OBSTETRICS & GYNECOLOGY
1.
Which of the following is the correct flow of blood from the uterine wall to
the endometrium?
A. Uterine artery arcuate artery radial artery
straight & coiled spiral artery
B. Uterine artery radial artery arcuate artery straight
& coiled spiral artery
C. Uterine artery arcuate artery straight artery radial
& coiled spiral artery
D. Uterine artery straight artery arcuate artery radial
& coiled spiral artery
2.
What is the functional life span of the corpus luteum?
A. 7 + 2 days
B. 14 + 2 days
C. 21 + 2 days
D. 28 + 2 days
3.
What hormone is secreted by the dominant ovarian follicle?
A. estriol
B. estrone
C. estradiol
D. progesterone
4.
During the embryonic period, where is the formation of blood first
demonstrable?
A. bone marrow
B. yolk sac
C. liver
D. spllen
5.
During the secretory phase, what is the uppermost layer from the uterine
cavity ?
A. Zona compacta
B. Zona basalis
C. Zona spongiosa
D. Decidua basalis
What stage of human development is implanted in the uterine cavity?
A. blastomeres
B. embryo
C. blastocyst
D. morula
How many new primary oocytes are there during puberty?
A. 0
B. 1,000
C. 10,000
D. 100,000
What is the important event that occurs prior to implantation?
A. Formation of daughter cells
B. Extrusion of the polar body
C. Accumulation of fluid between blastomeres
D. Disappearance of the zona pellucida
At what phase does regresson of the corpus luteum occur?
6.
7.
8.
9.
1
A.
B.
C.
D.
At the end of the proliferative phase
At the end of the secretory phase
During menstruation
After ovulation
10.
A 34 year old G4P4 delivered vaginally an 8 lb baby at home assisted by a
hilot. The placenta was delivered without difficulty. However, a few
minutes later, there was profuse vaginal bleeding and the patient wa
rushed to the hospital. In the ER, the patient was hypotensive, tachycardic
and pale. On abdominal examination, the uterine fundus was soft and
above the umbilicus. There were no vaginal or cervical lacerations. What
is the most probable diagnosis?
A. uterine inversion
B. retained placental fragments
C. uterine rupture
D. uterine atony
11.
A 33 year old G3P2 PU 18 weeks consulted at the ER because of watery
vaginal discharge accompanied by hypogastric pain. Vital signs were
normal. Speculum exam revealed pooling of watery discharge. I.E.
revealed an open cervix, palpable fetal parts at the os, uterus enlarged to
18 weeks AOG. What is the most probable diagnosis?
A. Recurrent abortion
B. Incomplete abortion
C. Inevitable abortion
D. Threatened abortion
12.
At what part of the fallopian tube does tubal rupture occur earliest?
A. Interstitial
B. B. Ampullary
C. Isthmic
D. Fimbria
13.
What is the most commonly associated condition for abruption placenta?
A. External trauma
B. Pregnancy- induced hypertension
C. alcohol consumption
D. Short cord
14.
Which of the following transvaginal utrasonographic cervical findings
correlate positively with preterm delivery?
A. negative transfundal pressure
B. funneling
C. 2.7 cm cervical length
D. T- shaped cervix
15.
Preterm infant is an infant who is:
A. less than 2000 grams at birth
B. less than 2500 grams at birth
C. less than 37 weeks AOG
D. less than 38 weeks AOG
A 35 year old G1P0 had an infertility work-up fro which she was
prescribed clomiphene citrate. She got pregnant and was diagnosed to
have twin pregnancy. What is the most probable type of twinning?
A. Monozygotic
B. Dizygotic
C. Conjoined
16.
2
D. Locked
17.
Which of the following is the most important parameter in the assessment
of patient in true labor?
A. intactness of the amniotic membrane
B. cervical dilatation and effacement
C. presenting part
D. bony pelvis
18.
The level of the presenting part in the birth canal described in relationship
to the ischial spines, which is halfway between the pelvic inlet and the
pelvic outlet is called
A. position
B. B. effacement
C. Dilatation
D. station
19.
The characteristic curve pattern of cervical dilatation in a normal labor is
described as:
A. A. hyperbolic
B. sigmoidal
C. diagonal straight
D. horizontal
20.
A 30 year old G1P0, term was admitted for labor pains. FH- 34 cm, FHT140 bpm. IE- cervix is 4 cm dilated, 60% effaced, cephalic, station -2,
rupture BOW. Uterine contractions every 2-3 mins, moderate. After 2
hours, IE- cervix 4-5 cm dilated, 70 % effaced, station -2. After 2 hours, IEcervix is 5-6 cm dilated, 80% effaced, station -1.Describe the progress of
labor.
A. Normally progressing
B. Protracted cervical dilatation
C. Protracted descent
D. Arrest in descent
21.
What phase of the active labor reflects the feto-pelvic relationship?
A. latent phase
B. B. acceleration phase
C. phase of maximum slope
D. deceleration phase
22.
A 19 year old G1P0 PU 40 weeks, not in labor, was seen at the OPD for
decreased fetal movement. She was hooked to an electronic fetal monitor
and tracing showed: Baseline FHT- 140’s, good variability, with more than
2 accelerations of 20 bpm lasting for 20 secs. The tracing is interpreted
as:
A. reactive
B. non-reactive
C. positive
D. negative
23.
Fetal tachycardia is defined as a baseline heart rate greater than:
A. 140 bpm
B. 150 bpm
C. 160 bpm
D. 170 bpm
3
24.
What is the presentation type when the fetal head is artially flexed with the
anterior fontanel or bregma is presenting?
A. face
B. vertex
C. brow
D. sinciput
25.
You were the intern on duty in the ER and you did an abdominal exam on
a 22 year old G2P1 PU 37 weeks who consulted because of hypogastic
pain. You found out that the fundus is occupied by a hard ballotable mass.
What Leopold’s maneuver did you perform?
A. LM 1
B. LM 2
C. LM 3
D. LM 4
26.
There is an increase in the size of cardiac silhouette in X-ray during
pregnancy because the heart is displaced to the:
A. left and upward
B. left and downward
C. right and dowmward
D. right and upward
27.
During pregnancy, the diaphragm rises by
A. 2 cm
B. 4 cm
C. 6 cm
D. 8 cm
28.
Impaired gall bladder contraction during pregnancy is due to
A. estrogen
B. estrogen and progesterone
C. progesterone
D. anatomical change in gall bladder
29.
Naegele’s rule is use to estimate the expected date of delivery by ____.
A. adding 3 days to the first day of PMP and count back 7
months
B. adding 7 days to the first day of PMP and count back 3
months
C. adding 7 days to the first day of bleeding and count back
3 months
D. adding 7 days to the first day of LMP and count back
3 months
30.
Which of the following is proven teratogen?
A. Vitamin A derivatives
B. Metronidazole
C. Cephalosporins
D. Ampicillin
31.
Which of the following vaccines is contraindicated during pregnancy?
A. Pneumococus
B. Hepatitis B
C. Influenza
D. Mumps, measles, rubella
4
32.
The preferred method for the delivery of the aftercoming head is
A. Piper’s forceps extraction
B. Mauriceau-Smellie-Veit Manuever
C. Bracht maneuver
D. Prague maneuver
33.
You were assigned to deliver the baby of a 25 year old G1P0 PU 38
weeks. You applied the forceps on the fetal head with the following
findings: head was at station +2 with the sagittal suture at left occiput
anterior position. This is classified as
A. outlet forceps delivery
B. low forceps delivery
C. midforceps delivery
D. high forceps delivery
34.
A 22 year old G1P0 patient at 39 weeks AOG was admitted for elective
Cesarean Section for breech presentation. She requested to her
obstetrician that a transverse suprapubic abdominal incision be done to
her. This type of incision is called
A. Kerr
B. Kronig
C. Pfannensteil
D. Classical
35.
Which of the following is one of the requirements that must be present
before obstetric forceps must be used?
A. The membranes should be intact
B. Cephalic presentation
C. The fetal head must be floating
D. The cervix must be fully dilated and retracted
36.
The single most significant risk factor in the development of post-partum
pelvic infection is
A. early rupture of membranes
B. Prolonged labor
C. Cesarean delivery
D. Multiparity
37.
The process by which the uterus returns to its normal size, tone and
position after delivery is called
A. involution
B. puerperium
C. subinvolution
D. atony
38.
What is the mechanism behind the increase in cardiac output right after
delivery?
A. maternal exhaustion
B. increase caval compression
C. sympathetic stimulation
D. autotransfusion
39.
Congenital rubella syndrome is more likely common during which AOG?
A. 8-10 weeks
B. 12-14 weeks
C. 16-18 weeks
D. 36-38 weeks
5
40.
What is the diagnostic procedure of choice for identifying gallstones in
pregnancy?
A. CT Scan
B. X-Ray
C. Ultrasound
D. MRI
41.
A patient consulted because her husband is a seaman and will be coming
home in 2 months for a 1-month vacation. She just had her menses 2
days ago. What is the most effective reversible form of contraception will
you give?
A. combined oral contraceptive
B. calendar rhythm method
C. Depo-Provera
D. combined oral contraceptives
42.
A 30 year old G1P1 consulted at the OPD for Pap smear. According to
her, she had an IUD in-situ for 1 year. On PE, you can not visualize the tail
of the IUD string. What is the best thing to do for this patient?
A. Assume that the device has been expelled
B. Assume that the patient is telling a lie
C. Perform an transvaginal ultrasound
D. Assume that the device has been expelled and perform
the Pap smear
43.
A 35 y.o., G3P3 (3-0-0-3) complained of scanty menstrual flow and
continuous severe cramping throughout the menstrual period after
undergoing cryotherapy due to chronic cervicitis. What is the most likely
cause of her complaint?
A. pelvic inflammation
B. ectopic endometrial tissue
C. cervical stenosis
D. stress and tension
44.
A 21 y.o. patient, nulligravid , single came in because of severe vaginal
bleeding of 2 days duration. What is the management of choice in this
case?
A. D & C
B. High dose progestins
C. High dose estrogen
D. Hysteroscopy
45.
The most common cause of DUB in the premenarcheal and
postmenopausal woman is _____.
A. Ovulatory
B. Anovulartory
C. Organic
D. Iatrogenic
46.
A 32 y.o., G2P2 (2-0-0-2) consuted for amenorrhea since delivery up to
almost 1 year after. Breastfeeding was not practiced.The last pregnancy
was delivered via NSD with history of uterine atony and blood transfusion.
What is the most likely cause of her amenorrhea?
A. Asherman’s syndrome
B. Sheehan’s syndrome
C. Simmond’s syndrome
6
D. Polycystic ovarian syndrome
47.
Menometrorrhagia is defined as:
A. Abnormal uterine bleeding occurring at regular intervals
B. Prolonged uterine bleeding at irregular intervals
C. Normal amount of vaginal bleeding at frequent intervals
D. Decreased amount of vaginal bleeding at frequent
intervals
48.
Which of the following statements is true of DUB?
A. Anovulatory bleeding is the most common cause in the
premenarcheal years
B. There is continuous estrogen production without
corpus luteum formation
C. Halban’s syndrome is a common cause of DUB
D. It is usually associated with severe dysmenorrhea
49.
The most common histologic type of vaginal cancer is:
A. Squamous carcinoma
B. Adenocarcinoma
C. Malignant melanoma
D. Sarcoma
50.
A 69- year old G4P4 (4004) consulted for an ulcerated mass on the right
labium majus. She had been to several physicians who have prescribed
unrecalled topical creams and solutions without relief. Upon seeing the
patient, your recommendation would be:
A. Observation
B. Steroid topical cream
C. Excision biopsy of the mass
D. Simple vulvectomy
51.
The area of the cervix that is most prone to precancerous and cancerous
neoplasms is the:
A. Histologic portio
B. Transformation zone
C. Histologic endocervix
D. Isthmus
52.
Which of the following HPV Types is associated with high oncogenic
potential?
A. HPV Type 1
B. HPV Type 5
C. HPV Type 6
D. HPV Type 18
53.
