history of hemophilia A in her family. The physician
instructs the client that newer techniques now allow amniocentesis to be performed as early as which
of the following?
8 weeks'gestation.
10 weeks'gestation.
12 weeks' gestation.
14 weeks' gestation.
16 weeks' gestation.
A 40-year-old gravida 4 client at 10 weeks' gestation and her husband are coming into the clinic to
discuss tests that are available during the first or early second trimester to diagnose an abormality of
the fetus. Which of the following tests are appropriate?
Electrocardiogram.
Chorionic villus sampling (CVS).
External fetal monitoring (EFM).
Nonstress test
Auscultation of fetal heart rate
A 40-year-old gravida 4 client at 10 weeks' gestation and her husband are coming into the clinic to
discuss tests that are available during the first or early second trimester to diagnose an abnormality of
the fetus. Which of the fol¬lowing tests are appropriate?
Electrocardiogram.
External fetal monitoring (EFM).
Amniocentesis.
Nonstress test
Vaginal examination
M., 25 years old, multipara. Full term of pregnancy. Initiation of labor was 7 hours ago. The
membranes ruptured 40 minutes ago. Pelvic sizes: 25,28,31,20 cm. Fetal heart rate is 132 per
minute with satisfactory characteristics. Per vaginum: the cervix is completely dilated. The amniotic
sac is absent. Fetal head is in the plane of the greatest diameter of the true pelvis. The face line is in
the right oblique size. The chin is palpated under the symphysis. What is the moment of labor
biomechanism?
A woman in her 40th weeks of pregnancy, the second labour, has regular labour activity. Uterine
contractions take place every 3 minutes. All of criteria describe the beginning of the II labor stage
EXEPT:
Cervical dilatation by no less than 4 cm
B.
C.
D.
E.
693.
A.
B.
C.
D. *
E.
694.
A.
B. *
C.
D.
E.
695.
A.
B. *
C.
D.
E.
696.
A.
B.
C.
D. *
E.
697.
A.
B.
C. *
D.
E.
Cervical dilation to 10 cm
Duration of uterine contractions over 30 seconds
Presenting part is in the lower region of small pelvis
Rupture of fetal bladder
A primigravid adolescent client at approximately 15 weeks' gestation who is visiting the prenatal
clinic with her mother is to undergo alphafetoprotein (AFP) screen¬ing. When developing the
teaching plan for this client, the physician should include which of the following pieces of
in¬formation?
Ultrasonography usually accompanies AFP testing.
Results are usually very accurate until 20 weeks' gestation.
A clean-catch midstream urine specimen is needle
Increased levels of AFP are associated with neural tube defects.
Elevated level of alphafetoprotein is responsible for preterm labour
Woman with in-time pregnancy. Bears down during 40-45 seconds with intervals 1-2 minutes. The
rupture of the membrane has occurred 10 minutes ago. Vaginal examination: fetal head is on the
pelvic floor. Sagittal suture is in anterior-posterior diameter of pelvic outlet. Amniotic sac is absent.
What is the stage of labor?
Cervical
Pelvic
Cranial
Early postpartum
Placental
A 40-year-old client at 8 weeks' gestation has a 3-year-old child with Down syndrome. The physician
is dis_cussing amniocentesis and chorionic villus sampling as genetic screening methods for the
expected baby. The physician is confident that her teaching has been understood when the client
states which of the following?
“Each test identifies a different part of the infant's genetic makeup.”
”Chorionic villus sampling can be performed earlier in pregnancy.”
“The test results take the same length of time to be complete”
“Amniocentesis is a more dangerous procedure for the fetus.”
“Amniocentesis is the most safe procedure for the fetus sex”
A 27-year-old primigravid client with insulin-dependent diabetes at 34 weeks' gestation undergoes a
nonstress test, the results of which are documented as reactive. The physician tells the client that the
test results indicatw which of the following?
A contraction stress test is necessary.
The nonstress test should be repeated
Chorionic villus sampling is necessary.
There is evidence of fetal well-being.
This is indication to emergency Cesarean section
A primigravid client with insulin-dependent diabetes tells the physician that the contraction stress test
performed earlier in the day was suspicious. The physician interprets this test result as indicating that
the fetal heart rate pattern showed which of the following?
Frequent late decelerations
Decreased fetal movement
Inconsistent late decelerations
Lack of fetal movement
Late acceleration
698.
A.
B.
C.
D. *
E.
699.
A.
B. *
C.
D.
E.
700.
A.
B.
C. *
D.
E.
701.
A.
B.
C.
D. *
E.
702.
A.
B.
C.
D.
E. *
703.
A.
B.
C.
D. *
E.
A 34-years-old woman at 36 week’s gestation has been scheduled for a biophysical profile. She asks
the physician why the test needs to be performe. The physician would tell her that the test:
Determines how well her baby will breathe after born
Evaluates the response of her baby’s heart to uterine contractions
Measures her baby’s head and length
Observes her baby’s activities to ensure that her baby is getting enough oxygen
Identify lung maturation
A 40-year-old woman at 18 week’s of gestation is having Triple Marked test performed. She is obese
and her health history reveals that she is Rh negative. The primary purpose of this test is screen for
Spina bifida
Down syndrome
Gestational diabetes
Rh antibody
Pregnancy induced hypertension
During a contraction stress test, four contractions lasting 45 to 55 seconds were recorded in a 10
minute period. A late deceleration was noted during the third contraction. The physician conducting
the test would document which of the following result
negative
positive
Suspicious
Unsatisfactory
Normal
Primapara. At vaginal examination: opening of cervix is 8 cm, sagittal suture in a transversal size of
the pelvic inlet, small fontanel is palpated as a leading point. For which type of presentation is it
typical?
The brow presentation
The vertex presentation.
The face presentation
The anterior occiput presentation.
The posterior occiput presentation
Postpartum patient. A girl was born by mass 3800 g. In pressing above the symphysis umbulical cord
doesn't change it length. How do you call this sign of placenta separation?
Positive Shreder sign
Positive Alfeld sign
Positive Vasten sign
Positive Chukalov-Kustner sign
Negative Chukalov-Kustner sign
Pregnant D. admitted to the maternity hospital with pregnancy at term and regular uterine
contractions during 6 hours. This pregnancy is first. Pelvic sizes: 25-26-31-20 cm. Fetal heart rate
136 in 1 min. What is the doctor’ conclusion about the pelvic sizes?
Normal pelvis
The true conjugate decreased
The external conjugate decreased
Distantia cristarum decreased
Distantia spinarum decreased
704.
A.
B. *
C.
D.
E.
705.
A.
B.
C. *
D.
E.
706.
A.
B. *
C.
D.
E.
707.
A. *
B.
C.
D.
E.
708.
A.
B.
C. *
D.
E.
709.
A.
B.
C. *
D.
E.
The doctor is measuring the patient’ pelvic size between the anterior spines of the os ileum. Which
size is measuring by the doctor?
Distantia cristnarum
Distantia spinarum
Distantia trochanterica
Conjugata externa
Conjugata vera
The last menstrual period of patient was 22.12. 2017.What is the exposed term of labor on the
Negele’ formula?
15.09.18
29.08.18
29.09.18
22.09.18
22.10.18
The pregnant C. was admitted in the pathology’pregnancy department. Pregnancy ІІ, 39 weeks.
Circumference of abdomen – 110 cm, height of the uterine fundus – 36 cm. The fetal lie is
longitudinal, cephalic presentation. What is the exposed fetal weight by Volskov’ method?
3700 g
3960 g
4200 g
2880 g
3270 g
The neonatologist is measuring the sizes of the newborn head. The baby is at term, weight 3200 g.
One of the fetal head size is 9.5 cm, circumference 32 cm. Which size is measured?
Small obligue (suboccipitobregmatic)
Middle obligue (suboccipitofrontal)
Large obligue (occipitomental)
Biparietal
Bitemporal
The external conjugate of patient is 21 cm. Solovjov’s index 15cm. What is the average of the true
conjugate?
11 cm
10 cm
12 cm
13 cm
14 cm
M., 28 years old, para 2. Full term of pregnancy. Initiation of labor was 8 hours ago. The membranes
ruptured 20 minutes ago. Pelvic sizes: 25,28,31,20 cm. Fetal heart rate is 132 per minute with
satisfactory characteristics. Per vaginum: the cervix is completely dilated. Fetal head is in outlet
plane of pelvic. The chin is palpated under the symphysis. Which moment of biomechanism?
First
Second
Third
Fourth
Fifth
710.
A. *
B.
C.
D.
E.
711.
A.
B. *
C.
D.
E.
712.
A.
B. *
C.
D.
E.
713.
A.
B.
C.
D. *
E.
714.
A. *
B.
C.
D.
E.
715.
A. *
B.
M., 22 years old. According to gestational age 40 weeks of gestation. Complaints of regular uterine
contractions for 5 hours. Fetal heart rate is 140 per minute with satisfactory characteristics. Per
vaginum: the cervix is dilated for 4 cm. The amniotic sac is presented. Fetal head is in plane of pelvic
inlet. Sagittal suture and small fontanel is palpated. Indicate stage of labor.
Active phase of cervical stage
Latent phase of cervical stage
Passive stage
Active phase of pelvic stage
Latent phase of pelvic stage
M., 22 years old. According to gestational age 40 weeks of gestation. Complaints of regular uterine
contractions for 3 hours. Fetal heart rate is 140 per minute with satisfactory characteristics. Per
vaginum: the cervix is dilated for 2 cm. The amniotic sac is presented. Fetal head is in plane of pelvic
inlet. Sagittal suture and small fontanel is palpated. Indicate stage of labor.
Active phase of cervical stage
Latent phase of cervical stage
Passive stage
Active phase of pelvic stage
Latent phase of pelvic stage
199. Just after delivery of placenta in 60 kg woman 35years old woman after delivery 4000g boy
400ml blood appeared from the vagina. After uterine palpation through abdominal wall softness of
uterus was revealed. What is the physiological blood loss for this patient?
250 ml
300 ml
600ml
400 ml
200 ml
Woman 40y.o. weight 80 kg, delivered 4200g baby. Just after delivery of placenta 400ml blood
appeared from the vagina. What is the physiological blood loss for this patient?
250 ml
300 ml
600ml
400 ml
200 ml
A woman at 39th week of pregnancy, the second labor, has regular birth activity. Uterine
contractions take place every 3 minutes. What criteria describe the beginning of the II labor stage the
most precisely?
Cervical dilatation by no less than 4 cm
Cervical effacement over 90%
Duration of uterine contractions over 30 seconds
Presenting part is in the lower region of small pelvis
Rupture of fetal bladder
In 10 min after childbirth by a 22-year-old woman, the placenta was spontaneously delivered and 100
ml of blood came out. Woman weight - 84 kg, infant weight - 4100 g, length - 53 cm. The uterus
contracted. In 10 minutes the hemorrhage renewed and the amount of blood is about 300 ml. What
amount of blood loss is permissible for this woman?
420 ml
1000 ml
C.
D.
E.
716.
A. *
B.
C.
D.
E.
717.
A. *
B.
C.
D.
E.
718.
A. *
B.
C.
D.
E.
719.
A. *
B.
C.
D.
E.
720.
A.
B.
C.
D. *
E.
500 ml
650 ml
300 ml
Vaginal inspection of a parturient woman revealed: cervix dilation is up to 2 cm, fetal bladder is
intact. Sacral cavity is free, sacral promontory is reachable only with a bent finger, the inner surface
of the sacrococcygeal joint is accessible for examination. The fetus has cephalic presentation. Sagittal
suture occupies the transverse diameter of pelvic inlet, the small fontanel to the left, on the side.
What labor stage is this?
Cervix dilatation stage
Preliminary stage
Prodromal stage
Stage of fetus expulsion
Placental stage
After delivery and revision of placenta there was found the defect of placental lobule. General
condition of woman is normal, uterus is firm, and there is moderate bloody discharge. Speculum
inspection of birth canal shows absence of lacerations and raptures. What action is necessary?
Manual exploration of the uterine cavity
External massage of uterus
Introduction of uterine contracting agents
Urine drainage, cold on the lower abdomen
Introduction of hemostatic medications
A 22-year-old woman is having interm labor continued for 5 hours. Light amniotic fluid came off.
The fetus head is fixed to the orifice in the small pelvis. The probable fetal weight is 4000,0 g.
Heartbeat of the fetus is normal. In vaginal examination – cervix is dilated to 1 cm, the fetal
membranes are not present. The head is in 2-st plane of the pelvis. In which stage of labor does the
woman present?
First, latent phase
First, active phase
First, spontaneous phase
Second, active phase
Third, latent phase
A woman, primagravida, consults a gynecologist on 05.03.2018. A week ago she felt the fetus
movements for the first time. Last menstruation was on 10.01.2018. When should be the day of
delivery according Neegle rule?
17 October
.25 July
22 August
11 July
5 September
33 years old woman, multipara, consults a gynecologist on 25.02.2018. A week ago she felt the fetus
movements for the first time. Last menstruation was on 11.12.2018. When should be the day of
delivery according Neegle rule?
17 October
.25 July
22 August
18 September
5 September
721.
A.
B.
C. *
D.
E.
722.
A.
B.
C.
D.
E. *
723.
A.
B. *
C.
D.
E.
724.
A.
B. *
C.
D.
E.
725.
A.
B. *
C.
D.
E.
726.
A. *
B.
In 10 min after delivery by a 32-year-old woman, the placenta was spontaneously delivered and 150
ml of blood came out. Woman weight is 90kg, infant weight - 3800 g, length - 52 cm. The uterus
contracted. In 10 minutes the hemorrhage renewed and the total amount of blood loss is 350 ml.
What amount of blood loss is physiologic for this woman?
400 ml
1000 ml
450 ml
650 ml
300 ml
In 14 min after delivery by a 22-year-old woman, the placenta was spontaneously delivered and 50
ml of blood came out. Woman weight is 60kg, infant weight - 3100g, length - 52 cm. The uterus
contracted. In 15 minutes the hemorrhage renewed and the total amount of blood loss is 250 ml.
What amount of blood loss is physiologic for this woman?
400 ml
1000 ml
450 ml
650 ml
300 ml
In 18 min after delivery by a 28-year-old woman, the placenta was spontaneously delivered and 80
ml of blood came out. Woman weight is 64kg, infant weight - 03100g, length - 50 cm. The uterus
contracted. In 10 minutes the hemorrhage renewed and the total amount of blood loss is 300 ml.
What amount of blood loss is physiologic for this woman?
400 ml
320 ml
450 ml
650 ml
300 ml
In 20 min after delivery by a 19-year-old woman, the placenta was spontaneousely delivered and 60
ml of blood came out. Woman weight is 76kg, infant weight - 3500g, length - 50 cm. The uterus
contracted. In 15 minutes the hemorrhage renewed and the total amount of blood loss is 250 ml.
What amount of blood loss is physiologic for this woman?
400 ml
380 ml
450 ml
650 ml
300 ml
A couple presented with infertility since last 2 years. Husband’s semen analysis was advised. What is
WHO criterion – for minimum sperm count in normal semen?
10 million
20 million
30 million
70 million
40 million
A 23- year old primagravidara presents with abdominal pain, syncope and vaginal spotting.
Assessment reveals that she has an ectopic pregnancy. The most common site of pregnancy is:
Ampulla
Istmus
C.
D.
E.
727.
A.
B.
C.
D.
E. *
728.
A. *
B.
C.
D.
E.
729.
A.
B.
C.
D. *
E.
730.
A. *
B.
C.
D.
E.
731.
A.
B. *
C.
D.
E.
732.
A.
B.
C.
D. *
E.
Fimbrial part
Abdomen
Cervix
Second degree of uterovaginal prolapse is characterized by:
Complete protrusion of uterus outside introitus
Descent of genital tract within vagina
Descent of genital tract up to introitus
Descent of genital tract outside the introitus
Descent of cervix below the ischial spine
A 63- year old lady presents with abdominal mass and weight loss, was diagnosed as having an
ovarian tumor. The most common ovarian tumor in this woman would be:
Epithelial tumor
Germ tumor
Stromal tumor
Sex cord tumor
Trophoblastic tumor
A young girl, 23- year old is presented with complaints of abdominal pain, menorrhagia and 18
weeks size mass arising from hypogastrium. The most likely diagnosis is:
Endometriosis
Pelvic inflammatory disease
Ovarian cyst
Uterus fibroid
Mesenteric cyst
A 25-year old school teacher Para 1 wants to use oral contraceptive pills for contraception. She
asking about the mode of action of oral contraceptivepills. The mechanism of action of oral
contraceptive pills is:
Inhibiting ovulation by suppression of serum FSH
Inducing endometrial atrophy
Increasing cervical mucous hostility
Inducing endometritis
Inhibiting prolactin
Women complaining of milky whitish discharge with fishy odor. No history of itching. Most
likely diagnosis is:
Trichomoniasis
Bacterial vaginosis
Candidiasis
Malignancy
Urinary tract infection
A medical student has come to you with complaints of oligomenorrhea, hirsutism and weight
gain, ultrasound reveals bulky ovaries with sub-cupsular cysts. Most likely diagnosis is:
Ovarian cancer
Pelvic inflammatory desease
Cushing’s syndrome
Polycystic ovarian disease
Uterus fibroid
733.
A.
B.
C.
D. *
E.
734.
A.
B.
C. *
D.
E.
735.
A.
B.
C.
D. *
E.
736.
A. *
B.
C.
D.
E.
737.
A.
B.
C.
D.
E. *
738.
A.
B.
C. *
D.
E.
739.
A.
A 43 year old woman has come to you with complaints of heavy but regular menstrual bleeding with
flooding and clots. There is no anatomical reason for heavy flow. The most effective remedy for
reducing her menstrual flow is:
Dilatation and curettage
Misoprostol
Ergometrine maleate
Tranexemic acid
Progesterone acetate
A 28 year old woman has 14 weeks size irregular uterus. She does not complain of abdominal pain or
menorrhagia. Her Pap smear is normal. The best next step in her management would be:
Continued observation
Endometrial biopsy
Pelvic ultrasonography
Hysterectomy
Laparoscopy
The most effective treatment of pruritis vulve associated with atrophic vulvitis is:
Antihistamines
Hydrocortisone
Alcohol injections
Topical estrogen therapy
Tranquilizers
A 40-year old mulptiparous woman complains of involuntary loss of urine associated with
coughing, laughing, lifting or standing. The history is most suggestive of:
Stress incontinence
Fistula
Urge incontinence
Urethral diverticulum
Urinary tract infection
A 28-year old G3, P2, has presented with comlaints of brownish vaginal discharge, passage of
vesicles and excessive vomiting. Ultrasound scan shows snowstorm appearance in uterus with no
fetus. The most likely diagnosis is:
Septic induced abortion
Fibroid utrus
Twin pregnancy
Ectopic pregnancy
Gestational trophoblastic disease
A 28-year old patient complains of amenorrhea after having dilatation and curettage. The most likely
diagnosis is:
Kallman’s syndrome
Turner’s syndrome
Asherman’s syndrome
Pelvic inflammatory disease
Anorexia nervosa
A large cystic ovarian tumor is detected in a woman on routine antenatal check up. The most
common complication she can encounter is:
Infection
B.
C.
D. *
E.
740.
A.
B.
C.
D. *
E.
741.
A.
B.
C.
D. *
E.
742.
A.
B.
C.
D. *
E.
743.
A.
B.
C.
D. *
E.
744.
A.
B.
C. *
D.
E.
745.
A.
B.
C.
D. *
E.
Rupture
Haemorrhage
Torsion
Degeneration
A 20-year old medical student presents with five years history of weight gain, irregular periods and
worsening fascial hair. What is the most likely diagnosis?
Hypothyrodism
Obesity
Cushing’s syndrome
Polycystic ovarian disease
Nephrotic syndrome
28-year old woman with previous history of having baby with Down’s syndrome is now 12 weeks
pregnant. Which of the following would you suggest to her:
Obstetric ultrasound
Fetal blood sampling
Amniocentesis
Chorionic villus sampling
Wait till eighteen weeks for detailed ultrasound
A newly married girl comes to gynae OPD with history of dysuria, burning, micturition and sore
perineum. What is your likely diagnosis:
Trichomonas infection
Trauma due to coitus
Candida infection
Honey moon cystitis
Genital herpes infection
The most likely cause of abnormal uterine bleeding in 13-year old girl is:
Uterine cancer
Ectopic pregnancy
Trauma
Anovulation
Uterus fibroid
A 58-year old woman has presented with complaints of postmenopausal bleeding for the past two
weeks. The most essential investigation would be:
Colposcopy
Pap smear
D&C
Hysteroscopy
Ultrasound examination
A 56 year old woman has come to you with the complaints of hot flushes irritability, joint pains with
lack of sleep. Most appropriate treatment would be:
Vitamins
Phytooestrogens
Selective estrogen receptor modulators
Combined estrogen, progesterone preparations
Hysterectomy
746.
A. *
B.
C.
D.
E.
747.
A.
B.
C.
D.
E. *
748.
A. *
B.
C.
D.
E.
749.
A. *
B.
C.
D.
E.
750.
A. *
B.
C.
D.
E.
In the 30years old primapara intensive uterine contractions with an interval of 1-2 min, duration 50
sec have begun. In time of the fetal head delivery the patient complaints on severe pain in the
perineum. The perineum is 5 cm, its skin become pale. What is it necessary to perform:
Perineotomy
Episiotomy.
Protection of the perineum.
Vacuum - extraction of the fetus.
Waiting tactics.
The primapara 24 is admitted in to the hospital due to high body temperature – 38,7 0, 1 stage of
labor, regular uterine contractions. Sizes of pelvis: 25-28-30-20 cm. Abdominal circumference is 100
cm, level of uterine fundus 28 cm, presenting part is absent. Right side the fetal head is palpated, left
– the breech, fetal heart sounds are absent. Vaginal examination: the uterine cervix is fully dilated,
amniotic membrane is whole. What is the tactic of labor conducting?
Cesarean section after full dilatation
Cesarean section immediately
External version of the fetus on a head
Stimulation of uterine contractions
Classic obstetric version of the fetus
In patient 25 year, labor III. The pelvic sizes: 24-27-30-19 cm. After stormy uterine contractions and
pushing at a highly standing fetal head and positive Vasten’ sign uterine contractions were stopped
suddenly, bloody excretions from a vagina appeared, fetal heart rate is not listened. The condition of
patient suddenly became worse, blood pressure went down to 70 mm Hg, pulse 140 in a 1 minute, the
skin is pale. Reason of the shock condition?
Uterine rupture
Threatened rupture of uterus
Abruption placentae
Syndrome of squeezing of lower hollow vein
Placenta previa
A 30 years old woman has the 2-nd labour that has been lasting for 14 hours. Hearbeat of fetus is
muffled, arrhythmic, 100/min. Vaginal examination: cervix of uterus is completely opened, fetus
head is at the pelvis outlet. Saggital suture is in the straight diameter, small fontanel is near
symphysis. What is the further tactics of handling the delivery?
Applying obstetric forceps
Stimulation of labor activity by oxytocin
Cesarean section
Antihypoxic drugs
Use of mid forceps
A woman is 34- year old, it is her tenth labor at full term. It is known from the anamnesis that the
labor started 11 hours ago, labor was active, painful contractions started after discharge of waters and
became continuous. Suddenly the parturient got knife-like pain in the lower abdomen and labor
activity stopped. Examination revealed positive symptoms of peritoneum irritation, ill-defined uterus
outlines. Fetus was easily palpable, movable. Fetal heartbeat is not auscultable. What is the most
probable diagnosis?
Rupture of uterus
Uterine inertia
Discoordinated labor activity
Risk of uterus rupture
II stage of labor
751.
A. *
B.
C.
D.
E.
752.
A.
B.
C. *
D.
E.
753.
A.
B.
C.
D. *
E.
754.
A.
B. *
C.
D.
E.
755.
A.
B. *
C.
D.
E.
Multipara, the second stage of delivery, fetal head is in the pelvic cavity. Contractions last for 60
seconds in 2 minutes. Fetal heart beat slowed to 100 per min. What is the management?
Applying obstetric forceps
Oxytocin stimulation of uterus activity
Perform a classic podalic version
C-section
nothing above
The woman is admitted to the maternity home with discontinued uterine contractions and slight
bloody discharges from the vagina. The condition is severe, the skin is pale, consciousness is
confused. BP – 80/40 mm Hg. The heart rate of the fetus is not determined. In anamnesis there was a
cesarean section a year ago. Establish the diagnosis:
Placental presentation
Placenta previa
Uterine rupture
Premature gush of the amniotic fluids
Nothing above
In the primapara, 30 years, intensive uterine contractions with an interval of 1-2 min, duration 50 sec
have begun. In vaginal examination cervical dilation is complete. Amniotic sac is intact. Fetal head is
present in 0 station. What is it necessary to perform:
Vacuum - extraction of the fetus.
Protection of the perineum.
Episiotomy.
Amniotomy
Nothing
Pregnant N., 25 years is delivered in the maternity department with complaints of periodic pains in
lower part of abdomen and lumbal region, during 7 hours and bloody excretions from a vagina,
which appeared 1 hour ago. Amniotic fluid is present. Pregnancy 4, labor is first, previous 3
pregnancies ended by artificial abortion. Fetal heart rate is 136 in 1min. At vaginal examination: the
uterine cervix is effaced, opening 6-7 cm, from one side soft spongy tissue is palpated before the
presenting head, the amniotic membrane is whole. Blood loss is 50 ml. What is the doctor’ tactic?