A 37 year old, G3P3 was admitted because of vaginal bleeding. Pregnancy
test is negative. She underwent diagnostic curettage. While doing the
curettage humps and bumps were noted. What is the most likely diagnosis?
A. intramural myoma
B. subserous myoma
C. submucous myoma
D. broad ligament myoma
54.
A 68 year old woman has a biopsy result of atypical complex hyperplasia.
What is the most appropriate treatment for her?
A. Judicious observation
7
B. Repeat fractional D&C after 6 months
C. Give cyclic progestin therapy to promote monthly
withdrawal bleeding
D. Perform TAHBSO
55.
This granulose-theca cell tumor has this characteristic inclusion body.
A. Psamomma bodies
B. Call-Exner bodies
C. Schiller Duvall bodies
D. keratin pearls
56.
A 33 year old nulligravid patient consulted in your clinic because of cervical
mass. She was diagnosed as a case of prolapsed myoma . What is the best
management for her case?
A. Do myomectomy by laparotomy
B. Do subtotal hysterectomy
C. Do transcervical resection of the myoma
D. Do total abdominal hysterectomy only
57.
A 28 year old, single, nulligravid patient consulted in the OPD for the result of
her pelvic ultrasound. It revealed a 18mm x 10mm x 14mm and a 13mm x
16mm x 10 mm intramural myomatas. She is asymptomatic.
58.
How will you manage the patient?
A. Work up the patient , then schedule her for myomectomy
B. Give her GnRH agonists
C. Reevaluate the patient at 6-month interval to determine
the rate of growth
D. Perform fractional D & C
59.
This is the diagnostic procedure of choice for endometrial cancer.
A. Progesterone challenge test
B. Ultrasound
C. Pap smear
D. Fractional D&C
60.
This is the drug of choice for syphilis.
A. Oral doxycycline
B. Oral tetracycline
C. Oral Penicillin
D. Parenteral Penicillin G
61.
A 29 year old sexually active female consulted in your clinic because of vulvar
lesion. History revealed that it started as paresthesia of the vulvar skin then
papule and subsequent vesicle formation. Simple clinical inspection revealed
ulcers which are painful when touched with cotton-tipped applicator. The most
likely diagnosis is _____.
A. Syphilis
B. Granuloma inguinale
C. LGV
D. Genital herpes
62.
What are the most important goals of the medical therapy of acute PID?
A. prevention and treatment of the disease
B. early diagnosis and prompt treatment of the disease
C. prevention of the disease and preservation of tubal function
8
D. resolution of symptoms and preservation of tubal
function
63.
This occurs when increased intraabdominal pressure is not transmitted
equally to the bladder and the functional urethra.
A. detrussor instability
B. urethral sphicteric dysfunction
C. genuine stress incontinence
D. true incontinence
64.
This occurs when a bladder is overdistended because of its instability to
empty.
A. true incontinence
B. overflow incontinence
C. genuine stress incontinence
D. detrussor instability
65.
A 35 year old G1P0 (0-0-1-0) consulted because failure to become
pregnant 1 year after her abortion. Her condition is considered
A. unexplained infertility
B. primary infertily
C. secondary infertility
D. normal after an abortion
66.
The first drug to offer in women with anovulation is
A. bromocriptine
B. GnRH
C. Gonadotrophins
D. clomiphene citrate
67.
The most common cause of tubal/peritoneal factors of infertility is
A. surgery on the tubes
B. tuberculosis
C. PID
D. endometriosis
68.
Among the factors causing female infertility, the easiest to diagnose and
manage is
A. cervical factors
B. uterine factors
C. ovulatory factors
D. tubal/peritoneal factors
69.
An absolute contraindication to hormone replacement therapy is:
A. Thromboembolic disease
B. Bronchial asthma
C. Diabetes mellitus
D. Hypertension
70.
Over the counter pregnancy test kits will test for which placental hormone?
((Baja-Panlilio Chapter 6, p. 64)
A. estrogen
B. progesterone
C. human placental lactogen
D. human chorionic gonadotropin
9
71.
Mefenamic acid taken by pregnant women may result in the closure of
what structure? (Baja-Panlilio, Vol I pp. 82-83)
A. ductus venosus
B. foramen ovale
C. ductus arteriosus
D. ventricular septal defect
72.
Hydroureter during pregnancy is more marked on the right than on the left
because of: (Baja panlilio Chapter 8 Page 107)
A. renal artery crossing the ureter on the right
B. dextrorotation of the uterus
C. sigmoid colon on the right
D. majority of fetus staying on the right maternal side
73.
In which of the following are relatively low levels of hCG detected in
maternal blood? (Baja Panlilio Chapter 6 page 64)
A. Down syndrome
B. hydatidiform mole
C. multiple gestation
D. Impending abortion
74.
The majority of spontaneous abortions are due to: (Baja-Panlilio, Chapter
27, p. 317)
A. chronic infections
B. endocrine abnormality
C. chromosomal defects
D. uterine synechial
75.
A 39 year old, G4P3 (3003) patient with a history of repeated episodes of
pelvic inflammatory disease was diagnosed to have an unruptured ectopic
pregnancy. The cause of her ectopic pregnancy is: (Baja-Panlilio,
Chapter 28, p. 327)
A. uterine tumor
B. adhesions
C. ovarian tumor
D. salpingitis
76.
The best basis for the diagnosis of Preterm Labor in this patient is the
presence of: (Baja Panlilio Chapter 37 , page 355)
A. mucoid vaginal discharge
B. painful uterine contractions
C. contractions occurring every 10 to 15 minutes
D. cervical dilatation and effacement
77.
A blood pressure of 160/110 mmhg. Proteinuria of 4 gm/day, with elevated
liver enzymes is classified as: (Baja-Panlilio, Chapter 35 p 231)
A. preeclampsia mild
B. preeclampsia severe
C. chronic hypertension
D. gestational hypertension
78.
A 29 year old G1P0, consulted for the 1st time on her 28 weeks AOG. Her
BP was 160/120 mmHg. She had severe headache and her fundic height
was only at the level of the umbilicus. The appropriate laboratory exams
to be done initially is: (Baja-Panlilio, Chapter 35 p. 337
A. non-stress test
B. doppler velocimetry
10
C. biophysical profile
D. liver enzymes
79.
A 35 year old, G6P5 (5005) on her 12th week of pregnancy was diagnosed
on ultrasound to have an h-mole. What will be the management for this
case? ((Baja-Panlilio, Chapter 30, p. 350)
A. single agent chemotherapy
B. hysterotomy
C. suction curettage
D. hysterectomy, followed by prophylactic
chemotherapy
80.
When the long axis of the fetus parallels the longitudinal axis of the uterus,
the lie of the fetus is called: (Panlilio, Textbook of Obstetrics (Pathologic
and Physiologic) 2nd ed, Page 210)
A. transverse
B. longitudinal
C. cephalic
D. breech
81.
The tracings showed that the fetus: (Baja-Panlilio, Chapter 21 pp. 237
A.
B.
C.
D.
has normal tracings
has a late deceleration
has an early deceleration
has a variable deceleration
82.
In intrapartum monitoring, the management for severe bradycardia
preceded by late deceleration and absent variability is done by: (BajaPanlilio, Chapter 21 pp. 236
A. giving oxygen inhalation at 3-4 L/mins.
B. infusion of intravenous fluids
C. immediate termination of pregnancy
D. placing patient at left lateral decubitus
83.
A 25 year old G1P0, 38-39 wks. AOG consulted at the emergency room
due to labor pains. She has no prenatal check-ups and family history
revealed diabetes mellitus in sister and mother. Abdominal exam
revealed fundic height = 40 cm, uterine contractions every 2-3 mins, 4550 secs. duration. Internal exam has remained unchanged at 6 cms
dilated, fully effaced, station -2, cephalic, (-) BOW for the past 2 ½ hrs.
The serious complication during vaginal delivery of this baby where there
is arrest in delivery of the shoulder is: (Baja-Panlilio, . 421-422)
11
A.
B.
C.
D.
Shoulder dystocia
Deep transverse of the head
Erb’s palsy
Prolonged second stage of labor
84.
A well-nourished patient on her third trimester of pregnancy has a
Hemoglobin value of 10.5 gms/dl. This low value could be explained by:
(Baja Panlilio 2nd Ed Chapter 8 page 112)
A. iron deficiency anemia
B. increase in blood volume
C. no increase in RBC production
D. bone marrow failure during pregnancy
85.
Iron supplementation during pregnancy is mandatory because of: (Baja
Panlilio 2nd Ed Chapter 8 page 112)
A. increased physiologic Fe loss during pregnancy
B. poor Fe absorption during pregnancy
C. increased demand by the increased production of
RBCs
D. poor bone marrow response to anemia
86.
Pregnancy is said to be a diabetogenic state because of: (Baja Panlilio 2 nd
Ed Chapter 8 page 114)
A. decreased insulin production
B. increased caloric intake of the mother
C. increased fat utilization
D. increased insulin resistance
87.
An increase in the following hormone is an indication of Thyrotoxicosis
during pregnancy: (Baja Panlilio 2nd Ed Chapter 54 page 595
A. free Thyroxine hormone
B. total Thyroxine hormone
C. thyroid Stimulating Hormone
D. thyroid Releasing Hormone
88.
A puerpera came for her postnatal follow up 2 weeks after an
uncomplicated vaginal delivery. The following are expected findings on her
physical examination: (Panlilio, Textbook of Obstetrics (Pathologic and
Physiologic) 2nd ed, Pages 295-298)
A. uterus at the level of the symphysis pubis
B. lochia alba
C. cervix open and thick
D. bipedal edema
89.
A week after delivery by emergency cesarean section after a prolonged
labor, a patient came because of fever of 38 ۫ C. Puerperal infection is
suspected if she has: (Panlilio, Textbook of Obstetrics (Pathologic and
Physiologic) 2nd ed, Pages pages 556-561)
A. breast engorgement
B. foul smelling lochia and tender uterus
C. milk fever
D. thrombophlebitis
90.
A 42 year old G2P1 at her 32 weeks gestation with known renal disease
and hypertension presents with BP of 220/120 mmHg but is
asymptomatic. The diagnostic test you will perform to detect chronicity of
her illness is: (Baja-Panlilio, Chapter 35 p. 342)
12
A.
B.
C.
D.
Doppler velocimetry
urine protein
fundoscopy
elevated serum creatinine
91.
The monitoring done to detect increased severity of preeclampsia is:
(Baja-Panlilio, Chapter 35, p. 336)
A. maternal fibronectin
B. urine protein
C. serum uric acid
D. serum creatinine
92.
The most common pathophysiologic mechanism in perimenopausal
bleeding is: (Compre Gyne, 1082)
A. cervical ancer
B. endometrial cancer
C. anovulation
D. abnormal pregnancy states
93.
A 34 yo G3P3 (3-0-0-3) presents with episodes of missed period for 2
cycles then irregular and profuse bleeding for the past two weeks. Her
pregnancy test is negative with unremarkable pelvic exam findings except
for the moderate bleeding. What is the most likely diagnosis: (Compre
Gyne, p. 1082-1083)
A. threatened abortion
B. hydatidiform mole
C. dysfunctional uterine bleeding
D. endometrial cancer
94.
A 60 yo G5P5 (5-0-0-5) has been menopausal for the past 12 years
presents with minimal vaginal bleeding. What diagnostic exam will you
recommend? (Compre Gyne, p. 1082-1083)
A. colposcopy
B. laparoscopy
C. diagnostic Dilatation and Curettage
D. Transvaginal Ultrasound
95.
An adnexal cystic mass was seen appreciated on TVS, 6 cm in diameter,
in a 24 yo patient who presents with abnormal vaginal bleeding. What is
the most likely diagnosis? (Compre Gyne, p. 506-507)
A. follicular cyst
B. dermoid cyst
C. serous cyst
D. corpus luteum cyst
96.