Stimulation of labor
Amniotomy
Obstetric forceps
Fetal destroying operation
Cesarean section
Patient 23 years. Pregnancy 39-40 weeks, position the fetus is longitudinal, cephalic presentation.
Sizes of pelvis: 24-25-29-18 cm. The uterine contractions proceed 10 hours, last 2 hours are very
painful, patient behaves very uneasily. Amniotic fluid released 2 hours ago. At the external
examination a contractile ring is palpated on 2 fingers higher than umbilicus, Vasten’ sign is positive.
Fetal heart rate 160 in 1 min. At internal examination: amniotic membrane is absent, opening of
uterine cervix 8 cm, head presentation, large fontanel is palpated. The fetal head is in the plane of the
pelvic inlet. What is the probable diagnosis?
The rupture of uterus is completed
Threatening rupture of uterus
Dyscoordinative uterine contractions
Placental abruption
Tetanus of uterus
756.
A.
B.
C. *
D.
E.
757.
A. *
B.
C.
D.
E.
758.
A.
B.
C. *
D.
E.
759.
A. *
B.
C.
D.
E.
760.
A.
B.
C. *
D.
E.
Primapara in I period of labor acute pain in the region of uterine fundus appeared suddenly,
insignificant bloody excretions from a vagina. Uterus is firm. Fetal heart rate – 175. In anamnesis:
acutening of chronic pyelonephritis during pregnancy. At vaginal examination: the uterine cervix is
effaced, opening of uterine cervix 4 cm. Amniotomy is conducted. Amniotic fluid released with
blood. What is the doctor’ tactic?
Stimulation of labor.
Treatment of fetal hypoxia
Cesarean section immediately.
To appoint tocolitics
To appoint coagulants
Patient C., 26 year old, 18 hours are found in labor: pushing appeared hour ago – on 30 sec. in 3-4
minutes. Fetal heart rate is arhythmical, to 100 in 1 min. It is definite at vaginal examination, that a
head is found in narrow part of small pelvis. What is your subsequent obstetric tactic?
Obstetrical forceps
The cardiomonitoring supervision
Cesarean section.
To perform perineotomy.
Conservative management of labor
Patient N., 33 years, labor I, term gestation 42 weeks. Position of the fetus is longitudinal, cephalic
presentation. Amniotic fluid released, were colored by meconium. Auscultation: fetal heart rate
arhythmical, to 170 in 1 min. Uterine contractions on 20-25 sec. after 4-5 min. At vaginal
examination: cervix is immature. What tactic of conduct of labor?
Obstetric forceps
The cardiomonitoring supervision
Cesarean section.
Perineotomy.
Vaginal delivery
Patient 28 years with the expressed edema is found in a maternity hall, in the ІІ period of labor. Head
of fetus in narrow part of small pelvis. Head pains began, twinkling of “spots” before eyes,
contractions of muscles of the face. BP - 170/110 mm Hg. What is tactic of conduct of labor?
Obstetric forceps
Conservative conduct of labor
Vacuum-extraction of the fetus
Labor stimulation
Cesarean section
In patient 25 years (labor III) after excessive uterine contractions and pushing at a highly standing
head and positive Vasten’ sign. Uterine contractions was stopped suddenly, bloody excretions from a
vagina appeared, fetal heart rate was not listened. The condition of patient suddenly became worse,
BP went down to 70 mm Hg, pulse 140 in a 1 minute, a skin is pale-grey. Reason of the shock
condition?
Threatened rupture of uterus
Placentae abruption
Uterine rupture
Syndrome of squeezing of lower hollow vein
Placenta previa
761.
A. *
B.
C.
D.
E.
762.
A.
B.
C.
D.
E. *
763.
A.
B. *
C.
D.
E.
764.
A. *
B.
C.
D.
E.
765.
A.
B. *
C.
D.
E.
766.
A.
B. *
C.
D.
Postpartum patient 28 years. A girl was born by mass 3800 g., by length 52 cm. Placenta was
delivered in 15 minutes and 300 ml of blood was discharged. Bleeding proceeds. At the review of
cervix and vagina the traumas of them are not found. At the review of placenta – vessels pass to the
edge of placenta on membranes and are ruptured. What is the subsequent tactic?
To perform the manual exploration of uterus cavity
Total hysterectomy.
Uterotonics
To conduct the external massage of uterus.
Uterine tamponade
At postpartum patient 30 years at the manual removal of placenta and examination of uterus the
rupture of uterine cervix is exposed in the right side with transition on a lower segment. Blood lost is
arrives at 1300 ml and continues. Tactic of doctor?
Subtotal hysterectomy
External massage of uterus
Tampon with ether in a posterior fornix
Oxytocin 10 units intramuscularly
Total hysterectomy
Patient K. 24- year old has II delayed delivery, II period lasts 2 hours. Fetal head is fixed to the pelvic
inlet. Pelvic dimensions 24, 26, 29, 18cm. Half an hour ago, fetal heartbeat disappeared. Tactics of
the doctor?
Immediate cesarean
Fetal destroying operation
Apply forceps
Conduct induction of labor
Make podalic version
In women with pelvic contraction II degree diagnosed transverse fetus lie and fetal death. Doctor
decided to perform fetal destroying operation. Which of these operations is carried out in such
situation?
Decapitation
Amniotomy
Craniotomy
Thoracotomy
Perforation of subsequent head
Due to the presence of a dead fetus and clinically contracted pelvis was decided to perform the fetal
destroying operation. Breech presentation. Which of the following operations can be applied?
Craniotomy
Perforation of following head
Decapitation
Evisceration
Vacuum extraction
At birth in the mixed breech presentation fell pulsing umbilical cord loops. Dilatation of cervical os is
8cm. Pelvic dimensions: 26,27 ,31, 17cm.Fetus heart rate is120/min. Make a plan of delivery
Immediate extraction of the fetus at the end of the pelvic
Urgent C-section
Continue conservative management of labor
Make an external version of the fetus
E.
767.
A.
B. *
C.
D.
E.
768.
A. *
B.
C.
D.
E.
769.
A.
B.
C.
D. *
E.
770.
A. *
B.
C.
D.
E.
771.
A. *
B.
C.
D.
E.
Keep labor conservative, intervene only when there will be fetal distress
In patient K. 24 years II delayed delivery, the second period lasts for 2 hours. Fetal head fixed to the
pelvis inlet. Pelvic size are 24, 26, 29, 18cm. Half of hour ago ceased heartbeat of the fetus. Tactics
of doctor?
Immediately hysterotomy
Fetal destroying operation
Apply obstetric forceps
Conduct stimulation uterus activity
Make podalic version and extraction of the leg
At patient on the 5th day of postpartum period suddenly there was an increasing of the temperature.
The body temperature is 38,5oС, mammary glands are normal, lactation is satisfied. Signs of
perotoneal irritation are abcent. In pelvic examination purulent excretions from the uterus are present,
uterus is soft in painfull in palpation. The uterus is increased, soft, painful in palpation.What is the
most probable diagnosis?
Endometritis
Mastitis
Lochiometra
Pelvioperitonitis
Peritonitis
At patient on the 7th day of puerperal period suddenly there was a hallucinatory syndrome: patient is
not oriented in space and time, does not recognize neighbors. The temperature of body rose to
38,5oС, purulent excretions from the uterus appeared. At vaginal examination: the uterus is increased,
soft, painful at palpation, the uterine cervix freely skips 1 finger. What reason of psychical violations,
that arose up at postpartum patient?
Psychical diseases in anamnesis
Negative emotional influence of labor on patient
Astenic-vegetative syndrome
Puerperal infection
Manifestation of postpartum blue
A woman consulted a doctor on the 14th day after labour about sudden pain, hyperemia and
induration of the left mammary gland, body temperature rised up to 39oC, headache, indisposition.
Objectively: fissure of nipple, enlargement of the left mammary gland, pain during palpation. What
pathology would you think about in this case?
Lactational mastitis
Lacteal cyst with suppuration
Fibrous adenoma of the left mammary gland
Breast cancer
Phlegmon of mammary gland
Examination of placenta revealed a defect. An obstetrician performed manual investigation of uterine
cavity, uterine massage. Prophylaxis of endometritis in the postpartum period should involve
following actions:
Antibacterial therapy
Instrumental revision of uterine cavity
Haemostatic therapy
Contracting agents
Intrauterine instillation of dioxine
772.
A.
B. *
C.
D.
E.
773.
A.
B.
C.
D. *
E.
774.
A.
B. *
C.
D.
E.
775.
A.
B.
C.
D.
E. *
In the woman of the first day after labor the rise of temperature up to 39oС was registered. The
rupture of the fetal membranes has taken place 36 hours prior to labor. The investigation of the
bacterial flora of cervix of the uterus revealed – hemolytic streptococcus of a group A. The uterine
body is soft, tender. Discharges are bloody, with a pus. Establish the most probable postnatal
complication.
Thrombophlebitis of veins of the pelvis
Metroendometritis
Infected hematoma
Infective contamination of the urinary system
Endometritis
Postpartum patient., 26 years, transferred from the department of physiological obstetrics in
observative on a 4 day of puerperal period. Labor are second, coursed normally. Perineal rupture of
the ІІ degree sutured by cetgut and silk stitches. A postnatal period during the first two days was
without complications. At the end of the third day the body temperature increased to 37,30С, head
ache appeares, pain in the area of perineum and vagina. Breasts are not tense, hyperemia is not
present. Abdomen is soft, uterine fundus on 3 transversal fingers below the umbilicus, an uterus is
firm, unpainful. Lochia rubra, in normal amount. Stitches on a perineum are covered by a purulent
discharges, surrounding tissue are edematic, hyperemia present, painful at palpation. What is the
complication of puerperal period ?
Puerperal parametritis
Puerperal endometritis
Trombophlebitis of veins of pelvis
Postpartum ulcer
Mastitis
On a 4 day after the first labor by a fetus with a mass 4200 g postpartum patient complaints of pain in
the area of vagina, T-36,9oC, AT – 115/70 mm Hg. At examination: in lower third of right lateral
wall of vagina the wound surface to 2 cm in a diameter is exposed, covered by a purulent discharge.
A wound bleeds, in surrounded tissue edema and erythema are present. Diagnosis?
Puerperal endometritis
Puerperal ulcer of vagina
Haematoma of vagina
Parametritis
Puerperal ulcer of perineum
Labor are at term, first, amniotic membrane ruptured before beginning of the uterine contractions 12
hours ago. Duration of labor 10 hours. On the 4th day after labor a temperature increased to 38-39oC,
tahicardiya, chill appeared. Pulse is 96 in 1 min, rhythmic. BT 105-70 mm Hg. Skin is pinky color.
Breasts without pathology. Uterine body on 2 cm below the umbilicus, soft consistency, painful at
palpation. Lochia rubra with an odor. Diagnosis?
Parametritis
Metrotrombophlebitis
Pelvioperitonitis
Postpartum ulcer of perineum
Acute puerperal endometritis
776.
A. *
B.
Patient 23 years. Pregnancy 39-40 weeks, position the fetus is longitudinal, cephalic presentation.
Sizes of pelvis: 24-25-29-18 cm. The uterine contractions proceed 10 hours, at last 2 hours very
painful, patient behaves very uneasily. Amniotic fluid released 2 hours ago. At the external
examination a contractile ring is palpated on 2 fingers higher than umbilicus, Vasten’ sign is positive.
Fetal heart rate 160 in 1 min. At internal examination: amniotic membrane is absent, opening of
uterine cervix 8 cm, head presentation, large fontanel is palpated. The fetal head is in the plane of
the pelvic inlet. What is the probable diagnosis?
The rupture of uterus is completed
Threatening rupture of uterus
Dyscoordinate uterine contractions
Placental abruption
Tetanus of uterus
Primapara in I period of labor acute pain in the region of uterine fundus appeared suddenly,
insignificant bloody excretions from a vagina. Uterus in hypertonus. Fetal heart rate – 175. In
anamnesis: acutening of chronic pyelonephritis during pregnancy. At vaginal examination: the
uterine cervix is effaced, opening of uterine cervix 4 cm. Amniotomy is conducted. Amniotic fluid
released with blood. What is the doctor’ tactic?
Stimulation of labor.
Treatment of fetal hypoxia
Cesarean section immediately.
To appoint tocolitics
To appoint coagulants
Patient C., 26 years, 18 hours are found in labor: pushing appeared hour ago – on 30 sec. in 3-4
minutes. Fetal heart rate is arhythmical, to 100 in 1 min. It is definite at vaginal examination, that a
head is found in narrow part of cavity of small pelvis. Your subsequent obstetric tactic?