A 5 year old child was initially treated with antibiotics for purulent vaginal
discharge for a week. On follow up, the discharge was noted to be foul
smelling and bloody. The most probable cause is: (Comprehensive
Gynecology, 4th ed, page 274-277)
A. monilial infection
B. child molestation
C. foreign body in the vagina
D. precocious puberty
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97.
A mother is concerned with the appearance of whitish, non puritic vaginal
discharge on her 11 year old child noted since 8 month preceding
menarche. It is best to; (Comprehensive Gynecology, 4th ed, page 276)
A. do gram stain on the discharge
B. advise vaginal douche
C. prescribe oral antibiotics
D. reassure the mother and the child that the discharge
is normal
98.
The most frequent symptoms of endometrial hyperplasia is: (Compre
Gyne, p. 870)
A. foul smelling vaginal discharge
B. abnormal vaginal bleeding
C. pelvic pain
D. alternating constipation and diarrhea
99.
A 46 yo G4P4 (4-0-0-4) with a nodular uterus, enlarged to 20 weeks AOG
presents with menorrhagia. What is the most likely diagnosis?
(Comprehensive Gynecology Chapter 18 Page 502)
A. Subserous myoma
B. Submucous myoma
C. Adenomyosis
D. Abnormal pregnancy
100.
A 65 year old nulligravida consulted at the emergency room due to
postmenopausal bleeding for 3 yrs. She’s obese and known to be
hypertensive for 10 years. Her menstrual history revealed irregularly
irregular cycles. She was treated for breast cancer 6 years ago and has
been taking tamoxifen for the past 5 years. The most probable cause of
her bleeding is a pathology in the: (Compre Gyne, p. 860-867)
A. Cervix
B. Endometrium
C. Ovary
D. Vagina
101.
A 35 year old, G6P6 (6006) wife of a seaman, consulted due to postcoital
bleeding. Speculum exam revealed a flat warty lesion along the posterior
cervical lip. Histopathology of cervical punch biopsy done revealed
dysplastic cells involving nearly the whole thickness of the epithelium.
The most probable diagnosis is CIN? (Compre Gyne, 802-803)
A. I
B. II
C. III
D. IV
A 65 year old nulligravida consulted at the emergency room due to
postmenopause bleeding x 3 yrs. She’s obese and known to be
hypertensive for 10 years. Her menstrual history revealed irregularly
irregular cycles. She was treated for breast cancer 6 years ago and has
been taking tamoxifen for the past 5 years. The most appropriate
diagnostic test is: (Compre Gyne, 870-871)
A. Pap smear
B. Cervical punch biopsy
C. Fractional curettage
D. Transvaginal ultrasound
102.
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103.
A 25 year old, G6P0 (0060) consulted at the emergency room due to
postcoital bleeding x 3 months duration. She’s a victim of child
prostitution. On pelvic exam, there was a 2 cm cauliflower – like lesion on
the anterior lip of the cervix. The vagina and parametria are smooth. What
is the most appropriate diagnostic test? (Compre Gyne, p. 844)
A. pap smear
B. colposcopy with biopsy
C. direct punch biopsy
D. cone biopsy
104.
A 20 year old commercial sex worker presented at the clinic due to painful
shallow ulcers in the vulva associated with burning sensation during
urination. She also has multiple oral ulcers at the time of consultation. The
most likely diagnosis is: (Compre Gyne, , Chapter 22, page 656)
A. Herpes simplex infection
B. granuloma inguinale
C. Lymphogranuloma venereum
D. Syphilis
105.
A 38 year old diabeteic patient presented at the clinic due to vaginal
pruritus and whitish vaginal discharge. On examination, the vulva is beefy
red in appearance with whitish curdled discharge. The most likely
diagnosis is: (Compre Gyne, Chapter 22, page 669)
A. Trichomoniasis
B. Candidiasis
C. Bacterial vaginosis
D. Mucopuruloent Cervicitis
106.
The presence of heavy concentration of coccobacilli surrounding vaginal
epithelial cells with loss of distinct cell margins is the appearance of;
(Compre Gyne, Chapter 22, page 671)
A. Donovan bodies
B. Clue cells
C. chancre
D. inclusion cells
107.
A patient with chronic ulcers in the vulva had smears done taken from the
ulcers. Findings shows presence of dark staining bacteria with a bipolar
appearance found in the cytoplasm of large mononuclear cells .These are
diagnostic of ; (Compre Gyne, Chapter 22, page 660
A. Granuloma inguinale
B. Lymphogranuloma venereum
C. Chancroid
D. Syphilis
108.
A patient with painless vulvar ulcers came with a positive screening test
for syphilis. Confirmatory test that should be done can either be any of the
following except: (Compre Gyne, Chapter 22, page 664)
A. RPR
B. TPI
C. FTA-ABS
D. MHA-TP
15
109.
According to CDC, treatment of patients diagnosed with HIV includes the
following except: (Compre Gyne Chapter 22, page 686)
A. behavioral
B. psychosocial
C. emotional
D. medical
110.
A patient diagnosed with gonorrhea should: (Compre Gyne, Chapter 22,
page 692)
A. be treated with Chloramphenicol
B. also be treated for Chlamydia infection
C. have follow-up cultures done for asymptomatic women
D. not have serologic test for syphilis if cultures for
gonorrhea are positive
111.
Linda, 65 year old, G7P7 came to your clinic complaining of vaginal itching
with burning discomfort. This condition may be due to a decrease in what
hormone? (Compre Gyne, p.1223)
A. LH
B. progesterone
C. estrogen
D. FSH
112.
Linda, 18 year old, delivered an 8 lbs baby. There was note of laceration
on the lateral wall off the vaginal vault with profuse vaginal bleeding.
There was a sudden drop of BP. Post partum there was note of
amenorrhea. Lab examination shows destruction of the pituitary gland.
Linda has what syndrome? (Compre Gyne p. 1116)
A. Simmonds syndrome
B. Sheehan’s syndrome
C. Edward’s syndrome
D. Asherman’s syndrome
113.
Factors promoting puerpueral infection include:
A. prolonged rupture of membranes
B. limited number of vaginal examination
C. normal hemoglobin levels
D. normal labor
Textbook of Obstetrics (Baja-Panlilio, et al), p. 517-8
114.
The fetal heart tones can be best heard in this area if the following were
the Leopold’s findings:
L1- large nodular mass
L2 – hard, resistant structure at the right side of the mother
Small, irregular, mobile parts on the left side of the mother
L3 – movable hard round mass
L4 – tips of the fingers able to meet
A. right lower quadrant
B. left lower quadrant
C. right upper quadrant
D. left upper quadrant
Textbook of Obstetrics (Baja-Panlilio, et al), p. 122-123
16
115.
116.
The patient with abnormal uterine bleeding is a:
A. 18 y.o. whose interval of menses is 24 to 30 days
B. 41 y.o. whose menses last 8 to 10 days
C. 29 y.o. on DMPA with occasional vaginal spotting
D. 22 y.o. leukemic patient with menstrual blood loss of 80
ml
Compre Gyne 4th ed, p. 1079-80
A 55 y.o. G5P5 (5005) consulted for fish-wash like vaginal discharge and
on-and-off vaginal bleeding. Pelvic exam showed the cervix to be
converted to a 6 x 5 cm nodular, fungating mass extending to the R lateral
fornix, the right parametria nodular and fixed while the left was free. Based
on the information given, this patient can be clinically staged as
A. IIB
B. IIIA
C. IIIB
D. IVA
Compre Gyne 4th ed, p. 897
117.
A 53 y.o. G1P1 (1001) underwent exploratory laparotomy for an ovarian
new growth. Intraoperative findings showed the right ovary to be
converted to a 10 cm predominantly cystic mass with excrescences on its
outer capsule. The left ovary was grossly normal. All other abdominopelvic
organs were grossly normal. Based on the information given, the
Intraoperative stage of this patient is
A. IA
B. IB
C. IC
D. IIA
Compre Gyne 4th ed, p. 966
118.
Speculum exam of a 27 y.o. complaining of leucorrhea showed copious
frothy greenish vaginal discharge with strawberry-like mucosa. This is
most likely due to:
A. candidiasis
B. trichomoniasis
C. gonococcal infection
D. bacterial vaginosis
Compre Gyne 4th ed, p. 672-73
119.
The main arterial blood supply of the uterus is a branch of :
A. pudendal artery
B. external iliac
C. ovarian artery
D. hypogastric artery
120.
The uterus is derived from the:
A. Wollfian duct
B. Gartner’s duct
C. Mullerian duct
D. Urogenital sinus
17
121.
The violaceous discoloration of the vagina during pregnancy is called:
A. Godell’s sign
B. Hegar’s sign
C. Chadwick’s sign
D. Pawlik’s sign
122.
Which of the following is markedly increased by about 28 weeks
gestation?
A. fetal movement
B. plasma volume
C. amniotic fluid
D. human chorionic gonadotropin
123.
This maneuver is done to promote extension of the fetal head:
A. Wood’s maneuver
B. Mauriceau’s maneuver
C. Ritgen’s maneuver
D. Robert’s maneuver
124.
One of the following is a presumptive sign of pregnancy:
A. softening of the isthmus
B. outlining of the fetus
C. violaceous vaginal mucosa
D. ballottement
125.
The fundus of the uterus is at this level at 12 weeks gestation:
A. Just below the umbilicus
B. Above the symphysis
C. At the level of the symphysis
D. Midway between the symphysis and the umbilicus
126.
During the second and third trimester, daily caloric intake should be
increased by:
A. 400
B. 300
C. 200
D. 100
127.
Lightening is the result of :
A. dilatation of the cervix
B. descent of the fetus
C. increase in Braxton Hicks contractions
D. expulsion of bloody show
128.
The relation of the point of direction to the right and left of the maternal
birth canal is called:
A. presentation
B. posture
C. position
D. station
129.
Which ligament is considered as the strongest support of the uterus?
A. Cardinal
B. broad
C. utero-sacral
D. round
18
130.
Average duration of the first stage of labor in primigravidas:
A. 24 hours
B. 12 hours
C. 8 hours
D. 5 hours
131.
Average duration of the third stage of labor among multiparous patients:
A. 5 minutes
B. 20 minutes
C. One hour
D. Two hours
132.
Milk ejection is the result of the action of:
A. Oxytocin
B. prolactin
C. estrogen
D. human placental lactogen
133.
Complete anesthesia for abdominal delivery necessitates a block from:
A. T10 to S5
B. T10 to S1
C. T8 to S1
D. T8 to S5
134.
The motor pathways to the uterus leaves the spinal cord at the level of:
A. T9T10
B. T7T8
C. T6
D. T7
135.
Phase 0 of parturition is characterized by:
A. uterine tranquility
B. ripening of the cervix
C. development of the lower uterine segment
D. progesterone withdrawal
136.
Secondary arrest of cervical dilatation is cessation of cervical dilatation for:
A. one hour or more
B. two hours or more
C. three hours or more
D. 12 hours or more
137.
TRUE of hypertonic uterine contractions EXCEPT:
A. absence of basal hypertonus
B. usually respond to sedation
C. distorted gradient pressure
D. absence of fundal dominance
138.
Method of delivery in a 19 year old primigravid patient, 39 weeks
pregnant, transverse lie in labor:
A. internal podalic version under general anesthesia
B. emergency low transverse cesarian section
C. emergency classical cesarian section
D. internal podalic version with complete breech extraction
19
139.
Significant oligohydramnios is defined as an amniotic fluid index of ____
cm. or less:
A. 20
B. 15
C. 10
D. 5
140.
Patient with heart disease without any obstetrical indication are best
delivered by:
A. cesarian section under general anesthesia
B. normal spontaneous delivery under pudendal block
C. outlet forceps extraction under epidural anesthesia
D. cesarian section under epidural anesthesia
141.
Which antihypertensive is NOT recommended during pregnancy?
A. methyl- dopa
B. ace inhibitors
C. hydralazine
D. nifedipene
142.
The following are beta agonist tocolytic agents EXCEPT:
A. Ritrodrine
B. salbutamol
C. indomethacin
D. terbutaline
143.