Obstetrical forceps
The cardiomonitoring supervision
Cesarean section.
To perform perineotomy.
Conservative labor
Patient N., 33 years, labor I, term gestation 42 weeks. Position of the fetus is longitudinal, cephalic
presentation. Amniotic fluid released, were colored by meconium. Auscultation: fetal heart rate
arhythmical, to 170 in 1 min. Uterine contractions on 20-25 sec. after 4-5 min. At vaginal
examination: cervix is immature. What tactic of conduct of labor?
Obstetric forceps
The cardiomonitoring supervision
Cesarean section.
Perineotomy.
Conservative labor
Patient 28 years with the expressed edema is found in a maternity hall, in the ІІ period of labor. Head
of fetus in narrow part of small pelvis. Head pains began, twinkling of “spots” before eyes,
contractions of muscles of the face. BP - 170/110 mm Hg. What is tactic of conduct of labor?
Obstetric forceps
Conservative conduct of labor
C.
D.
E.
The Vacuum-extraction of the fetus
Labor stimulation
Cesarean section
A.
B. *
C.
D.
E.
777.
A.
B.
C. *
D.
E.
778.
A. *
B.
C.
D.
E.
779.
A.
B.
C. *
D.
E.
780.
781.
C.
In patient 25 years (labor III) after excessive uterine contractions and pushing at a highly standing
head and positive Vasten’s sign. Uterine contractions stopped suddenly, bloody excretions from a
vagina appeared, fetal heart rate was not listened. The condition of patient suddenly became worse,
BP went down to 70 mm Hg, pulse 140 in a 1 minute, a skin is pale-grey. What is the reason of the
shock condition?
Threatened rupture of uterus
Abruptio placentae
Uterine rupture
Syndrome of squeezing of lower hollow vein
Placenta previa
Postpartum patient., 26 years, transferred from the department of physiological obstetrics in
observative on a 4 day of puerperal period. Labor are second, coursed normally. Perineal rupture of
the ІІ degree sutured by cetgut and silk stitches. A postnatal period during the first two days coursed
without complications. At the end of the third day the body temperature increased to 37,30С, head
ache appeares, pain in the area of perineum and vagina. Breasts are not tense, hyperemia is not
present. Abdomen is soft, uterine fundus on 3 transversal fingers below than umbilicus, an uterus is
dense, unpainful. Lochia rubra, in normal amount. Stitches on a perineum are covered by a festering
discharges, surrounding tissue are edematic, hyperemia present, painful at palpation. What
complication of puerperal period take place?
Puerperal parametritis
Puerperal endometritis
Trombophlebitis of pelvis veins
Mastitis
Postpartum ulcer
Patient C. 21р., complains of insignificant excretions from sexual ways, itching of external genital
organs, which appeared after sexual intercourse. At the examination there is hyperemia of vaginal
vault and cervix . In the area of posterior fornix there are accumulation of liquid, greyish-yellow,
foamy excretions. What is previous diagnosis?
Acute trihomoniasis
Acute gonorrhoea
Urogenital chlamidiosis
Micoplasmosis
Ureaplasmosis
Female patient, 28 years old, has IIB type of PAP-smear. She has been treated by coagulation. When
she should visit obstetritian-gynecologist next time?
In 2 years after coagulation
Control assessment (colposcopy, cytological test, bacterioscopy) should be performed after next
menstruation
In 1 year
In 3 months after coagulation
There is no correct answer
Female patient, 25 years old, has IIIA type of PAP-smear. When she should visit
obstetritian-gynecologist next time?
In 1 year
Control assessment (colposcopy, cytological test, bacterioscopy) should be performed after next
menstruation
Should be directed to the oncological hospital
D.
In 3 months
A.
B.
C. *
D.
E.
782.
A.
B.
C.
D.
E. *
783.
A. *
B.
C.
D.
E.
784.
A.
B.
C.
D. *
E.
785.
A.
B. *
E.
786.
A.
B.
C. *
D.
E.
787.
A.
B.
C.
D.
E. *
788.
A.
B.
C. *
D.
E.
789.
A.
B.
C.
D. *
E.
790.
A.
B.
C.
D. *
E.
791.
A.
B. *
In 6 months
What treatment should be prescribed to the 48-year old female patient with severe cervical dysplasia
with involved cervical canal and ovarian cyst?
Electroconization of cervix uteri
Electrocoagulation of cervix uteri
Total hysterectomy with adnexa uteri
Solcovagin treatment
Total hysterectomy without adnexa uteri
Female patient, 33 year old, complains for genital itching, pain in vagina, white discharge. During
assessment: mucous – edematous, hyperemic, in folders – whitish cheeslike dischurge. Primary
diagnose?
Trichomonal colpitis
Chlamidia colpitis
Urogenital mycoplasmosis
Bacterial colpitis
Candidiasis colpitis
Female patient, 34 year old, complains for genital itching, pain in vagina, white discharge. During
assessment: mucous – edematous, hyperemic, in folders – whitish cheeslike dischurge. Choose
appropriate medication:
cifran
Flagil
Dyflucan
Trichopol
Levamisole
43 years old patient complains of contact bleeding in the last 6 months. In the speculum - the cervix
looks like cauliflower. Schiller tests are positive. Bimanually: Cervix is increased in size, limited in
mobility. What is the most likely diagnosis?
Fibroids
Cervical polyp
Cervical pregnancy
Cervical cancer
Leukoplakia
Patient 58 -year old complaints of bloody discharge from the genital tract. Menopause has been for
8 years. Gynecological examination: Uterus is somewhat enlarged, firm, limited in mobility,
appendages of the uterus are not defined, the parameters are free. After fractional curettage of the
uterus, it’s obtained considerable tissue scraping. What is the most likely diagnosis?
Cervical cancer
Adenomyosis
Chorionepithelioma
Hysterocarcinoma
Hormone-producing ovarian tumor
Patient 60-year old was admitted to the gynecology department with complaints of a slight bloody
discharge from the genital tract, which appeared after 4 years of menopause. During speculum
examination: cervix cylindrical epithelium non injuried. Bimanual examination: uterus is in
anteflexio versio, slightly increased in size, mobile. Adnexes are not define. After diagnostic
curettage of the uterus,has received special-shaped scraping. What is the most likely diagnosis?
Menopausal bleeding
Hysterocarcinoma
C.
D.
E.
792.
A.
B. *
C.
D.
E.
793.
A.
B.
C. *
D.
E.
794.
A.
B. *
C.
D.
E.
795.
A.
B.
C.
D.
E. *
796.
A. *
B.
C.
D.
Fibroids of the uterus
Ovarian dysfunction
Adenomyosis of the uterus
Patient 64 –year old admitted to the Department with uterine bleeding and anemia. After 12-years of
absence of menstruation, 7-8 months ago had appeared firstly serous, watery then bloody-serous,
such as "meat slops" discharge from the vagina and abdominal pain. Which pathology is most
likely?
Incomplete abortion
Cancer of the uterus
Molar pregnancy
Chorionepithelioma
Internal genital endometriosis
Patient 56, complains of general weakness, dull abdominal pain, increased abdomen. Menopause for
5 years. On examination, marked ascites. During bimanual examination: size of the uterus is small ,
shifted to the right, left and posteriorly is palpable firm, nodular, nonmoveable tumor formation,
10 x 12 cm in size .Wich is the most likely diagnosis?
Colon tumor
Subserous hysteromyoma
Ovarian cancer
tubo-ovarian abscess
Genital endometriosis
Patient 48 years complained of dull pain, gravity in the lower regions of the abdomen, a significant
increase in the abdomen for the last 4 months. Menses were normal. Gynecological examination
revealed: cervix is normal, the uterus of normal size, painless, mobile on both sides of the uterus
palpable tumor size of 10 - 12 cm, dense texture, irregular surface, motionless. In the abdominal
cavity is defined by a significant amount of free fluid. What is the most likely diagnosis?
Cirrhosis
Ovarian Cancer
Benign ovarian tumors
tubo-ovarian abscess
Genital endometriosis
Patient aged 47 complained of heavy menstrual flow. Last menstrual period was 10 days ago.
Gynecological examination: the cervix is cylindrical, deformed by old scar , the anterior lip with
leukoplakia. The body of the uterus enlarged to 14 - 15 weeks of pregnancy, with a rough surface,
solid, mobile, painless. Appendages are not palpable. The vaults are deep. Which treatment should
you choose?
Conservative myomectomy
hormone therapy
antiinflammatory, antibacterial therapy
haemostatic therapy
Hysterectomy
Patient age 47 suffer from uterine cancer 8 years, not being treated over the past year, the tumor grew
to the size of 15-week pregnancy. What is the plan of surgical treatment?
Total hysterectomy with appendages
Enucleation of myoma nodes
Supravaginal hysterectomy without adnexal
Supravaginal hysterectomy with appendages
E.
Total hysterectomy without appendages
797.
Patient 45- year old complains of contact bleeding during past 5 months. In the speculum: cervix
enlarged, looks like cauliflower, bleeds when touched by the probe. In bimanual examination uterus
has thick consistency. The body of the uterus is not enlarged, reduced mobility. Appendages are not
palpable, the parameters are free. The vaults are deep. What is possible diagnosis?
Polyposis of the cervix
Hysterocarcinoma
Protruded myoma
Cervical pregnancy
Cervical cancer
The patient 58- year after 10 years of menopause had heavy uterine bleeding. Bimanual and
speculum examination cause heavy bleeding, other pathologies haven’t been identified. A possible
diagnosis?
Incomplete abortion
Hemorrhagic metropatiya Schroeder
Hysterocarcinoma
Myoma
Violation of the menstrual cycle, climacteric period
The patient, aged 45, complained of dull abdominal pain, weakness, appetite loss, weight loss for the
last 3 months to 12 kg, an increase in the abdomen. Examination revealed: Ascites, on the side of
right adnexa palpated dense, nodular, limited mobility of the tumor. In the clinical analysis of blood increased ESR to 50 mm / h. A possible diagnosis?
Cyst
Ectopic pregnancy
Fibroids of the uterus
Ovarian cancer
Right-hand adnexitis
The patient F, 57- year old, complains of dull pain in lower quadrants for last 1,5 years. Examination
revealed: the patient's ovarian tumor captures both the ovary, fallopian tube and uterus, germinates in
the parameter reaches the walls of the pelvis, there are not any metastasis to distant organs and lymph
nodes. Which is stage of the process?
III A
III B
III b
IV
IV B
The patient T, 42 -year old, complains of dull abdominal pain, weakness, loss of appetite and
weight loss for the last 3 months, increasing of the abdomen. Examination revealed: cancer of the
body of the uterus with local growth and localization at the bottom of the uterus, without deep
invasion, there are not any metastasis to distant organs and lymph nodes. Which is the optimal
surgery?
Radical Wertheim Hysterectomy
Hysterectomy without appendages
Hysterectomy with appendages
Supracervical hysterectomy
Can be restricted by radiotherapy and chemotherapy.
A.
B.
C.
D.
E. *
798.
A.
B.
C. *
D.
E.
799.
A.
B.
C.
D. *
E.
800.
A.
B.
C. *
D.
E.
801.
A. *
B.
C.
D.
E.
802.
A.
B.
C.
D. *
E.
803.
A.
B.
C.
D.
E. *
804.
A. *
B.
C.
D.
E.
805.
A.
B.
C. *
D.
E.
806.
A.
B.
C.
D. *
E.
807.
A. *
B.
C.
After instructing a 20-year-old nulligravid client about adverse effects of oral contraceptives, the
doctor determines that further instruction is needed when the client states which of the following as
an adverse effect?
Weight gain.
Nausea.
Headache.
Ovarian cancer.
Nothing of the above
Patient 45- year old complains of contact bleeding during past 5 months. In the speculum: cervix
enlarged, looks like cauliflower, bleeds when touched by the probe. In bimanual examination uterus
has thick consistency. The body of the uterus is not enlarged, reduced mobility. Appendages are not
palpable, the parameteriums are free. The vaults are deep. What is the most likely diagnosis?
Polyposis of the cervix
Hysterocarcinoma
Birth of fibromatous node
Cervical pregnancy
Cervical cancer
Patient age 49 suffer from uterine cancer 2 years, not being treated over the past year, the tumor grew
to the size of 13-week pregnancy. What is the plan of surgical treatment?
Total hysterectomy with appendages
Enucleation of myoma nodes
Supra-vaginal hysterectomy without appendages
Supravaginal hysterectomy with appendages
Hysterectomy without appendages
The patient 64 year- old after 12 years of menopause had heavy uterine bleeding. Bimanual and
speculum examination cause heavy bleeding, other pathologies haven't been identified. What is
possible diagnosis?