Which of the following is NOT true in the use of corticosteroids in
premature labor?
A. delivery is best delayed 24 hours after the last dose of
the drug
B. betamethasone is given at a dose of 12 mg. im every 24
hours X 2 doses
C. it produces induction of fat cells that regulate fetal
lunf maturity
D. it affects biochemical systems within type II cells that
produce surfactants
144.
Complete expulsion of sperm stored in the reproductive tracr beyond the
interrupted vas deferens takes about _____ ejaculations:
A. 2
B. 10
C. 20
D. 30
145.
A form of gestational trophoblastic disease characterized by excessive
trophoblastic proliferation and edema of the villous stroma without
excessive local invasion is:
A. H. mole
B. Invasive mole
C. Choriocarcinoma
D. Placental site trophoblastic tumor
146.
Internal examination in cases of abruption placenta maybe done to
determine:
A. location of placenta
B. if bag of water has ruptured
C. cervical dilatation
20
D. All of the above
147.
In uterine atony, the source of bleeding is the:
A. uterine lacerations
B. placental implantation site
C. cervical lacerations
D. myometrium
148.
What maneuver in shoulder dystocia involves flexing the maternal thighs
on the abdomen?
A. Woods
B. Pinard
C. Zavanelli
D. McRoberts
149.
A woman using the oral contraceptive pills for the first time should be
advised to start taking it :
A. on day 1 of menses
B. on day 5 of menses
C. on day 7 of menses
D. anytime as long as she is not pregnant
150.
Management of choice for procidentia uteri in a 60 year old multiparous
patient with marked cystorectocoele:
A. observation and close follow up
B. vaginal hysterectomy
C. vaginal hysterectomy with anterior-posterior repair
D. total abdominal hysterectomy with anterior-posterior
repair
151.
The following are characteristics of Rokitansky syndrome EXCEPT:
A. phenotypically female
B. normal ovaries
C. normal uterus
D. absent vagina
152.
The following are congenital anomalies of the mullerian duct EXCEPT:
A. imperforate hymen
B. transverse vaginal septum
C. unicornuate uterus
D. uterus didelphys
153.
The so called psammoma bodies are found in:
A. serous cystadenoma
B. mucinous cysadenoma
C. clear cell carcinoma
D. mucinous cystadenoma
154.
Abnormal uterine bleeding during the pubertal and perimenarcheal period
is due to:
A. polycystic ovaries
B. failing ovarian function
C. delayed,aynchronous hypothalamic maturation
D. exogenous estrogen stimulation
21
155.
Most common cause of vaginal bleeding among postmenopausal women:
A. endometrial carcinoma
B. endometrial hyperplasia
C. endometrial polyp
D. atrophic endometrium
156.
A woman with postmenopausal bleeding warrants:
A. an endometrial biopsy
B. observation and Pap’s smear yearly
C. total hysterectomy
D. total hysterectomy with bilateral salpingooophorectomy
157.
In Meig’s syndrome, the ovarian newgrowth is a:
A. Fibroma
B. mature teratoma
C. immature teratoma
D. cystadenoma
158.
Drug of choice for pregnant patients with Chlamydia infection:
A. Doxycycline
B. azythromicin
C. erythromycin
D. ampicilin
159.
The so called tobacco pouch appearance of the fallopian tube is seen in:
A. gonorrhea infection with tubo ovarian abscess
B. Chlamydia infenction with tubo ovarian abscess
C. Pelvic tuberculos
D. Old tubal ectopic gestation
160.
Type of endometrial hyperplasis which is mot likely to progress to
endometrial carcinoma:
A. simple hyperplasis with atypia
B. cystic hyperplasia with atypia
C. complex hyperplasia without atypia
D. complex hyperplasia with atypia
161.
A post coital test is best done:
A. pre menstrual
B. right after menses
C. periovulatory period
D. anytime during the cycle
162.
Hysterosalpingography is best done:
A. periovulatory period
B. before menses
C. after menses
D. anytime during the cycle
163.
Which of the following Pap’s smear will definitely require colposcopic
examination of the cervix:
A. AGUS
B. ASCUS
C. LSIL
D. HSIL
22
164.
Which of the following is considered a precursor of cervical carcinoma:
A. Metaplasia
B. dysplasia
C. eversion
D. severe eroisions
165.
Endometrial carcinoma is LEAST likely if endometrial thickness is:
A. 5 mm
B. <5mm
C. 10mm
D. <10mm
166.
Cystocele and rectocele occur because of weakness of the (ANS: C page
44)
A. uterosacral ligaments
B. anal sphincter
C. endopelvic fascia
D. cardinal ligament
167.
The sequence of events leading to menstruation (ANS: C page 106)
A. coiling of the arteries, vasoconstriction, decrease in
endometrial thickness, vasodilatation, menses
B. coiling of the arteries, vasodilatation, vasoconstriction,
decrease in endometrial thickness, , menses
C. decrease in endometrial thickness, coiling of the
arteries, vasoconstriction, vasodilatation, menses
D. vasoconstriction, decrease in endometrial thickness,
coiling of the arteries vasodilatation, menses
168.
Thromboxane differs from prostacyclin in that it (ANS: A page 89-90)
A. causes vasoconstriction
B. causes platelet aggregation
C. is not formed from arachidonic acid
D. is not an eicosanoid
169.
A main action prostaglandin 2 (PGF2) is ( ANS: C page 89-90)
A. vasodilatation
B. platelet aggregation
C. bronchoconstriction
D. smooth muscle relaxation
170.
A Pap smear is likely to identify all the following except (ANS: B page 150151)
A. cervical squamous cell carcinoma
B. gonorrhea
C. human papilloma virus
D. inflammatory changes
171.
Examination of a 3-year-old reveals labial adhesion. The child is able to
void without difficulty. One should initially recommend (ANS: A page 278)
A. topical estrogen
B. surgical separation
C. a work-up for sexual abuse
D. manual separation in the clinic
23
172.
The major mechanism of DMPA, which accounts for its contraceptive
effect, is the (ANS: A page 327)
A. inhibition of the midcycle gonadotropin surge
B. production of unfavorable endometrial environment
C. alteration of tubal motility
D. alteration of cervical mucus
173.
The most commonly encountered cancer of the breast (ANS: D page 383)
A. lobular carcinoma in situ
B. lobular infiltrating carcinoma
C. ductal carcinoma in situ
D. ductal infiltrating carcinoma
174.
Fibrocystic breast change is characterized by (ANS: B page 364)
A. cyclic enlargement of the lymph nodes
B. diffuse bilateral findings
C. blunted response to cyclic ovarian hormones
D. uniform histologic changes
175.
A 52-year-old woman has persistent, unilateral, spontaneous bloody
nipple discharge and a cluster of microcalcifications identified by
xeroradiography to be 3 cm deep under the nipple of the left breast. The
next step in her management should be (ANS: B page 429-430)
A. needle aspiration under ultrasound guidance
B. repeat mammography in 3 months
C. submission of the bloody discharge for cytologic
examination
D. open biopsy of the left breast on an out patient basis
176.
The greatest lifetime risk of breast cancer is associated with a(an) (ANS:
C page 430)
A. early menarche
B. late menopause
C. history of oral contraceptive use longer than 10 years
D. history of postmenopausal estrogen use longer than 10
years
177.
Anitiphospholipid antibodies have been found in the circulation of women
with (ANS: A page 425-426)
A. recurrent abortions
B. systemic lupus erythematosus only
C. a history of thrombocytopenia
D. a false negative result for syphilis
178.
The most consistent symptom of ectopic pregnancy is (ANS: D page 456)
A. amoenorrhea
B. vaginal bleeding
C. subjective symptoms of pregnancy
D. abdominal pain
179.
A morbidly obese woman undergoes preoperative evaluation for
adenocarcinoma of the endometrium. Because of the high risk associated
with an abdominal procedure, vaginal surgery is being considered. What
tumor marker may be of help in her condition? (ANS D page 934-935)
A. human chorionic gonadotropin (hCG)
B. carcinoembryonic antigen (CEA)
C. alpha-fetoprotein
24
D. CA-125
180.
The cell origin of the most common type of ovarian neoplasm is (ANS B
page 958)
A. germ cells
B. epithelial cells
C. stromal cells
D. lipoid cells
181.
The most common cause of direct maternal deaths in the Philippines:
(ANS: A p.4)
A. Hemorrhage
B. Hypertension
C. Infection
D. Heart disease
182.
Most perinatal deaths are due to the following maternal factors: (ANS: A
p.8)
A. Premature labor
B. Anoxia from maternal hemorrhage
C. Postmaturity
D. Cephalopelvic disproportion
The placental circulation (feto-maternal) is established by this day after
fertilization (ANS: D p.57)
A. 12th day
B. 14-15th day
C. 10th day
D. 17th day
183.
184.
The greatest concentration of hCG in human plasma/urine is found in this
age of gestation: (ANS: A p.63)
A. 8-10 weeks
B. 12-20 weeks
C. 5-6 weeks
D. 20-36 weeks
185.
This maneuver of Leopold is often called the umbilical grip and answers
the question, “What side is the fetal back?” (ANS: B p.122)
A. first maneuver
B. second maneuver
C. third maneuver
D. fourth maneuver
186.
“Triple screen” as a diagnostic tool for the detection fof Down’s syndrome
utilizes the following except: (ANS: D p.153)
A. unconjugated estriol
B. alphafetoprotein
C. human chorionic gonadotrophin
D. human placental lactogen
187.
The earliest access to the prenatal diagnosis of heritable conditions is
provided for by this technique: (ANS: B p.154)
A. amniocentesis
B. chorion villus sampling
C. cordocentesis
D. MRI
25
188.
Relation of the long axis of the fetus to the long axis of the mother; (ANS:
C p.183)
A. attitude
B. presentation
C. lie
D. position
189.
A 28 y/o at 32 weeks age of gestation consults at a clinic. She had one set
of twins both are alive and she had an abortion. Her OB code is:
A. G3P2(2102)
B. G3P1(1012)
C. G3P2 (2012)
D. G2P1(1012)
190.
The most common cause of arrest disorders in labor is:
A. CPD
B. Hypotonic uterine dysfunction
C. Malposition
D. Excessive sedation/anesthesia
191.
What is the maneuver were the index and middle fingers are applied over
the maxilla in order to free the head?
A.
Bracht
B.
Zavanelli
C.
Pinard
D.
Mauriceau
192.
The following anti-TB drugs can be given in pregnancy except:
A. rifampicim
B. pyrazinamide
C. ethambutol
D. isoniazid
193.
The most common cause of direct maternal deaths in the Philipppines is:
(p. 4)
A.
Hemorrhage
B.
Hypertension
C.
Infection
D.
Heart Disease
194.
Glucose transfer from the mother to the fetus is through: (p.110)
A. Facilitated diffusion
B. Simple diffusion
C. Carrier system
D. Pinocytosis
195.
The “fern” formation of dried cervical mucus is due to the effect of: (p.116)
A. Progesterone
B. Estrogen
C. Human placental lactogen
D. Relaxin
196.
“Quickening” refers to: (p.114)
A. Actual movements of the fetus seen sonologically
B. Perception of first movement by the mother
C. First documentation that the fetus is alive
26
D. Rate of fetal movement
197.
When is the earliest time that can hCG be detected in maternal urine after
implantation? (p.116)
A. 5-7 days
B. 14-16 days
C. 8- 9 days
D. 18-21 days
198.
A woman who has had three consecutive abortions and no other pregnancies is
called: (p.119)
A. Nullipara
B. Multipara
C. Primipara
D. Primigravida
199.
At what age of gestation should screening for glucose be done in a pregnant
woman: (P. 125)
A. 18-20 wks
B. 24-28 wks
C. 30-32 wks
D. 34-36 wks
200.
The Biophysical Profile represents all of the following EXCEPT: (p.162)
A. Accurate prediction of fetal well-being
B. Indirect measurement of fetal oxygenation
C. Fetal behavioral activities including fetal tone
D. Status of fetal cardiac function
201.
The fetus is described as complete breech presentation as: (p 185)
A. Legs and thighs are flexed
B. Legs and thighs are extended
C. Legs are flexed, thighs are extended
D. Legs are extended, thighs are flexed
202.
Cervical softening and ripening is brought about by: (p. 196)
A. Collagen breakdown and rearrangement
B. Decreased hyaluronic acid
C. Increased dermaton sulfate
D. Increased collagen synthesis
203.
The following characterize uterine changes during phase 2 of parturition: (p.
199)
A. The uterus is divided into an actively contracting upper
part and a relatively passive lower segment
B. The whole muscle contract simultaneously and with equal
intensity thus increasing the expulsive force on the fetus
C. After each contraction, the myometrium of the upper and lower
segment becomes fixed at a shorter length and this is known
as retraction
D. After delivery, the uterus diminish in size and the placenta
buckles because of limited elasticity
27
204.
The most ominous sign of fetal compromise: (p. 237)
A. Early deceleration
B. Late deceleration
C. Variable deceleration
D. Alternating deceleration
205.
Failure to maintain temperature regulation in the newborn may lead to one or all
of the following: (p. 246)
A. Peripheral vasoconstriction
B. Hypoxia
C. Acidosis
D. All of the above
206.
Puerperium lasts for how many weeks: (p. 251)
A. 4 wks
B. 5 wks
C. 6 wks
D. 7 wks
207.
What is the average maternal weight loss immediately after delivery? (p. 254)
A. 4 kg
B. 5 kg
C. 6 kg
D. 7 kg
208.
The lochia consisting of servical mucus and debris from healing tissues and
leucocytes, lighter yellow and creamy in color: (p. 254)
A. Rubra
B. Alba
C. Cervicosa
D. Serosa
209.
The advantage/s of home delivery is/are: (p. 259)
A. Emotional support from family
B. Less expensive
C. Less tendency for nosocomial infections
D. All of the above
210.
This refers to 3 or more consecutive spontaneous abortions: (p. 274)
A. missed abortion
B. serial abortion
C. habitual abortion
D. consecutive abortion
211.
The implantation of a fertilized ovum outside the endometrium lining the uterine
cavity is called: (p. 279)
A. Eccyesis
B. Ectropion
C. Endosalpingosis
D. Blighted ovum
212.
Most ectopic pregnancies are found in the: (p. 279)
A. Cervix
B. Tube
C. Ovary
D. Omentum
28
213.
The triad of symptoms of ectopic pregnancy are: (p. 282)
A. Amenorrhea, syncope and vaginal bleeding
B. Abdominal pain, vomiting and vaginal bleeding
C. Syncope, abdominal rigidity and amenorrhea
D. Amenorrhea, abdominal pain and vaginal bleeding
214.
The mechanism of preterm labor in chorioamnionitis is: (p. 294)
A. Stretching of the uterine wall due to inflammation
B. Increased prostaglandin synthesis
C. Increased neutrophilic infiltrates in the cervix
D. Irritation of the fetal membranes
215.
HELLP Syndrome is the pnemonic for: (p. 332)
A. Hypertension, elevated liver enzymes, low protein
B. Hemolysis, elevated liver enzymes, low platelet count
C. Hemoglobinuria, elevated liver proteins
D. Hyeprtensive encephalopathy, low liver perfusion
216.
The anticonvulsant of choice control of convulsion secondary to pregnancyinduced hypertension is: (p. 339)
A. Methyldopa
B. Hydralazine
C. Magnesium sulfate
D. Diazepam
217.
Toxicity of magnesium sulfate therapy may be monitored using: (p. 339)
A. Urine output
B. Deep tendon reflexes
C. Respiratory rate
D. All of the above
218.
The most common cause of maternal morbidity in hypertensive disease of
pregnancy is: (p. 342)
A. Cerebrovascular accidents
B. Myocardial infarction
C. Pulmonary edema
D. Postpartum hemorrhage
219.
In case of discordant twins resulting from “twin to twin transfusion”, the smaller
twin usually presents with: (p. 348)
A. Severe anemia
B. Growth retardation
C. Oligohydramnios
D. All of the above
220.
The fetal mortality rate in multifetal pregnancy is highest in: (p. 348)
A. Monozygotic, dichorionic, diamniotic
B. Monozygotic, monochorionic, diamnionic
C. Monozygotic, monochorionic, monoamnionic
D. Dizygotic, dichorionic, diamnionic
221.
A pregnancy is considered portterm if it lasts longer than: (p. 363)
A. 280 days
B. 284 days
C. 290 days
D. 294 days
29
222.
The most common cause of respiratory distress syndrome (RDS) in the preterm
neonate is: (p. 395)
A. Hyaline Membrane Disease
B. Bronchopulmonary Dysplasia
C. Meconium Aspiration
D. Pneumothorax
223.
What antenatal procedure is used to detect fetal lung maturity? (p. 395-396)
A. Cordocentesis
B. Amniocentesis
C. Chorionic villus sampling
D. X-ray of the fetal lungs
224.
In breech presentation, engagement is considered to have occurred when this
has passed the pelvic inlet: (p. 434)
A. Biparietal diameter
B. Bitrochanteric diameter
C. Knees
D. Navel
225.
Which is considered an indication for internal podalic version: (p. 445)
A. Oblique lie in case of fetal demise
B. Delivery of second of twins
C. Fetal distress in cephalic presentation with fully dilated cervix
D. Prolapsed cord with 8 cm dilated cervix, live, cephalic
226.
A carefully monitored trial of labor may be undertaken in normal term
pregnancies with average infants following a previous Cesarean section
performed for the following indications, EXCEPT: (p. 458-459)
A. Abruption placenta
B. Placenta previa centralis
C. Contracted pelvis
D. Fetal distress due to prolapsed cord
227.
Cesarean hysterectomy may be indicated as a lifesaving measure in cases of
postpartum hemorrhage due to: (p.462)
A. Retained placenta fragments
B. Abruption placenta
C. Cervical lacerations
D. Uterine atony
228.
Postpartum hemorrhage is blood loss during the first 24 hours after delivery in
excess of : (p.465)
A. 100 cc
B. 300 cc
C. 500 cc
D. 1,000 cc
229.
The following are viral infections known to be related to congenital infection
syndromes, EXCEPT: (p. 524-525, 533)
A. Herpes virus
B. Cytomegalovirus
C. Toxoplasmosis
D. Rubella
30
230.
What is the daily minimum requirement for elemental iron in pregnancy? (p.
561)
A. 4-6 mg
B. 6-8 mg
C. 8-10 mg
D. 10-12 mg
231.
The principal cause of thrombocytopenia in pregnancy is: (p. 564)
A. Idiopathic
B. Premature rupture of bag of waters
C. Drug-induced from intake of prenatal vitamins
D. Pre-eclampsia, eclampsia
232.
A primigravid patient at 28 weeks AOG came in due to hypogastric and
lumbosacral pain. On physical examination uterine contraction was noted
occurring every 5 to 10 minutes. I.E.: cervix is noted to be 1 cm dilated,
50% effaced, intact bag of water. Which of the following is a β-adrenergic
receptor stimulant that can be used to inhibit preterm labor in this patient?
A. Isoxsuprine HCL
B. Magnesium Sulfate
C. Indomethacin
D. Nifedipine
ANS: A (APMC page 421)
233.
This is the most critical issue in the management of postterm
pregnancies? (page 431)
A. Number of pregnancies
B. Confirmation of gestational age
C. Maternal age
D. Estimated fetal weight
ANS: B (APMC page 431)
234.
In all growth-restricted fetuses, which of the following biometric
parameters will be the first to show discrepancy in measurement? (page
438)
A. Head circumference
B. Femur length
C. Abdominal circumference
D. Biparietal diameter
ANS: C (APMC page 438)
235.
In a patient with monozygotic twinning, if cell division occurs about 8 days
after fertilization, what type of twinning will develop?
A. Monoamnionic, monochorionic twin pregnancy
B. Dichorionic, diamnionic twin pregnancy
C. Diamnionic, monochorionic twin pregnancy
D. Conjoined twin pregnancy
ANS: A (APMC page 411)
236.
A patient at 38 weeks AOG came in labor. I.E. cervix is 5 cm dilated, 50%
effaced, intact BOW, cephalic, station -3. Clinical pelvimetry shows the
ischial spine is bilaterally prominent, pelvic sidewalls are convergent and
concavity of the sacrum is shallow. With these findings, you suspect the
presence of:
A. Pelvic inlet contraction
B. Midpelvic contraction
C. Pelvic outlet contraction
31
D. Pelvis is adequate
ANS: B (APMC page 204)
237.
When the fetal head is fully flexed, the chin lies in front of the chest and
the presenting anteroposterior diameter is suboccipitobregmamtic. What
type of presentation is this?
A. Vertex (occiput) presentation
B. Sinciput Presentation
C. Brow presentation
D. Face presentation
ANS: A (APMC page 211)
238.
Which Leopold’s maneuver will identify the location of the cephalic
prominence?
A. Leopold’s maneuver 1
B. Leopold’s maneuver 2
C. Leopold’s maneuver 3
D. Leopold’s maneuver 4
ANS : D (APMC page 216)
239.
The cardinal movements of labor were as follows:
A. Engagement, descent, flexion, internal rotation,
extension, external rotation, expulsion
B. Descent, engagement, flexion, internal rotation,
extension, external rotation, expulsion
C. Engagement, descent, extension, external rotation,
flexion, internal rotation, expulsion
D. Descent, engagement, extension, external rotation,
flexion, internal rotation, expulsion
ANS : A (APMC page 242)
240.
A multigravid patient at 39 weeks AOG came in due to hypogastric and
lumbosacral pain. Which of the following additional statements will
characterize that the patient is in true labor?
A. The cervix is dilated and effaced
B. Contraction is stop by sedation
C. The interval in between contraction is longer
D. The intensity of uterine contraction is unchanged
ANS: A (APMC page 248)
241.
This type of deceleration is characterized by symmetrical fall in FHR
beginning at or after the peak of a uterine contraction and returning to
baseline only after contraction has ended.
A. Early deceleration
B. Variable deceleration
C. Late deceleration
D. Sinusoidal pattern
ANS: C (APMC page 268
242.
This is considered as the most crucial event for the further development of
an antral follicle
A. activation of the aromatase system by FSH
B. activation of the aromatase system by LH
C. luteinization of the granulosa cell
D. luteolysis
ANS: A (APMC page 28)
32
243.
Rubin’s pathologic criteria for cervical pregnancy include the following,
EXCEPT:
A. there must be cervical glands opposite the placental
attachment
B. he attachment of the placenta to the cervix must be
intimate
C. fetal elements must be present in the corpus uteri
D. the whole portion of the placenta must be situated below
the entrance of the uterine vessels
ANS: B (APMC page 333)
244.
A 28-year old primigravida comes to your clinic on her 30th week of
gestation complaining of chest pain. Which of the following findings will
strengthen the diagnosis of heart disease in pregnancy?
A. an increase in the area of cardiac dullness
B. The left cardiac wall is displaced to the left by about ½
inch
C. Cardiomegaly
D. ECG findings of slight axis deviation, occasional T waves
and lowering of the waves
ANS: C (APMC page 107)
245.
The increase in plasma volume during pregnancy by about 50 to 65%
reaches its peak during the:
A. 1st trimester
B. Midtrimester
C. 3rd trimester
D. During labor
ANS: B (APMC page 107)
246.
Nayda, an 18-year old primigravida comes to the clinic on her 12th week of
gestation for her 1st check-up. She is curious as to when she can start to
perceive fetal movements. You will reassure her that this will occur :
A. anytime now
B. between the 16th and 18th week
C. between the 18th and 20th week
D. between the 20th and 24th week
ANS: C (APMC page 127)
247.
Which of the following immunizations is recommended for routine use
during pregnancy?
A. Rubella
B. Tetanus toxoid
C. C. Varicella-zoster
D. D. Hepatitis A
ANS : B (APMC page 197)
248.