Incomplete abortion
Hemorrhagic metropatiya
Uterus cancer
Myoma
Disorders of the menstrual cycle
The patient, aged 45, complained of dull abdominal pain, weakness, appetite loss, weight loss for the
last 3 months to 10 kg, an increase in the abdomen. Examination revealed: Ascites, on the side of left
adnexa palpated dense, nodular, limited mobility of the tumor. In the clinical analysis of blood increased ESR to 50 mm / h. A possible diagnosis?
Cyst
Ectopic pregnancy
Fibroids of the uterus
Ovarian cancer
Left side adnexitis
The patient O, 55 years old, complains of dull pain in right lower quadrant for last few months.
Examination revealed: the patient's ovarian tumor is confined to one ovary, there are not any
metastasis to distant organs and lymph nodes. Which is stage of the process?
IA
IB
II A
D.
E.
808.
A.
B.
C. *
D.
E.
809.
A.
B.
C.
D. *
E.
810.
A.
B.
C.
D.
E. *
811.
A.
B. *
C.
D.
E.
812.
A.
B. *
C.
D.
E.
II B
III B
The patient C, 45 years old, complains of dull abdominal pain, weakness, loss of appetite and
weight loss for the last 5 months. Which process does the type V reflect in Pap smear test?
Normal epithelium
Moderate dysplasia.
Cancer.
Inflammation.
Suspicion of malignization
The patient C, 38- year old, complains of excessive with odor discharge from the vagina lately.
Which process does the type IIA reflect in Pap smear test?
Normal epithelium.
Moderate dysplasia.
Cancer.
Inflammation.
Suspicion of malignization.
A woman complains of periodic pains and feeling of weight in lower parts of an abdomen.
Sometimes each evening there is a subfebril temperature. Menstruations are normal. Sexual life from
20 years. Two normal labors in anamnesis. The patient’ condition is satisfactory. Pulse -79 in a
minute, BP 120/70 mm Hg. Vaginally: bilateral tumors of adnexa are palpated, tumors are immobile,
a small pelvis is filled by tumors, on the lower pole of tumors the painful growths are palpated.
Blood test of ESR- 60 mm/hr, moderate lymphopenia, insignificant eozinophylia. Diagnosis?
Bilateral tubo-ovarian tumors of inflammatory genesis
Bilateral cystomas of ovaries
Stage IIIOvarian Cancer
Stage I Ovarian Cancer
Stage II Ovarian Cancer
Patient 20 year old is delivered in the gynecological department in the severe condition with
complaints of acute permanent pain in the area of left labia pudenda majora, impossibility of
movement. Objectively: temperature of body is 38,1 C. At the examination : left labia pudenda
majora is slightly swollen, skin above it and lower part of vagina is swollen, hyperhemia is present.
At palpation the pain is present. Inguinal lymphatic nodes are enlarged, especially to the left.
Laboratory: high leucocytosis, rise ESR to 33 mm/hr. What is possible diagnosis?
False abscess of Bartholin's gland
The true abscess of Bartholin's gland
Cyst of Bartholin's gland
An abscess of steam of urethral glands
Cystitis
Patient 25 years, complains of considerable foamy excretions from the vagina, pain at sexual
intercourse, itching in vagina. Menstrual function is normal. There were 2 labors and two abortions.
Is ill about one week. At examination: edema, erythema of vaginal mucous, excretions are yellow
and foamy. What is most reliable diagnosis?
Acute gonorrhea
Trichomoniasis.
Candidosis
Bacterial vaginosis
Chlamidiasis
813.
A.
B.
C.
D.
E. *
814.
A. *
B.
C.
D.
E.
815.
A.
B.
C.
D. *
E.
816.
A.
B.
C.
D. *
E.
817.
A.
B.
C.
D. *
E.
The patient 36 years complains of pain in lower parts of abdomen, rise of body temperature to 37,7 –
38oC, purulent-bloody excretions from a vagina. 3 days ago artificial abortion was done at pregnancy
8-9 weeks. Objectively: external genital organs without pathology, uterine cervix with the signs of
endocervicitis. The uterine body is enlarged to 5-6 weeks of pregnancy, the mobile is limited, soft,
not painful. Adnexa are not determined, a region of them is unpainful. Parametrium are free.
Excretions festering. Blood test: hemoglobin — 100 g/l, leucocytes — 12x109 /l. What agent is the
most reliable cause of endometritis?
Gardnerella
Trichomonas
Candidosis
Doderlein's bacillus
Gonococcus
Patient 46 year old complains of bloody excretions from genital organs after the sexual contact or
weight lifting. Bloody excretions are unconnected with a menstrual cycle. At a speculum
examination: cervix is cylindric, exernal os is closed, on a front part of the cervix a lot of the nipple
excrescences are visible, cervix is covered by festering excretions and easily bleed at contact. Body
of uterus and adnexa on either side without pathology. Parametriums are free. What is the most
reliable diagnosis?
Cancer of cervix
The true erosion.
Simple pseudo erosion
The endometriosis
Papillary pseudo erosion
The chief complaint interview on a client reveals vaginal discharge with itching and burning. The
client also reveals she experiences dyspareunia. If her diagnosis is monilial vulvovaginitis, you would
expect the wet mount slide to contain which of the following?
Bacteria
Clue cells
Trichomonads
Candida albicans
All of the above
At 35 years old patient it’s revealed intraepithelial cervical cancer. Which intervention would you
recommend:
Hysterectomy with appendages
Hysterectomy without adnexa
Cryolysis
Electro-conization of the cervix uteri
None of the above
69 year old patient complains on spotting from the genital tract after 18-year postmenopausal period.
The patient is treated by a therapist about hypertension. Blood pressure rises to 200/100 mm Hg At
the time of the inspection - 170/90 mm Hg . Her height is 165 cm and weight is 98 kg. At
gynecological examination: cervix is not changed, spotting, infiltrates in the pelvis does not. Probable
diagnosis:
Adenomyosis
Dysfunctional uterine bleeding
Cervical cancer
Endometrial cancer
Hysteromyoma
818.
A. *
B.
C.
D.
E.
819.
A. *
B.
C.
D.
E.
820.
A.
B. *
C.
D.
E.
821.
A.
B. *
C.
D.
E.
822.
A.
B. *
C.
D.
E.
823.
Patient 23 years is delivered in the gynecological department in the severe condition with complaints
of acute permanent pain in the area of left labia pudenda majora, impossibility of movement.
Objectively: temperature of body 38,7. At a review: left labia pudenda majora is slightly swollen,
skin above it and lower part of vagina is swollen, hyperhemia is present. At palpation the pain
become severe. Inguinal lymphatic nodes are enlarged, especially to the left. Laboratory: high
leucocytosis, rise ESR to 25 mm/hr. What is the diagnosis?
The true abscess of bartolin gland
False abscess of bartolin gland
Cyst of bartolin gland
An abscess is steam of urethral glands
Vestibulitis
Patient 22 years. Complains of pain in a right labia pudenda majora, rise of body temperature to 38.0
°C. At the review of genital organs the considerable increasing of right large sexual lip definites,
especially in the lower third. Erythema, edema, at palpation acutely painful, fluctuation is
determined. To conduct vaginal examination due to acute pain is impossible. Blood test: Leucocytes
— 10,0 x 109 per cu mm, Rod-nuclear — 10%.What method is main?
The dissection and drainage of abscess
To withdraw a bartolin gland within the limits of healthy tissue
To appoint physical therapy procedures
To appoint compresses with liniment
To expect a spontaneous regeneration of abscess
Patient A.complains for discharge from vagine, genital itching. Objectives: vaginal mucous is
edematous, hyperemic, foamy discharge. Diagnose?
Purulent colpitis
Trichomonal colpitis
Urogenital clamidiosis
Bacterial colpitis
Gonorrheal colpitis
Female patient, 30 years old, has IIA type of PAP-smear. When she should visit
obstetritian-gynecologist next time?
In 1 year
In 1 month to confirm effectiveness of treatment
Should be directed to the oncological hospital
In 6 months
There is no correct answer
Female patient, 35- year old, has IIB type of PAP-smear. When she should visit
obstetritian-gynecologist next time?
In 1 year
Control assessment (colposcopy, cytological test, bacterioscopy) should be performed after next
menstruation
Should be directed to the oncological hospital
In 6 months
There is no correct answer
Patient 25 years, complains about considerable foamy discharge from the vagina, pain at sexual
intercourse, itching in vagina. Menstrual function is normal. There were 1 labor and one abortion.
She is ill about a week. At examination: vaginal walls with edema, erythema, dischage are yellow
and foamy. What is most reliable diagnosis?
A. *
B.
C.
D.
E.
824.
A. *
B.
C.
D.
E.
825.
A. *
B.
C.
D.
E.
826.
A. *
B.
C.
D.
E.
827.
A.
B.
C.
Trichomoniasis.
Acute gonorrhea
Candidosis
Bacterial vaginosis
Chlamidiasis
The patient 35 years complains on pain in lower parts of abdomen, rise of body temperature to 37,7 –
38oC, purulent-bloody excretions from a vagina. 7 days ago artificial abortion was done at pregnancy
9-10 weeks. Objectively: external genital organs without pathology, uterine cervix with the signs of
endocervicitis. The uterine body is enlarged to 5-6 weeks of pregnancy, the mobile is limited, soft,
not painful. Adnexa are slightly determined, regions of them are painful. Parametrium are free.
Excretions festering. Blood test: hemoglobin — 105 g/l, leucocytes — 13x109 /l. What agent is the
most reliable cause of endometritis?
Gonococcus
Gardnerella
Trichomonas
Syphylis
Doderleyn’ bacilli
Patient 43- year old appealed to female dispensary with complaints of the presence of cervical
erosion which was exposed at routine medical examination by the midwife. In anamnesis: labors-4,
abortions-5. Меnarche at 12 years, menstruations every 28 days, during 3 days, are regular,
unpainful. Sexual life from 19 years. At colposcopy: on the uterine cervix the area of transformation
is found out. The biopsy is carried out and the diagnosis of displasia is confirmed. At cytological
examination reveals IIIB type of Pap’ smear. Define the necessary volume of treatment of the
patient:
Cervical diatermoconisation
The diatermocoagulation of the cervix
The total hysterectomy without adnexa
The criodestruction of the cervix
Subtotal hysterectomy of cervix
In the gynecological department a woman 25- year old appealed with complaints about the rise of
temperature of body to 38,60С, pain in lower parts of abdomen, dyzuria. Became ill 3 days before,
when the indicated complaints appeared after artificial abortion. At gynecological examination: the
uterine cervix is cylinder, external os is closed. Body of uterus a few enlarged, painful, soft. The
adnexa of uterus are not palpated. Excretions festering-bloody. In the blood test leycocytosis with
displacement of formula of blood to the left, speed-up ESR. What diagnosis is most credible?
Acute endometritis
Acute endocervicitis
Acute salpingoophoritis
Acute cystitis
Piosalpinx
Female patient, 35 year old, year ago masculinization signs appeared: hair on the mammary glands
and face, voice timbre has changed, menstruation ceased. Before: menstruation was regular, in
anamnesis – 1 delivery and 2 artificial abortion. Gynecological assessment: atrophy of mammory
glands, uterus hypoplasia, tumour near the uterus – 7 cm in diameter with glandular surface. What is
the diagnosis?
Policystic syndrom
Genital infantilism
False female hermafroditism
D. *
E.
828.
A.
B.
C.
D. *
E.
829.
A.
B.
C.
D. *
E.
830.
A.
B.
C.
D.
E. *
831.
A.
B.
C.
D.
E. *
832.
A.
B.
C.
D.
E. *
833.
A.
B.
C.
D.
Androblastoma
Androgenital syndrom
The chief complaint interview on a client reveals vaginal discharge with itching and burning. The
client also reveals she experiences dyspareunia. If her diagnosis is vulvovaginitis, you would expect
the wet mount slide to contain which of the following?
Bacteria
Clue cells
Trichomonads
Budding hyphae
All of the above
At 35 year old patient was revealed intraepithelial cervical cancer. Which intervention would you
recommend:
hysterectomy with appendages
hysterectomy without adnexa
cryolysis
Electro-conization of the cervix uteri
none of the above
A 32 year old patient complains of dischurge from vagine, genital itching. Objectives: vaginal
mucous is edematous, hyperemic, foamy discharge. Diagnose?
Purulent colpitis
Urogenital chlamidiosis
Candidosis
Gonorrheal colpitis
Trichomonal colpitis
Female patient, 35- year old, has IIB type of PAP-smear. When she should visit
obstetritian-gynecologist next time?
In 1 year
Should be directed to the oncological hospital
In 6 months
There is no correct answer
Control assessment (colposcopy, cytological test, bacterioscopy) should be performed after next
menstruation
What treatment should be prescribed to the 46-year old female patient with severe cervical dysplasia
with involved cervical canal and ovarian cyst?