In vertex presentation, the posterior fontanel is lowermost and the
presenting head diameter is the:
A. Occipitofrontal
B. Biparietal
C. Suboccipitobregmatic
D. submentobregmatic
ANS: C (APMC page 211)
33
249.
This movement of the head refers to turning of the occiput from its original
transverse oblique position towards the symphysis pubis or less
commonly towards the hollow of the sacrum:
A. internal rotation
B. extension
C. external rotation
D. flexion
ANS: A (APMC page 244)
250.
Overt diabetes during pregnancy is diagnosed by:
A. random plasma glucose level > 126 mg/dl
B. polydipsia, polyuria or unexplained weight gain
C. fasting glucose of 105-125 mg/dl
D. fasting plasma glucose of 126 mg/dl or higher
ANS: D (APMC page 591)
251.
Among mothers with thyrotoxicosis. Their neonates are usually
A. euthyroid
B. With goitrous thyrotoxicosis
C. with nonimmune hydrops
D. with hypothyroidism
ANS: A (APMC page 596)
252.
Subclinical hypothyroidism is diagnosed when there is:
A. low serum thyrotropin level and low thyroxine level
B. high serum thyrotropin level and normal thyroxine
C. high serum thyrotropin level and high thyroxine level
D. low serum thyroxine level and normal thyroxine level
ANS: B (APMC page 596)
253.
A 38 year old G4P3 at 18 weeks age of gestation has BP of 150/100
mmHg with no other signs and symptoms. Her prepregnancy BP was 130140 / 80-90 mmHg controlled by intake of a calcium channel blocker.
Urinalysis is negative for proteinuria. The most probable diagnosis of this
patient:
A. gestational hypertension
B. pre-eclampsia
C. chronic hypertension
D. chronic hypetension w/ supper imposed pre eclampsia
ANS: C (APMC page 393)
254.
A 28 year old G1P0 at 35 weeks AOG consulted in the ER with chief
complaint of severe abdominal pain. Accompanied by moderate vaginal
bleeding. Her BP is 180/120 mmHg, PR-88/min, RR: 22/min. On palpation
of the abdomen the uterus was tetanically contracted and the FHT was
faint. The most probable diagnosis is:
A. placenta previa
B. abruptio placenta
C. acute abdomen
D. uterine rupture
ANS: B (APMC page 374 & 376)
255.
Pneumococcal vaccine recommended for
A. all pregnant patients
B. immunocompromised patients
C. pregnant patients with influenza pneumonia
D. hypertensive pregnant patients
34
ANS: B (APMC page 586)
256.
A G3P2 PU at 12 weeks is complaining of cough, weight loss and
hemoptysis. The most important screening test at this time is
A. chest X-ray with abdominal shield
B. tuberculin test
C. sputum AFB smear
D. sputum culture for TB
ANS: B (APMC page 586)
257.
Among the anti-TB regimen, the drug which is contraindicated during
pregnancy is
A. INH
B. Rifampicin
C. Ethambutal
D. Streptomycin
ANS: D (APMC page 586)
258.
A 30 year old G3P2 at 24 weeks AOG complained of urinary frequency,
dysuria, urgency, fever, chills and costovertebral angle tenderness.
Urinalysis showed pyuria and bacteriuria. The most probable diagnosis is
A. asymptomatic bacteriuria
B. cystitis
C. urethritis
D. acute pyelonephritis
ANS: D (APMC page 640-641)
259.
This type of forceps has a double pelvic curve to facilitate application to
the after coming head in breech presentation
A. Simpson forceps
B. Barton forceps
C. Piper forceps
D. Kielland
ANS : C (APMC page 529)
The following are contraindications for vacuum extraction EXCEPT
A. fetal postmaturity
B. prior fetal scalp trauma
C. active bleeding
D. nonvertex presentation
ANS: A (APMC page 533)
260.
261.
This is known as the low longitudinal incision of the uterus, used to
delivery babies abdominally
A. Classical cesarean section
B. Kerr incision
C. Kronig incision
D. a and c
ANS: C (APMC page 541)
262.
A 25 y/o G2P2, three weeks postpartum came in because of profuse
vaginal bleeding. She was afebrile with a BP of 100/70 mmHg and pulse
rate of 105/min. What is the most likely diagnosis?
A. subinvolution
B. wound infection
C. post-partum ovarian vein thrombosis
D. necrotizing faciitis
ANS: A (APMC page 560)
35
263.
What is the first histologic indication of the effect of progesterone on the
endometrium?
A. presence of mitotic figures
B. glandular proliferation
C. subnuclear vacuolization
D. stromal edema
ANS: C (APMC page 44)
264.
At this gestational age, gross examination of the external genitalia
identifies the sex of the fetus:
A. 8 weeks
B. 11 weeks
C. 12 weeks
D. 16 weeks
ANS: D (APMC page 81)
265.
The most specific test for HIV is
A. Enzyme-linked Immunosorbent Assay
B. Polymerase Chain Reaction
C. Western Blot Technique
D. Viral Culture
ANS: B (compre page 686)
266.
A 26 y/o patient was seen in the OPD complaining of a vaginal discharge.
The vaginal pH was 4.5. What is the most likely cause of the vaginitis
A. Bacterial Vaginosis
B. Trichomoniasis
C. Atrophic Vaginal Discharge
D. Moniliasis
ANS: D (compre page 669)
267.
Infections with this virus is strongly linked to CIN :
A. HSV II
B. CMV
C. HPV
D. HIV
ANS: C (compre page 868)
268.
The least of the nodal involvement for distant metastasis of cervical
cancer is via the:
A. Paracervical nodes
B. Hypogastric nodes
C. External iliac nodes
D. Presacral nodes
ANS: D (compre page 898)
269.
A 45 year old G2P2 female came in due to postcoital bleeding. Pelvic
exam revealed a nodular cervix which bleeds to touch, sidewalls are free
of lesion. What is the stage of the disease?
A. Carcinoma-in-situ
B. Stage IB
C. Stage IIA
D. Stage IIB
ANS: B (compre page 899)
36
270.
Operative treatment for cervical cancer that guarantees the removal of the
entire cervix and uterus with the ureters undisturbed.
A. Class I
B. Class II
C. Class IV
D. Class V
ANS; A (compre page 902)
271.
A 54 year old G5P5 woman came in due to metrorrhagia. She’s of heavy
build, and a smoker of the following risk factors, what would have the least
risk for developing endometrial carcinoma?
A. Smoking
B. Obesity
C. Multiparity
D. late menopause
ANS: C (compre page 920)
272.
A tumor metastatic to the ovary, usually bilateral, consisting of signet ring
cells, that usually originate from GIT is
A. mucinous tumor
B. krukenberg tumor
C. serous tumor
D. sex-cord stromal tumor
ANS: B (compre page 956)
273.
A 30 year-old G0P0 was found to have stage 1a grade 1 serous
cystadenocarcinoma of the ovary. The best form of management is:
A. TAHBSO
B. TAHUSO
C. USO with follow up Ultrasound of the contralateral
ovary
D. USO with wedge resection of contralateral ovary
ANS: C (compre apge 974)
274.
A 13 year old who has not had menarche was brought in for consult with
the following features: short stature, low breast development, with
webbing of the neck. The diagnosis is:
A. Gonadal agenesis
B. Turner syndrome
C. Hypothalamic failure
D. Testicular feminization
ANS: B (compre page 1105)
275.
It is a malformation of a 46-XX individual with a normal ovarian function
resulting in failure of the uterus and vagina to form
A. Androgen resistance syndrome
B. Rokitansky Kusterhaus syndrome
C. Gonadotropin resistance ovary syndrome
D. Kallmann syndrome
ANS: B (compre page 1107)
276.
A 35- year old female came in for infertility work-up. When is the best time
to do hysterosalpingography (HSG)?
A. during menses
B. during the week following the end of menses
C. at mid cycle
D. before menses
37
ANS: B (compre page 1176)
277.
What is the pathognomonic symptoms of menopause caused by estrogen
depletion?
A. hot flushes
B. osteoporosis
C. Alzheimer-like symptoms
D. irritability
ANS: A (compre page 1224)
278.
Which of the following statements is true regarding LH?
A. LH acts on the theca cells to produce androgen.
B. LH surge inhibits ovulation.
C. LH stimulate follicular growth.
D. LH receptors are found in the pituitary.
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 23
279.
What event induces follicular rupture and subsequent ovulation?
A. FSH surge
B. LH surge
C. Increase in progesterone levels
D. Decrease in progesterone levels
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 30
280.
Which of the following explains uterine enlargement during pregnancy?
A. It is due to increased number of muscle fibers.
B. It is due to decreased number of fibrous tissue.
C. It is due to increased synthesis of Polysaccharide.
D. Muscle cells hypertrophy to 10 times the non pregnant
state.
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 96
281.
Which of the following are endometrial changes during pregnancy?
There is conversion of secretory endometrium into
decidua.
Stromal cells are diffused and far apart.
Stromal cells are anucleic and avascular.
There is a decrease in the endometrial glands.
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 96
282.
Which of the following are cervical changes during pregnancy?
There is a decrease in vascularity.
The cervix is edematous.
There is a decrease in glands.
Softening of the cervix starts at 10 wk AOG.
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 102
38
283.
Which of the following are cardiovascular changes in pregnancy?
There is an increase in heart beat to 10 beats per
minute.
There is a decrease in cardiac output.
There is marked fall in plasma volume before delivery.
There is an increase in diastolic pressure.
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 104
284.
The following are respiratory changes in pregnancy except:
Vital capacity is increased.
Respiratory rate is increased.
Tidal volume is decreased.
Respiratory rate volume is decreased.
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 105
285.
What is the average increase in maternal blood volume during pregnancy?
A. 10 %
B. 25 %
C. 50 %
D. 75 %
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 104
286.
Which of the following is a positive sign of pregnancy?
A. Amenorrhea
B. Ballottement
C. Recognition of the fetus by ultrasound
D. Enlargement of the abdomen
Answer:
c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 113
287.
A radiologic evidence of fetal death that shows significant overlapping of
fetal skull bones
A. Spalding’s sign
B. Robert’s sign
C. Brakeman’s sign
D. Ladin’s sign
Answer:
a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 118
288.
The mean duration of a normal pregnancy calculated from the first day of
LMP averages
close to
.
A. 40 weeks
B. 37 weeks
C. 42 weeks
D. 28 weeks
Answer:
a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 120
39
289.
At what age of gestation can fetal cardiac activity be detected by
ultrasound?
A. 4 weeks ovulation age
B. 6 weeks ovulation age
C. 8 weeks gestational age
D. 10 weeks gestational age
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 75
290.
At what age of gestation will the testes start to descend?
A. 24 weeks
B. 28 weeks
C. 32 weeks
D. 36 weeks
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 78
291.
What is the term used to describe the encirclement of the largest fetal
head diameter by the vulvar ring?
A. full dilatation
B. full effacement
C. crowning
D. engagement
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 226
292.
What is the main disadvantage of median episiotomy?
A. Pain
B. difficult repair
C. rectal extension
D. more blood loss
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 229
293.
What is the purpose of the WHO partograph?
A. To show accurately the course of labor.
B. To identify patients needing timely intervention.
C. To identify neonatal outcome.
D. To predict a parturient’s complications.
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 224
294.
A 31 year old, primigravid was admitted 5 cms. station -1 at 12 noon. In an
hour she was 7cm, station 0. At 2 pm she was 9 cm Station +1 and was
fully dialted at 3 pm. She delivered shortly thereafter. What is your
assessment?
A. normal labor
B. precipitate labor
C. protracted descent
D. protracted active phase dilatation
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 224
40
295.
A 32 year old G6P5 patient comes in 7cm. dilated at 10 am. What time do
you expect her to be fully dilated if labor progress is normal?
A. 11 am
B. 12 am
C. 1 pm
D. 2 pm
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 224
296.
A G3P2 patient had a cesarean delivery because of a previous
myomectomy. In the ER she was 3-4 cms, breech presentation, with
contractions every 4-7 minutes. What is the best management for this
patient?