Electrocauterizing conization of cervix uteri
Electrocoagulation of cervix uteri
Solcovagin treatment
Uterus exterpation without adnexa uteri
Hysterectomy with adnexa uteri
Female patient, 35- year old, complains of genital itching, pain in vagina, white discharge. During
assessment: mucous – edematous, hyperemic, in folders – whitish cheeslike dischurge.What is the
pimary diagnose?
Trichomonal colpitis
Chlamidia colpitis
Urogenital mycoplasmosis
Gonorrea
E. *
834.
A.
B.
C.
D.
E. *
Candidosis colpitis
Woman 30- year old came to the gynecologist on the medical examination. No complaints. In
anamnesis delivery - 1, abortion - 1. Menstruation is regular. Objectively: the cervix is cylindrical,
uterus body of normal size, firm, mobile, painless. On both sides of the uterus palpable tumor (8 x 10
cm on the left, 10 x 12 cm on the right) tight elastic consistency, with a smooth surface, mobile,
painless. The fluid in the abdominal cavity has not defined. What is the most likely diagnosis?
Ovarian Endometriosis
Krukenberg’ Canser
Abdominal pregnancy
Fibromatosis of the uterus
Bilateral cysts
Назва наукового напрямку (модуля):
Семестр: 10
Акушерство та гінекологія СРС
Опис:
5 курс 10 семестр
Перелік питань:
1.
A.
B.
C.
D. *
E.
2.
A. *
B.
C.
D.
E.
3.
A. *
B.
C.
D.
E.
4.
A. *
B.
C.
D.
E.
5.
A.
B. *
C.
D.
E.
6.
A.
What is the less crown-rump length of 7 months embryo when the heartbeat must be seen on
ultrasound?
2 mm
4 mm
5 mm
7 mm
10 mm
A definitive diagnosis can be made when a gestational sac containing a yolk sac is visualized within
the uterine cavity.
of an intrauterine pregnancy
of the tubal pregnancy
of missed abortion
uterine polyp
molar pregnancy
Crown-rump length of 7 mm on ultrasound at the first visit is revealed, heartbeat can’t be seen clear,
you should:
repeat the ultrasound after 11 days
diagnose an “early pregnancy loss” and make D and C
diagnose an ectopic pregnancy
prescribe progestines
prescribe misoprostol
An “early pregnancy loss” which is defined by American College of Obstetricians and Gynecologists
could be diagnosed with ultrasound:
the absence of cardiac activity in an embryo 11 days or more after a scan that showed a gestational
sac with a yolk sac
the presence of cardiac activity in an embryo 2 weeks or more after a scan that showed a gestational
sac without a yolk sac
Mean sac diameter of 25 mm or greater and active embryo
Mean sac diameter of 15 mm or greater and embryo with a heartbeat
the presence of cardiac activity in an embryo 11 days or more after a scan that showed a gestational
sac with a yolk sac
An “early pregnancy loss” which is defined by American College of Obstetricians and Gynecologists
could be diagnosed with ultrasound:
the presence of cardiac activity in an embryo 11 days or more after a scan that showed a gestational
sac with a yolk sac
the absence of cardiac activity in an embryo 2 weeks or more after a scan that showed a gestational
sac without a yolk sac
the presence of cardiac activity in an embryo 2 weeks or more after a scan that showed a gestational
sac without a yolk sac
Mean sac diameter of 25 mm or greater and active embryo
Mean sac diameter of 15 mm or greater and embryo with a heartbeat
An “early pregnancy loss” which is defined by American College of Obstetricians and Gynecologists
could be diagnosed with ultrasound:
the presence of cardiac activity in an embryo 11 days or more after a scan that showed a gestational
sac with a yolk sac
B.
C. *
D.
E.
7.
A. *
B.
C.
D.
E.
8.
A. *
B.
C.
D.
E.
9.
A.
B.
C. *
D.
E.
10.
A. *
B.
C.
D.
E.
11.
A.
the presence of cardiac activity in an embryo 2 weeks or more after a scan that showed a gestational
sac without a yolk sac
Mean sac diameter of 25 mm or greater and no embryo
Mean sac diameter of 25 mm or greater and active embryo
Mean sac diameter of 15 mm or greater and embryo with a heartbeat
Oligohydramnios as ultrasound diagnosis means:
is defined as an amniotic fluid index (AFI) less than 5 cm or a maximum vertical pocket less than 2
cm
is defined as an amniotic fluid index (AFI) less than 15 cm or a maximum vertical pocket less than 12
cm
is defined as an amniotic fluid index (AFI) less than 25 cm or a maximum vertical pocket less than 22
cm
is defined as an amniotic fluid index (AFI) less than 0,5 cm or a maximum vertical pocket less than
0,2 cm
is defined as the single smallest vertical pocket of amniotic fluid without evidence of umbilical cord
or fetal parts visualized in utero
The SDP specifically single deepest pocket (SDP) technique records is:
the single largest vertical pocket of amniotic fluid without evidence of umbilical cord or fetal parts
visualized in utero
the single smallest vertical pocket of amniotic fluid without evidence of umbilical cord or fetal parts
visualized in utero
the single largest transverse pocket of amniotic fluid without evidence of umbilical cord or fetal parts
visualized in utero
the summative measurement of the single deepest vertical pocket of fluid without evidence of cord or
fetal parts noted in all four quadrants of the uterus
is defined as an amniotic fluid index (AFI) less than 15 cm or a maximum vertical pocket less than 12
cm
The AFI (amniotic fluid index) technique is the summative measurement of the single deepest
vertical pocket of fluid without evidence of cord or fetal parts noted in all four quadrants of the
uterus.
the single largest vertical pocket of amniotic fluid without evidence of umbilical cord or fetal parts
visualized in utero
the single smallest vertical pocket of amniotic fluid without evidence of umbilical cord or fetal parts
visualized in utero
the summative measurement of the single deepest vertical pocket of fluid without evidence of cord or
fetal parts noted in all four quadrants of the uterus
the single largest transverse pocket of amniotic fluid without evidence of umbilical cord or fetal parts
visualized in utero
the single smallest transverse pocket of amniotic fluid without evidence of umbilical cord or fetal
parts visualized in utero
Polyhydramnios which is a term to describe:
an abnormally large amount of fluid
significantly low amniotic fluid
significantly large intestinum of the fetus
significantly large stomach of the fetus
significantly large head of the fetus
Polyhydramnios is defined by
an AFI greater than 4 cm or a single deepest vertical pocket (SDP) greater than 8 cm
B. *
C.
D.
E.
12.
A.
B.
C. *
D.
E.
13.
A.
B.
C. *
D.
E.
14.
A.
B.
C. *
D.
E.
15.
A. *
B.
C.
D.
E.
16.
A. *
B.
C.
D.
E.
17.
A. *
B.
C.
an AFI greater than 24 cm or a single deepest vertical pocket (SDP) greater than 8 cm
an AFI greater than 14 cm or a single deepest vertical pocket (SDP) greater than 8 cm
an AFI greater than 34 cm or a single deepest vertical pocket (SDP) greater than 8 cm
an AFI greater than 24 cm or a single deepest vertical pocket (SDP) greater than 28 cm
What is gestational Age when Mean Transvaginal Gestational Sac Diameter is 8 mm (mm)?
12-13 weeks
24 weeks
less than 5-6 weeks
10-11 weeks
16-17 weeks
What is gestational Age (wk) when Mean Transvaginal Gestational Sac Diameter is 16 mm (mm)
and emryo is visible?
12-13 weeks
24 weeks
6-7 weeks
10-11 weeks
16-17 weeks
a serious developmental defect of the central nervous system in which the brain and cranial vault are
grossly malformed
Gastroshchizis
Omphalocele
Anencephaly
Gastroptosis
Aneuploidy
The greatest risk factor for vertical mother-to-child transmission of HIV is thought to be
advanced maternal disease, likely due to a high maternal HIV viral load
Smoking
alcohol taking
intensive antiretroviral therapy
mild antiretroviral therapy
Indications for amniocentesis:
to deliver intra-amniotic dye in cases in which premature rupture of membranes is suspected
to measure fetal abdomen
to treat HIV infection
to prevent influenza transmission
to measure fetal head
Amnioreduction is:
Procedure to reduce uterine distention and decreases risk for preterm premature rupture of
membranes and preterm delivery
Is referred to as artificial rupture of membranes (AROM) is the procedure by which the amniotic sac
is deliberately ruptured so as to cause the release of amniotic fluid, usually performed for the purpose
of inducing or expediting labor.
is a medical procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections,
and also for sex determination, in which a small amount of amniotic fluid, which contains fetal
tissues, is sampled from the amniotic sac surrounding a developing fetus
D.
E.
18.
A. *
B.
C.
D.
E.
19.
A. *
B.
C.
D.
E.
20.
A.
B. *
C.
D.
E.
21.
A.
B.
C. *
D.
E.
22.
A.
B.
C.
D. *
E.
23.
A.
B. *
C.
D.
E.
is a procedure to deliver intra-amniotic dye in cases in which premature rupture of membranes is
suspected
is a procedure for determining fetal lung maturity
Indications for amnioreduction:
setting of twin-to-twin transfusion syndrome (TTTS), where it is performed to reduce fluid volume in
the recipient twin and thereby increase blood flow to the donor twin by decreasing pressure inside the
amniotic cavity
to deliver intra-amniotic dye in cases in which premature rupture of membranes is suspected
determining fetal lung maturity
Is referred to as artificial rupture of membranes (AROM) is the procedure by which the amniotic sac
is deliberately ruptured so as to cause the release of amniotic fluid, usually performed for the purpose
of inducing or expediting labor.
to treat HIV infection
Missed, incomplete, or inevitable abortion present before 13 weeks' gestation needs therapy:
misoprostol as an alternative to surgery
Progestines
Antiviral therapy
Combined oral contraceptives
Oxytocin 10 IU
Missed, incomplete, or inevitable abortion present before 13 weeks' gestationneeds therapy:
Antiviral therapy
performance of suction
Progestines
Combined oral contraceptives
Oxytocin 10 IU
Missed, incomplete, or inevitable abortion present before 13 weeks' gestationneeds therapy:
Combined oral contraceptives
Oxytocin 10 IU
performance of dilation and curettage
Progestines
Antiviral therapy
The most common cancers found in pregnant women mirror those found in their nonpregnant
counterparts, to include the following EXCEPT:
Thyroid cancer
Lymphoma
Colorectal carcinoma (0.10-1.0 cases per 1000 pregnancies)
Osteosarcoma
Colorectal carcinoma (0.10-1.0 cases per 1000 pregnancies)
What is a success rate of medical abortion with the combination of mifepristone and vaginal or
buccal misoprostol to 63 days gestation?
of 53-55%
of 93-95%
of 83-85%
of 73-75%
of 63-65%
24.
A.
B.
C.
D. *
E.
25.
A.
B.
C.
D. *
E.
26.
A.
B.
C.
D. *
E.
27.
A.
B.
C.
D. *
E.
28.
A. *
B.
C.
D.
E.
29.
A.
B. *
C.
D.
E.
30.
A.
B.
Cardiac conditions that still carry maternal mortality rates and may be the indication for medical
abortion include EXCEPT:
mitral stenosis, coarctation of the aorta,
severe uncorrected tetralogy of Fallot, aortic stenosis
history of myocardial infarction
moderate arterial hypertension
presence of artificial heart valves
Maternal medical conditions that carry significant risks in pregnancy and may be maternal
indications for abortion include the following EXCEPT:
severe diabetes with retinopathy with cardiac or renal complications
advanced cardiac or respiratory disease,
sickle cell disease
femur fracture
psychiatric disease
Fetal conditions that are incompatible with life include the following EXCEPT:
Anencephaly
trisomy 13
trisomy 18
esophageal or duodenal atresia
thanatophoric dysplasia
A cephalic disorder in which the prosencephalon (the forebrain of the embryo) fails to develop into
two hemispheres is defined as:
Aneuploidy
ventricular atresia
Wilson disease
Holoprosencephaly
Anencephaly
Medical abortion is contraindicated in patients with:
chronic steroid use
Mild hypertensia
Moderate anemia
HIV infection
after rape
Medical abortions are indicated for women who consent to elective medical abortion. What is
maximal gestational age for the FDA-approved protocol with misoprostol from the LMP?
38 days
49 days
63 days
75 days
90 days
What is the tablets appointment schedule for medical abortion?
On day 1, mifepristone 200 mg PO once as a single dose (FDA-approved regimen), levonorgestrel
after 24 hours
On day 1, mifepristone 800 mg PO once as a single dose (FDA-approved regimen), is administered
in the office. Misoprostol 100 mcg buccal administration is then administered at home 24-48 h after
the mifepristone dose
C. *
D.
E.
31.
A.
B.
C. *
D.
E.
32.
A.
B. *
C.
D.
E.
33.
A. *
B.
C.
D.
E.
34.
A.
B.
C.
D.
E. *
35.
A.
B.
C.
D. *
E.
36.
A.
On day 1, mifepristone 200 mg PO once as a single dose (FDA-approved regimen), is administered
in the office. Misoprostol 800 mcg buccal administration is then administered at home 24-48 h after
the mifepristone dose
On day 1, ulipristal acetate 30 mg, is administered in the office. Misoprostol isn’t necessary
On day 1Misoprostol 800 mcg buccal administration; mifepristone isn’t necessary
Method of selective reduction (selective fetocide) is following:
Gel with prostaglandins into cervix
Oxytocin 10 IU intravenously
Cord occlusion techniques, such as Nd:YAG laser photocoagulation; fetoscope cord ligation; bipolar
cord coagulation; and monopolar cord coagulation
Misiprostol vaginally 800 mg
Fetocide is forbidden nowadays
Method of selective reduction (selective fetocide) is following:
Misiprostol vaginally 800 mg
Cord occlusion techniques, such as embolization with alcohol or enbucrilate gel;
Gel with prostaglandins into cervix
Oxytocin 10 IU intravenously
Fetocide is forbidden nowadays
Pregnant women are:
at increased risk for severe complications from influenza infection as compared with non-pregnant
women and the general population
at the same level risk for severe complications from influenza infection as compared with
non-pregnant women and the general population
at reduced risk for severe complications from influenza infection as compared with non-pregnant
women and the general population
at minimal risk for severe complications from influenza infection as compared with non-pregnant
women and the general population
at 100% lethal risk from influenza infection as compared with non-pregnant women and the general
population
The inactivated influenza vaccine is recommended for:
all pregnant women only in 1-st trimester
all pregnant women only in 2-nd trimester
all pregnant women only in 3-rd trimester
Can’t be used in pregnant women
all pregnant women in all trimesters
Live Attenuated Influenza Vaccine (LAIV) in pregnancy is recommended for:
all pregnant women only in 1-st trimester
all pregnant women only in 2-nd trimester
all pregnant women only in 3-rd trimester
is not approved in pregnant women
all pregnant women in all trimesters
The following recommendations regarding Tdap immunization (Tetanus toxoid, reduced diphtheria
toxoid and acellular pertussis) in pregnancy are provided by ACIP and endorsed by ACOG. But
choose one incorrect postulate:
Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) immunization is
recommended once during each pregnancy, including in women with prior vaccination.
B.
C.
D. *
E.
37.
A.
B.
C.
D. *
E.
38.
A.
B.
C. *
D.
E.
39.
A.
B.
C.
D. *
E.
40.
A.
B.
C.
D. *
E.
41.
A.
B.
Optimal vaccine timing is between 27 and 36 weeks with ideal administration as early as possible in
that window to maximize passive neonatal immunity.
Tdap may also be given at any time in pregnancy.
Tdap can’t be given while pregnancy at all
Optimal vaccine timing is between 11 and 12 weeks with ideal administration as early as possible in
that window to maximize passive neonatal immunity.
Hepatitis A virus (HAV) in pregnancy. Choose the incorrect answer:
Pregnancy is not a contraindication to vaccine administration and ACIP and ACOG advise
Pregnant women who have been exposed to individuals with HAV infection and have not previously
been immunized should receive post-exposure prophylaxis as described above.
Immune globulin does not pose a risk in pregnancy and exposed pregnant women should receive both
immune globulin and HAV immunization as soon as possible after exposure.
can’t be given while pregnancy at all
HAV vaccine in pregnancy for women in whom the risk of HAV infection exceeds the theoretical
risk of immunization (pregnant women who plan to travel to areas where there is an increased risk for
exposure to hepatitis A) can be vaccinated
Hepatitis B (HBV) in pregnancy. Choose the incorrect answer:
ACIP and ACOG recommend HBV immunization for pregnant women at risk of infection.
Pregnancy is not a contraindication to hepatitis B vaccine.
Pregnancy is a contraindication to hepatitis B vaccine.
Routine prenatal screening for HBsAg is recommended to detect HBV carriers and to ensure
neonatal immunoprophylaxis at birth if needed.
HBV infection in pregnancy, both acute and chronic infection, poses a risk of vertical transmission
with perinatally-acquired infection conferring the greatest risk of long-term consequences.
Meningococcal Disease in pregnancy. Choose the incorrect answer:
Neisseria meningitis is the encapsulated gram-negative bacterium
All meningococcal vaccines are inactivated and therefore low risk for adverse outcomes in pregnant
women or their offspring.
ACIP recommends that pregnant women at increased risk for meningococcal disease be immunized
according to existing adult recommendations.
can’t be given while pregnancy at all
Neisseria meningitis causes significant morbidity and mortality through meningococcal meningitis
and bacteremia
Anthrax immunization in pregnancy. Choose the incorrect answer:
Given the low-risk of anthrax exposure, pre-event immunization is not recommended for pregnant
women, as the benefit of immunization does not outweigh the theoretical risk of immunization.
the high morbidity and mortality of anthrax disease is observed
Individuals at highest risk of exposure include military populations, environmental investigators,
postal processing staff and individuals with laboratory exposures
can’t be given while pregnancy at all
pregnant women with an exposure to anthrax should receive AVA vaccination and anti-microbial
treatment
Poliovirus, vaccination in pregnancy. Choose the incorrect answer:
Pregnancy is a precaution to immunization with inactivated polio vaccine (IPV).
ACIP recommends that inactivated polio vaccine (IPV) be considered for pregnant women at risk for
exposure to wild-type poliovirus.
C.
D. *
E.
42.
A.
B.
C.
D.
E. *
43.
A.
B.
C.
D.
E. *
44.
A.
B.
C.
D.
E. *
45.
A. *
B.
C.
D.
E.
46.
A. *
B.
C.
D.
E.
adults at increased risk include: travelers to areas or countries where polio is epidemic or endemic,
individuals working with poliovirus in a laboratory setting, and healthcare workers in close contact
with patients who may have poliovirus
can’t be given while pregnancy at all
IPV may be administered to pregnant women
Rhabdovirus infection vaccination in pregnancy. Choose the incorrect answer:
Pregnancy is not an absolute contraindication to rabies immunization
Pregnant women at high risk for rabies exposure should be considered for pre-exposure
immunization
Post-exposure immunization is recommended for pregnant women in 1st trimestr.
Post-exposure immunization is recommended for pregnant women in 2nd trimestr.
Pregnancy is an absolute contraindication to rabies immunization.
Measles, Mumps, Rubella vaccination in pregnancy. Choose the incorrect answer:
No cases of congenital rubella syndrome have been reported after inadvertent MMR immunization in
pregnancy. MMR immunization in pregnancy should not be considered an indication for pregnancy
termination.
Pregnant women should be screened for rubella immunity in pregnancy. Rubella non-immune
women should be offered MMR immunization postpartum, prior to hospital discharge.
Women should be advised to wait 4 weeks after immunization before becoming pregnant, due to the
theoretical risk of immunization with a live vaccine.
Pregnancy is a contraindication for MMR immunization. Women should be asked about their
pregnancy status prior to immunization. Routine pregnancy testing is not recommended prior to
vaccine administration.
Is highly recommended at all terms of pregnancy routinely.
Varicella-zoster virus (VZV) immunization in pregnancy. Choose the incorrect answer:
Varicella-zoster virus (VZV) is a herpes virus that causes chickenpox and shingles.
Varicella non-immune pregnant women should be immunized immediately postpartum, prior to
hospital discharge. A second dose should be administered 4 weeks after the first dose, at the
postpartum visit.
Varicella vaccination in pregnancy should not be considered an indication for pregnancy termination.
No cases of congenital varicella syndrome have been reported after varicella immunization.
Varicella vaccination in pregnancy should not be considered an indication for pregnancy termination.
Breastfeeding and Vaccines in pregnancy. What is the exception for vaccination while
breastfeeding:
smallpox and yellow-fever
all live-attenuated vaccines are safe to administer to breastfeeding women
influenza
HPV (human papillomavirus)
Hepatitis B, A
The DFW Metroplex Cooperative RMS Group follow-up protocol for fetal wastage syndrome that is
associated with hypercoagulable blood protein/platelet defects includes all medications EXCEPT:
Warfarin Initial dose: 2 to 5 mg orally once a day, maintenance dose: 2 to 10 mg orally once a day
Aspirin: 81 mg/d, start preconception (time of diagnosis) and Calcium: 500 mg/d by mouth (PO)
Heparin: 5000 U SC q12h immediately postconception (added to aspirin, both to term)
Prenatal vitamins (Iron: 1 tab/d PO, Folic acid: 1 mg/d PO)
Dalteparin: 5000 U SC q24h immediately postconception (added to aspirin, both to term)
47.
A.
B.
C.
D. *
E.
48.
A.
B.
C.
D. *
E.
49.
A.
B. *
C.
D.
E.
50.
A.
B. *
C.
D.
E.
51.
A.
B.
C.
D. *
E.
52.
A. *
B.
C.
D.
E.
Laboratory assessment for fetal wastage syndrome that is associated with hypercoagulable blood
protein/platelet defects is necessary routinely EXCEPT:
Fetal activity chart daily, starting at 28 weeks
Biophysical profile and color Doppler flow ultrasonography of umbilical artery at 32, 34, 36, and 38
weeks
Complete blood cell (CBC)/platelet count and heparin level (anti–factor Xa method) weekly for 4
weeks; then CBC/platelet count and heparin level monthly to term
CT scan of uterus
CBC/platelet count and heparin level monthly to term
Mifepristone (Mifeprex, RU-486), choose false postulate:
It is blocking progesterone (it is antiprogesterone)
It provokes decidual necrosis and detachment of the pregnancy at the endometrium and uterine
contractions ensue.
It provokes abortion
It is a hormone that maintains pregnancy
It provokes softening and dilation of cervix;
Carboprost tromethamine (Rx), choose false postulate:
It is prostaglandin similar to F2-alpha
It is blocking progesterone (it is antiprogesterone)
It produces myometrial contractions that induce hemostasis at placentation site
It has longer duration than dinoprost
It is used for refractory postpartum uterine bleeding
Methotrexate, choose false postulate:
Is for Neoplasms treatment, Antineoplastic dosage range: 30-40 mg/m?/week to 100-12,000 mg/m?
with leucovorin rescue
It is blocking progesterone (it is antiprogesterone)
Primarily affects rapidly dividing cells first, such as trophoblast cells.
Is an antimetabolite that works by blocking enzyme dihydrofolate reductase, thereby inhibiting folate
production and, thus, DNA synthesis
Can be used for ectopic pregnancy management (Off-label), 50 mg/m? IM;
Methotrexate, choose usage in gynecologic practice:
Indicated for management of severe, active rheumatoid arthritis (RA) in adults who have had an
insufficient response or intolerance to an adequate trial of first-line therapy including full dose
NSAIDs
Meningeal Leukemia, Osteosarcoma
For symptomatic control of severe, recalcitrant, disabling psoriasis in adults not adequately
responsive to other forms of therapy; use only with established diagnosis (by biopsy and/or after
dermatologic consultation)
Trophoblastic neoplasms: 15-30 mg/day PO/IM for 5 days; may be repeated
Myasthenia Gravis, Orphan designation for treatment of myasthenia gravis
Oxytocin (Pitocin), choose FALSE postulate:
provoke cervical effacement and dilatation
has vasopressive and antidiuretic effects.
controls postpartum bleeding or hemorrhage
oxytocin is less effective than misoprostol for labor induction
Produces rhythmic uterine contractions and can stimulate the gravid uterus
53.
A. *
B.
C.
D.
E.
54.
A.
B. *
C.
D.
E.
55.
A.
B.
C. *
D.
E.
56.
A.
B. *
C.
D.
E.
57.
A. *
B.
C.
D.
E.
58.
A.
B. *
C.
D.
E.
59.
A.
B.
C. *
D.
Elective cerclage at 14-16 weeks: Recommendations:
in high risk cases, as identified from the history of previous mid-trimester pregnancy losses
Is recommended when there is bloody discharge from the vagina
Is recommended to correct the position of the fetus
Is recommended with placenta previa
Is recommended when placental abruption is diagnosed
Recommendations for cervical cerclage:
Is recommended when there is bloody discharge from the vagina
Cervical cerclage in response to shortened cervical length (as detected by ultrasound) is a reasonably
successful option
Is recommended to correct the position of the fetus
Is recommended with placenta previa
Is recommended when placental abruption is diagnosed
Emergency or rescue cerclage: Recommendations:
Is recommended to correct the position of the fetus
Is recommended with placenta previa
can be used up to 25-26 weeks, in response to an open cervix with bulging membranes;
can be used up to 35-36 weeks, in response to an open cervix with bulging membranes;
Is recommended when placental abruption is diagnosed
Cervical cerclage in response to shortened cervical length (as detected by ultrasound) was predictive
of delivery at less than 35 weeks.