A. Await vaginal delivery.
B. Start oxytocin to improve contractions.
C. Have her prepared for an emergency cesarean
delivery.
D. Send her home but advise to return with regular
contractions.
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 433-458
297.
A 21 y/o primigravid presents with severe abdominal pain associated with
shoulder pain and dizziness. BP – 90/60, PR – 110/min. These is rebound
tenderness on examination of the abdomen and exquisite tenderness on
wiggling the cervix. The patient has history of completion of abortion by
curettage at 6 weeks gestation 2 weeks prior to consult. Histopath findings
reveal decidual reaction. Pregnancy test is (+). The most likely diagnosis
is
.
A. Unruptured ectopic pregnancy
B. Ruptured ectopic pregnancy
C. Threatened uterine abortion
D. Ruptured corpus luteum
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 282
298.
A 39 y/o, G4P3, 33 weeks gestation presents with minimal bleeding.
Physical examination is unremarkable. Ultrasound report is total placenta
previa. The most appropriate
treatment is
.
A. Cesarean delivery
B. Vaginal delivery
C. Double set-up examination
D. Expectant management
Answer: d
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 314
299.
A 22 year old G2P1 (1001) at 35 weeks AOG has a chief complaint of
regular uterine contractions for 12 hours. She has stable vital signs.
Fundic height is 27 cm, estimated fetal weight is 2,400 grams. Fetal heart
tones are 148 bpm and presentation is cephalic. On internal examination,
the cervix is 7 cm dilated, fetal head at station -1, intact bag of waters.
What would be your management?
A. Start IV tocolytics to control labor.
B. Send her home with prescription for oral tocolytics.
C. Administer betamethasone.
41
D. Admit her and allow labor to progress.
Answer: d
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 358
300.
What is the ACOG recommendation in managing a postterm pregnancy
with a favorable cervix?
A. Immediate caesarean section
B. Induction of labor
C. Continue antenatal surveillance with NST and AFI
D. Continue antenatal surveillance with CST
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 364
301.
The following finding with postterm pregnancy mandates delivery.
A. active fetal movement
B. oligohydramnios
C. accelerations on fetal tracings
D. non-reactive NST
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 364
302.
A 17 y/o. primigravid registers at 16 weeks’ gestation with a BP of 100/60.
At 38 weeks’ gestation, she is seen in the clinic with a BP of 146/94 and
negative proteinuria. She is admitted in the hospital for further evaluation,
where, on overnight observation, she has persistent BP above 140/90. A
24-hour urine protein determination is 20mg. What is your diagnosis?
A. Gestational HPN
B. Mild Preeclampsia
C. Severe Preeclampsia
D. Chronic HPN
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 331
303.
What is the role of the hepatitis B surface antigen (+) patient in the
genesis of hepatitis B infection?
A. Chronic carrier state
B. Chronic active hepatitis
C. Acute hepatitis B
D. Facilitates entry of Hepatitis A virus
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 529
304.
What is the most common mode of transmission of Hepatitis B?
A. Through IV drug use
B. Eating of contaminated food
C. Anal intercourse
D. Mother-to-infant route
Answer: d
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 529
305.
A 21 y/o G1P0 12rh week AOG complained of sore throat, cough and
fever and developed
post-auricular lymphadenopathy. What is your
main consideration?
A. Varicella zoster
B. Rubella
C. Rubeola
D. Measles
42
Answer: b
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 576
306.
A primigravid at 39 weeks delivered by low forceps extraction. On the first
post-partum day, the patient complained of excruciating vulvar pain. On
examination, there was a fluctuant, violaceous gray, 8x6 cm mass on the
postero-lateral aspect of the vulva, tense and tender on palpation. What is
your diagnosis?
A. Gartner’s duct cyst
B. Bartholin’s glands abscess
C. Bartholin’s cyst
D. Vulvar hematoma
Answer: d
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 480
307.
R.C., 28 y/o, G2P2, delivered spontaneously to a live fetus 8 days ago at
home assisted by a nurse. She developed high-grade fever on the 5th
post-partum day associated with body malaise, lower abdominal pain &
moderate vaginal bleeding. On admission, the patient was febrile and on
IE, the cervix was open, the uterus was enlarged to 18 week-size & both
adnexae were tender and foul-smelling lochia was noted. Your impression
is
.
A. Puerperal infection
B. Pelvic inflammatory disease
C. Uterine subinvolution
D. Retained placenta fragments
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 472
308.
You are attending to a 25 y/o, G3P3 who just delivered vaginally to a live
term fetus. Five minutes later, signs of placental separation appeared
followed by profuse vaginal bleeding. Bleeding before placental delivery is
called
.
A. Early postpartum hemorrhage
B. Late postpartum hemorrhage
C. Third-stage bleeding
D. Puerperal bleeding
Answer: c
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 467
309.
The definitive treatment in a 40 y/o, G8P5 (5,0,3,5) who developed septic
shock due to endomyometritis is
.
A. Surgical removal of the nidus of infection
B. Dilatation and curettage
C. Triple antibiotic therapy
D. D & C after antibiotic coverage
Answer: a
Reference: Textbook of Obstetrics 1st edition, Baja-Panlilio et al, page 473-474
310.
A 16 y/o girl is complaining of irregular menstruation.What would be the
ideal treatment to restore her menstrual cycle?
A. Oral contraceptive pills
B. NSAIDs
C. Cyclic estrogen
D. Cyclic progesterone
43
Answer: d
Reference: Comprehensive Gynecology 3rd edition, page 1032
311.
When is it recommended to start doing Pap smear for screening of
cervical cancer?
A. At age 25 years old
B. At age 21 years old
C. At age 20 years old
D. At age 18 or earlier when sexually active
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 817
312.
Which of the following increases the risk of developing endometrial
cancer?
A. Multiparity
B. Use of contraception pills
C. Polycystic ovarian symdrome
D. Menopause at age 40
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, pages 866-867
313.
What is the most appropriate treatment for a 20 year nulligravid diagnosed
with simple hyperplasia without atypia by curettage?
A. Endometrial oblation
B. Continous or cyclic progestin
C. Total hysterectomy
D. External radiotherapy
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 871
314.
Which of the following is classified as homologous type of sarcoma?
A. High grade endometrial stromal sarcoma
B. Liposarcoma
C. Chondrosarcoma
D. Perabdo myosarcoma
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 888
315.
What type of ovarian tumor is Brenner tumor classified?
A. Epithelial tumor
B. Stromal tumor
C. Germ cell tumor
D. Sex cord tumor
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 904
316.
A patient underwent THBSO omentectomy and lymph node dissection for
an ovarian cancer. Histopathological report showed the tumor in the right
ovary measured 10x8x8 cm ruptured with extension to the fallopian tube
and omentum. One para aortic node showed malignant cells. What is the
stage?
A. Stage II-C
B. Stage III-A
C. Stage III-B
D. Stage III-C
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 912
44
317.
What is the primary treatment of malignant epithelial ovarian tumor?
A. Chemotherapy
B. Surgical removal of the tumor
C. Radiotherapy
D. Chemo and radiotherapy
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 918
318.
Definitive diagnosis of vulvar carcinoma is established by
A. Toluidine blue test
B. Colposcopy of the vulva
C. Pap smear of the vulva
D. Biopsy
.
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 949
319.
The major symptom of most vulvar atypias is
.
A. Bleeding
B. Pain
C. Pruritus
D. Burning sensation
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 948
320.
A 3 y/o girl was brought to the Emergency Room because of vaginal bleeding.
On inspection of the external genitalia, there was a mass protruding through the
vaginal introitus. It measured 4x3 cm and resembled a cluster of grapes forming
multiple polypoid masses. The most likely diagnosis is
.
A. Vaginal adenosis
B. Sarcoma botryoides
C. Epidermoid cancer
D. Condyloma acuminata
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 981
321.
The most common symptom of vaginal cancer is
.
A. Pain
B. abnormal bleeding
C. urinary frequency
D. tenesmus
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 975
322.
Which of the following patients with PID must be hospitalized?
A. A 22 y/o G2P2 with adnexal tenderness
B. A 21 y/o G1P0 at 10 weeks AOG
C. A 35 y/o G4P4 with fever
D. A 38 y/o G1P1 who is an OCW
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 677
323.
What is the most common route of spread of the organisms in PID?
A. Lymphatic spread
B. Hematogenous route
45
C. Direct extension
D. Ascending route
Answer: d
Reference: Comprehensive Gynecology 3rd Edition, page 663
324.
What is the route of spread of abdomino-pelvic Koch’s?
A. Direct extension
B. Lymphatic spread
C. Hematogenous spread
D. ascending route
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 684
325.
On histologic sections, what are the findings highly suggestive of AP
Kock’s?
A. Islands of endometrial glands
B. Necrotic foci in the endometrium
C. Langhan’s glant cell
D. Absence of stroma
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 684
326.
Which of the following is an indicator of ovulation?
A. Progesterone level of 10 mg/ml during luteal phase
B. 100°F to 110°F temperature
C. estradiol level 50mg/ml
D. Leteinizing hormone level 15mg/ml
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1118
327.
Which of the following is required in semen analysis?
A. 2-3 days abstinence before collection
B. collection done by masturbation at home
C. use of plastic cup for urine samples
D. submission of aspirated semen from vagina after coitus
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1119
328.
WHO standard for normal semen analysis include
.
A. 40 M sperm count
B. 60% M motility
C. 60% M morphology
D. 10 M white cell count
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1119
329.
Which of the following is required for hysterosalpingogram?
A. Done post menstrual, pre-ovulatory
B. Routine antibiotics given after procedure
C. Test for tubal function
D. Oil based contrast medium is better than water based
medium
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1121
46
330.
Which of the following organisms are hostile to sperm in the vagina?
A. Ureaplsma urealyticum
B. Amoeba
C. Mycobacterium tuberculosis
D. Clostridia
Answer: a
Reference: Comprehensive Gynecology 3rd Edition, page 1124
331.
A 12 y/o girl was noted to have breast budding. What is the average age
you would expect her to experience menarche?
A. 10 year old
B. 12 year old
C. 14 year old
D. 16 year old
Answer: c
Reference: Comprehensive Gynecology 3rd Edition, page 1046
332.
A 45 y/o patient consulted at your clinic because of amenorrhea of 10
months duration. She would want to know if indeed she is menopausal
already. What laboratory test will you request?
A. Estrogen assay
B. FSH assay
C. Progesterone assay
D. Prolactin assay
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 1161
333.
What will be the first index of declining ovarian function?
A. Increase in FSH
B. Declining inhibin levels
C. Increase in LH
D. Increase in prolactin
Answer: b
Reference: Comprehensive Gynecology 3rd Edition, page 1161
334.
Which of the following events is associated with menstrual flow?
A. withdrawal of progesterone
B. prolonged maintenance of estrogen
C. withdrawal of LH
D. prolonged maintenance of progesterone
MPL 0.25 p: 106
335.
A 47 year old woman has poorly differentiated endometrial carcinoma and
a uterine cavity that measures 10 cm in depth. The endocervix has
stromal invasion of endometrial carcinoma but no other structure is
involved. What is the stage of her disease?
A. I A
B. I B
C. II A
D. II B
MPL 0.5 p: 929
47
336.
What endoscopic procedure is utilized to evaluate tubal disease?
A. colposcopy
B. laparoscopy
C. hysteroscopy
D. hysterosalpingography
MPL 0.5 p: 719
337.
Tuberculosis of the genital tract invariably involves the
A. fallopian tubes
B. ovaries
C. cervix
D. vagina
MPL 1.0 p: 731
338.
A 26 year old G1P1 had cervical intraepithelial neoplasia involving the
entire thickness of the cervical epithelium. What is the best management?
A. cryosurgery
B. electrocautery
C. conization
D. hysterectomy
MPL 0.5 p: 878
339.