In women with ultrasound-indicated cerclage, optimized cut-off was 10 mm
In women with ultrasound-indicated cerclage, optimized cut-off was 20 mm
In women with ultrasound-indicated cerclage, optimized cut-off was 30 mm
In women with ultrasound-indicated cerclage, optimized cut-off was 40 mm
In women with ultrasound-indicated cerclage, optimized cut-off has no meaning
Choose the correct answer (cervical length and risk of preterm labor)
Rates of preterm labor increase fourfold among women with a cervical length of less than 25 mm at
24 weeks' gestation.
Cervical length is unimportant clinical sign
Normal cervical length in pregnancy is more than 50 mm
Normal cervical length in pregnancy is more than 60 mm
Normal cervical length in pregnancy is more than 70 mm
Choose the correct answer (cervical length and risk of preterm labor)
Normal cervical length in pregnancy is more than 50 mm
Cervical length, as determined on ultrasonograms, is inversely proportional to the risk of preterm
labor.
Normal cervical length in pregnancy is more than 60 mm
Normal cervical length in pregnancy is more than 70 mm
Cervical length is unimportant clinical sign
Choose the correct answer (cervical length and risk of preterm labor)
Normal cervical length in pregnancy is more than 70 mm
Cervical length is unimportant clinical sign
The cervical length decrease to less than 34 mm at 28 weeks' gestation
Normal cervical length in pregnancy is more than 50 mm
E.
60.
A.
B.
C.
D.
E. *
61.
A.
B.
C. *
D.
E.
62.
A.
B.
C.
D. *
E.
63.
A.
B.
C.
D. *
E.
64.
A.
B.
C.
D.
E. *
Normal cervical length in pregnancy is more than 60 mm
Choose the only FALSE answer about cervical incompetence and preterm labor:
The typical clinical scenario is that of ‘silent’ or ‘painless’ dilatation of the cervix, leading to bulging
fetal membranes extruding through the external os.
Cervical incompetence is a frequent cause of inevitable miscarriage in the second trimester, and it is
often associated with a poor fetal outcome.
It is a functional condition associated with a history of recurrent and usually painless, spontaneous
second-trimester abortions.
Cervical incompetence is defined as cervical dilatation without uterine contractions.
Cervical incompetence is a frequent cause of inevitable miscarriage in the first trimester, and it is
often associated with a poor fetal
Choose the correct answer about cervical incompetence and preterm labor:
The typical clinical scenario is extremely painful dilatation of the cervix, leading to bulging fetal
membranes extruding through the external os.
Cervical incompetence is the most rare cause of inevitable miscarriage in the second trimester, and it
is often associated with a poor fetal outcome.
It is a condition associated with a history of recurrent and usually painless, spontaneous
second-trimester abortions.
Cervical incompetence is defined as cervical dilatation with regular uterine contractions.
Pregnant women with cervical incompetence usually present with silent cervical dilatation between 6
and 8 weeks of gestation.
Choose the only FALSE answer about cervical incompetence and preterm labor:
When the cervix reaches 4 cm or more, active uterine contractions or rupture of membranes may
ensue.
Cervical incompetence may occur with clinically significant cervical dilation of 2 cm or more but
with minimal symptoms.
Pregnant women with cervical incompetence usually present with silent cervical dilatation between
16 and 24 weeks of gestation.
Pregnant women with cervical incompetence usually present with silent cervical dilatation between
6 and 8 weeks of gestation.
Fetal fibronectin isn’t an accurate test for cervical incompetence.
Fetal fibronectin (FFN) Choose false postulate about fetal fibronectin (FFN):
FFN is a glycoprotein found in amniotic fluid, placental tissue and the deciduas basalis.
It is normally found in the cervicovaginal secretions before 16 weeks of pregnancy, a time at which
the fusion between the amnion and the decidua is not yet completed.
it is not normally present in the cervicovaginal secretions after 22 weeks
appears after some antibiotics use
In women being screened for preterm labor, FFN provides a good negative predictive test (ie, a
negative FFN rules out preterm labor).
Choose false postulate about fetal fibronectin (FFN)
FFN cannot be used as a test for cervical incompetence.
In women being screened for preterm labor, FFN provides a good negative predictive test (ie, a
negative FFN rules out preterm labor).
It appears in the secretions due to disruption of the chorionic-decidual interface and is often
secondary to infection.
Cervical incompetence manifests around 16-20 weeks, a time when FFN may be found in the
cervicovaginal secretions in normal conditions.
FFN is the best to choose as a test for cervical incompetence.
65.
A.
B.
C.
D.
E. *
66.
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B.
C.
D. *
E.
67.
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B.
C.
D. *
E.
68.
A.
B.
C.
D.
E. *
69.
A.
B. *
C.
D.
E.
70.
A.
B.
C.
D. *
E.
71.
Twin-to-twin transfusion syndrome (TTTS). Choose the FALSE answer:
TTTS is the result of an intrauterine blood transfusion from one twin (donor) to another twin
(recipient).
TTTS only occurs in monozygotic (identical) twins with a monochorionic placenta.
The donor twin is often smaller with a birth weight 20% less than the recipient's birth weight.
The donor twin is often anemic and the recipient twin is often plethoric with hemoglobin differences
greater than 5 g/dL.
need an urgent fetocide of one of the fetuses
Twin-to-twin transfusion syndrome (TTTS). Choose the FALSE answer:
Monozygotic twins with monochorionic, diamniotic placentation or monochorionic, monoamniotic
placentation are at risk for TTTS
TTTS is a specific complication of monozygotic twins with monochorionic placentation.
The most common vascular anastomosis is a deep, artery-to-vein anastomosis through a shared
placental cotyledon.
Can be effectively treated with antibiotics
Severe TTTS has a 60-100% fetal or neonatal mortality rate.
Twin-to-twin transfusion syndrome (TTTS). Choose the FAlSE answer:
Acute exsanguination of the surviving twin into the relaxed circulation of the deceased twin can
result in intrauterine CNS ischemia.
Fetal demise of one twin is associated with neurologic sequelae in 25% of surviving twins.
Severe TTTS has a 60-100% fetal or neonatal mortality rate.
Can be effectively treated with glucose, protein, antihypoxant solutions intravenous supply
The recipient twin can also develop hypertension, hypertrophic cardiomegaly, disseminated
intravascular coagulation, and hyperbilirubinemia after birth.
Twin-to-twin transfusion syndrome (TTTS). Choose a FALSE postulate:
The recipient twin can also develop hypertension, hypertrophic cardiomegaly, disseminated
intravascular coagulation, and hyperbilirubinemia after birth.
The recipient twin can also develop hypertension, hypertrophic cardiomegaly, disseminated
intravascular coagulation, and hyperbilirubinemia after birth.
The recipient twin can become hydropic because of hypervolemia.
The donor twin can become hydropic because of anemia and high-output heart failure.
Can be effectively treated with glucose, protein, antihypoxant solutions intravenous supply
Management of severe TTTS:
Amniotomy at any term
Fetoscopic laser photocoagulation of chorionic plate vessels is a highly specialized procedure
Fetocide
Antibiotics administration
Glucose, protein, antihypoxant solutions intravenous supply
Fetal death can occur at any gestational age and usually results from fetal hypoxia acidosis, and
compromise. The signs are EXCEPT:
a maternal PaO2 less than 60 mm Hg (oxygen saturation < 90%)
decrease in maternal mean blood pressure of 20% during pregnant surgery
a decrease in maternal hematocrit greater than 50%
moderate obesity
oxygen saturation < 90%
Choose the laboratory tests data those can’t be correct:
A.
B.
C. *
D.
E.
72.
A.
B.
C. *
D.
E.
73.
A.
B.
C. *
D.
E.
74.
A. *
B.
C.
D.
E.
75.
A.
B. *
C.
D.
E.
76.
A.
B.
C. *
D.
E.
77.
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B.
C.
D.
E.
Total cholesterol (mg/dL) Pregnant 250; Nonpregnant 120;
Triglycerides (mg/dL) Pregnant 230; Nonpregnant 45-150
Total cholesterol (mg/dL) Pregnant 120; Nonpregnant 250;
Chloride (mEq/L) Pregnant 90-105; Nonpregnant 100-106
Bicarbonate (mEq/L) Pregnant 17-22; Nonpregnant 24-30
Choose the laboratory tests data those can’t be correct:
PO2 (mm Hg) Pregnant 98-100; Nonpregnant 101-104
PCO2 (mm Hg) Pregnant 35-50; Nonpregnant 25-30
PCO2 (mm Hg) Pregnant 85-90; Nonpregnant 25-30
Chloride (mEq/L) Pregnant 90-105; Nonpregnant 100-106
Bicarbonate (mEq/L) Pregnant 17-22; Nonpregnant 24-30
Choose the correct management for hyperemesis gravidarum:
Oxytocine 10 IU
Ampicillin
Intravenous hydration should be administered to patients who are unable to tolerate oral fluids for a
prolonged period and if clinical signs of dehydration develop.
Tranexamic acid
Ceftriaxone
Level A and Level B recommendations for Hyperemesis gravidarum management include:
Use Vitamin B6 (pyridoxine) alone or in combination with doxylamine as first-line pharmacotherapy,
as they are safe and effective.
Ampicillin is helpful
Progestines are highly recommended
Tranexamic acid
Ceftriaxone
Level A and Level B recommendations for Hyperemesis gravidarum management include:
Ceftriaxone
Methylprednisolone has been effective in some refractory cases of severe nausea and vomiting of
pregnancy; however, it should be considered a last-resort treatment as a result of its risk profile.
Tranexamic acid
Ampicillin is helpful
Progestines are highly recommended
Level A and Level B recommendations for Hyperemesis gravidarum management include:
Tranexamic acid
Ceftriaxone
Ginger may be used as a nonpharmacologic option, as it has had some beneficial effects in the
treatment of nausea and vomiting of pregnancy.
Ampicillin is helpful
Progestines are highly recommended
Clinical event associated with chorioamnionitis, choose the correct answer:
Prolonged rupture of the fetal membranes (>18 hours)
Mild hypertensive disorders
Myopia in woman
A glass of wine occasionally during pregnancy
Bicycle ride
78.
A.
B.
C. *
D.
E.
79.
A. *
B.
C.
D.
E.
80.
A.
B.
C.
D. *
E.
81.
A.
B.
C.
D.
E. *
82.
A.
B.
C.
D.
E. *
83.
A.
B.
C. *
D.
E.
Clinical events associated with chorioamnionitis, choose the correct answer:
Myopia in woman
A glass of wine occasionally during pregnancy
Preterm premature rupture of fetal membranes (before labor onset)
Mild hypertensive disorders
Bicycle ride
Therapy for the mother and/or neonate with chorioamnionitis includes early delivery, supportive
care, and antibiotic administration. What antibiotics should be avoided:
gentamicin
Cefoxitin
Clindamycin
Ampicillin
Metronidazole
Maternal fever (intrapartum temperature >100.4°F or >38.0°C). Baseline fetal tachycardia (>160
beats per min for 10 min or longer, excluding accelerations, decelerations, and periods of marked
variability), Maternal leukocytosis (total blood leukocyte count >15,000 cells/?L) in the absence of
corticosteroids, Definite purulent fluid from the cervical os, polyhydroamnion and uterine tenderness;
The following signs are typical in obstetrics for diagnosis:
Thyroid cancer in pregnancy
Uterine rupture
Placenta abruption
Chorioamnionitis
Start of normal labor
What medications can not cause abnormal uterine bleeding:
Adrenal steroids
Psychotropic medications
Tranquilizers affecting neurotransmission
Ginseng use
Tranexamic acid
Common laboratory studies for patients with abnormal uterine bleeding (AUB) include all
EXCEPT:
human chorionic gonadotropin (HCG),
complete blood count (CBC), thyroid functions and prolactin, liver functions, coagulation
studies/factors, and other hormone assays as indicated
Pap smear, endometrial sampling
Blood type, Rh factor
IgG to Rubella, Toxoplasma, Smallpox
High-risk women >35 years with chronic eugonadal anovulation, obesity, hirsutism, diabetes, or
chronic hypertension and with abnormal uterine bleeding (AUB) are at extreme risk for endometrial
hyperplasia/carcinoma, and what procedure must be recommended:
Pap smear
Coagulation factors
Endometrial sampling
Thyroid and liver function tests
Complete blood count
84.
A.
B.
C.
D.
E. *
Low-dose combination hormonal contraceptive therapy (20-35 ?g ethinylestradiol) is the mainstay
of treatment or at least acceptable for all EXCEPT:
adolescents up to age 18 years
in women aged 19-39 years;
in prepuberty (8-10 years)
for women aged 40 years or older
Menopause over a year