A 25 year old woman and her husband use natural family planning as their
method of contraception. Her menstrual cycle length range from 26 to 32
days. She does not measure her basal body temperature. The time of
her maximum or peak fertility with the first day of her menses defined as
day 1 would be between
A. day 1 – 14
B. day 8 – 14
C. day 8 – 21
D. day 14 – 21
MPL 0.5 p: 301
340.
What is the drug of choice for bacterial vaginosis?
A. tetracycline
B. fluconazole
C. cefoxitin
D. metronidazole
MPL 1.0 p: 671
341.
What type of myoma insinuates itself between the leaves of the broad
ligament?
A. parasitic
B. serosal
C. interstitial
D. intraligamentary
MPL 0.5 p: 498
342.
What tumor will be positive for the tumor marker HCG?
A. embryonal carcinoma
B. choriocarcinoma
C. endodermal sinus tumor
D. adenocarcinoma
MPL 0.5 p: 1053
48
343.
What type of abnormal uterine bleeding is excessive in amount and
duration of flow occurring at regular interval?
A. Menorrhagia
B. metrorrhagia
C. polymenorrhea
D. menometrorrhagia
MPL 0.5 p: 1079
344.
A 67 year old had episodes of vaginal bleeding 15 years after menopause.
Biopsy revealed endometrial hyperplasia. Transvaginal sonogram reveals
a solid adnexal mass of 4 cm diameter. She is not on hormonal
replacement therapy. What is the most likely cause of the bleeding?
A. sertoli-leydig tumor
B. granulose cell tumor
C. serous cystadenocarcinoma
D. endodermal sinus tumor
MPL 0.5 p: 173
345.
A 40 year old housewife complains of foul smelling vaginal discharge. On
examination, discharge was greenish-gray in color, fishy odor, and frothy.
What is the primary consideration?
A. Yeast
B. Trichomoniasis
C. Chlamydia
D. Bacterial vaginosis
MPL 0.5 p: 673
346.
A 36 year old G2P2 has amenorrhea of 11 months with hot flushes.
Examination reveals a small uterus. If this is a case of premature ovarian
failure, which finding is applicable?
A. biphasic basal body temperature
B. endometrial hyperplasia
C. elevated FSH > 40 IU/ml
D. tonically raised LH
MPL 0.5 p: 1100
347.
What is a contraindication to hormonal replacement therapy?
A. history of pulmonary thromboembolism
B. hot flushes, insomnia in a 50 year old with irregular
menses
C. history of fibrocystic disease of the breast
D. elevated serum lipids
MPL 0.33 p: 1249
348.
Which of these is the most likely site for implantation of endometriosis?
A. omentum
B. appendix
C. bladder mucosa
D. peritoneum of culdesac
MPL 0.5 p: 536
349.
Which disease of the vulva is best treated with wide excision?
A. hidradenitis suppuritiva
B. invasive vulvar cancer
C. angioma
D. contact dermatitis
MPL 0.5 p: 489
49
350.
What ovarian tumor will most commonly cause precocious puberty ?
A. teratoma
B. luteoma
C. granulosa cell tumor
D. sertoli leydig tumor
MPL 0.5 p: 173
351.
A woman with this type of pelvis is more prone to urethrocoele because of
more force of the fetal head on this area during descent in labor
A. platypelloid
B. anthropoid
C. gynecoid
D. android
MPL 1.0 p: 571
352.
Stage III vaginal cancer means extension of lesion up to
A. vaginal wall
B. subvaginal tissue
C. pelvic wall
D. rectal mucosa
MPL 0.33 p:1028
353.
On endometrial biopsy, glycogen-rich subnuclear vacuoles were seen in
the base of the cells lining the glands. What does this mean?
A. the woman is in her late luteal phase
B. ovulation has occurred
C. she is progesterone deficient
D. menstruation is about to set in
MPL 0.33 p: 104
354.
Which theory of endometriosis best explains remote sites of the disease
such as in the spinal cord, nasal septum or lungs?
A. iatrogenic dissemination
B. coelomic metaplasia
C. immunologic changes
D. lymphovascular metastasis
MPL 0.33 p: 533
355.
Which is an abnormal semen parameter?
A. white cell count of 105 per ml
B. sperm morphology 30 %
C. sperm count 40 x 106 per ml
D. progressive motility in 65 %
MPL 0.33 p: 1175
356.
A 32 year old has been having her regular pap smear for the last ten
years. Her latest result however revealed low grade SIL. What is the next
step to do?
A. colposcopic examination
B. repeat smear in 4 months
C. conization
D. laser ablation
MPL 0.33 p: 873
50
357.
A 19 year old was brought to the ER because of acute pain. There was
also vaginal spotting. Examination revealed a small tender adnexal mass.
Based on the LMP, she is on day 25 of her cycle. Pregnancy test was
negative. What is the most likely diagnosis?
A. ectopic pregnancy
B. acute salpingitis
C. ruptured corpus luteum
D. ruptured endometrial cyst
MPL 0.33
p: 509
358.
A 28 year old nulligravida with primary infertility and cyclic pelvic pain was
diagnosed to have endometriosis. She was placed on hormonal
treatment. However, while on this drug, she developed acne, hirsutism,
and deepening of the voice. What is a better alternative?
A. laparoscopic fulguration
B. GnRH agonist
C. Progesterone injectables
D. Oral contraceptives
MPL 0.33 p. 546
359.
A 35 year old consulted because of vesicular lesions in the vulva. She
related that several days prior to the appearance of the vesicles, she felt
numbing sensation over her vulvar skin. Which is the best treatment?
A. metronidazole
B. acyclovir
C. doxycycline
D. penicillin
MPL 0.33
p. 659
360.
A 17 year old consulted because of lower abdominal pain of 3 days
duration described as constant and dull. On speculum exam, purulent
vaginal discharge was noted. Patient was febrile at 38.5 C. Pertinent
finding on internal exam: tenderness with motion of the uterus and cervix.
What is the most likely etiologic agents?
A. Neisseria gonorrheae and Chlamydia trachomatis
B. Trichomonas vaginalis and gardnerela
C. Anaerobic gram negative bacteria
D. Pseudomonas
MPL 0.5 p. 724
361.
A woman consulted because of spontaneous milky discharge and missed
period of 8 weeks. Pregnancy test was negative. Prolactin levels after
appropriate blood collection was 35 ng/ml. What should be the next step
in the work-up?
A. repeat prolactin in a quiet room
B. CT scan of the brain
C. Cone view of the sella turcica
D. TSH determination
MPL 0.33 p. 1133
362.
A patient was diagnosed to have squamous cell cervical cancer. Clinical
evaluation revealed that the disease has involved the upper third of the
vagina. Parametrial tissues were indurated. However, there was no
evidence of pelvic well involvement. What is the best treatment for her?
A. radiotherapy
B. chemoradiation
C. RHBLND
51
D. Chemotherapy
MPL 0.33 p. 905
363.
A 19 year old consulted because of primary amenorrhea. On clinical
evaluation, the patient was found to have breast development but absent
uterus. Which of the following can best help arrive at diagnosis?
A. progesterone challenge test
B. GnRH level determination
C. Karyotyping
D. Gondal biopsy
MPL 0.33 p. 1106
364.
A 19 year old, primigravida, at 34 weeks gestation comes in for severe
headache and visual blurring. Previous blood pressure on prior prenatal
check up was at 140/90 mm Hg. Presently, her blood pressure was
170/110 mm Hg. She presented with bipedal edema. There was no
uterine contractions. Then she developed generalized tonic-clonic
seizures last for about 40 secs. What is most likely diagnosis?
A. Chronic hypertension
B. Severe pre-eclampsia
C. Chronic hypertension with superimposed
hypertension
D. Eclampsia
MPL 0.5 p. 764
365.
Which of the following conditions can be predicted by cervicovaginal
fibronectin?
A. pre-eclampsia
B. feta growth restriction
C. preterm labor
D. premature rupture of membrane
MPL 0.33 p. 937
366.
A G2P1 with 7 weeks missed period presents with one week diagnosis of
vaginal bleeding and hypogastric pains. Cervix is 1 cm open with intact
membranes. What is the diagnosis?
A. Threatened abortion
B. Imminent abortion
C. Inevitable abortion
D. Incomplete abortion
MPL 0.33 p. 243
367.
Which is a cause of polyhydramnios?
A. renal agenesis
B. prematurity
C. abruption
D. esophageal atresia
MPL 0.5 p. 526
368.
A 26 year old G3P2, Previous CS I, on her 29th week age of gestation
went to the hospital because of episodes of bright red vaginal bleeding
upon waking up without other symptoms. Vital signs were normal with no
uterine contraction noted. Leopolds maneuver showed a baby in cephalic
presentation, floating, FHT was 150/min. What is the diagnosis?
A. placenta previa
B. placenta abruption
C. Premature labor
52
D. Ruptured uterus
MPL 1.0 p. 630
369.
A nullipara was admitted on active labor at 5 cms., ruptured bag of waters,
station -2. After 3 hours of good contractions, cervix was 5 cms dilated,
station -2. What condition is she in?
A. prolonged latent phase of labor
B. arrest of cervical dilatation
C. arrest of descent
D. protracted active phase of labor
MPL 0.5 p. 499
370.
A patient diagnosed to have asymptomatic bacteriuria is one who has?
A. persistently multiplying bacteria in the urine but no
symptoms.
B. 100,000 organisms in culture specimen with pyuria
C. a sterile urine culture with frequency and urgency.
D. microscopic hematuria and colony count of 50,000/ml.
MPL 0.25 p. 1253
371.
Pigmentation of the face during pregnancy is considered as
A. an indication of increased androgen from a male fetus
B. a temporary state rapidly regressing postpartum
C. a benign but persistent condition
D. an indication for immediate hyroxyquinone application
MPL 0.33
p. 1430
372.
A 25 year old consulted for vaginal spotting and sharp pelvic pain. History
revealed 6 weeks amenorrhea. Pregnancy test was positive. Physical
exam elicited cervical wriggling tenderness with a vague mass and
tenderness in the left adnexae. Posterior vaginal fornix as full and
bulging. BP was 100/60 mm Hg., PR 102/min. What should be done next
to this patient?
A. culdocentesis
B. emergency transvaginal ultrasound
C. blood transfusion
D. immediate exploration
MPL 0.5
p. 890
373.
A woman on her 32nd week of gestation was admitted for threatened
preterm labor. Tocolytic management was initiated with magnesium
sulfate. Which of the following needs to be monitored closely while on
tocolysis?
A. SGOT
B. Glucose
C. Blood pressure
D. Potassium
MPL 1.0 p. 714
374.
A 20 year old primigravida at 39 weeks came in due to labor pains. This
patient was a diagnosed case of rheumatic heart disease. When should
she receive the initial dose of ampicillin-gentamycin?
A. about 2-3 hours after admission
B. prior to amniotomy
C. after the first internal examination
D. 30 minutes prior to anticipated delivery
MPL 0.25 p. 1189
53
375.
A puerperal women was rushed to the ER because of profuse bleeding.
On examination, a sac-like structure was seen out of the introitus with the
placenta still attached. A crater-like depression as noted on abdominal
palpation. Which of the following is part of good management?
A. immediate removal of the placenta before replacement
B. give oxytocin to facilitate replacement
C. administer fluids and magnesium sulfate for uterine
relaxation
D. do a vaginal hysterectomy
MPL 0.33 p. 643
376.
A pregnant women consulted because of itchy reddish wheal-like rashes.
The lesions were first seen in the abdomen eventually spreading to the
rest of the body. She denied having any allergies to food or drugs. What
treatment is appropriate?
A. antibiotics
B. estrogen cream
C. corticosteroids
D. lindane
MPL 0.33 p. 1025
377.
A pregnant woman on her 1st trimester of pregnancy was exposed to a
neighbor with german measles. What is the initial step in the
management?
A. active immunization
B. immunoglobulins
C. antiviral therapy
D. ask history of past infection
MPL 0.33 p. 1469
378.
Immediately after an apparently normal labor and delivery, the mother
suddenly manifested with dyspnea and went into convulsions. Blood
pressure likewise dropped sharply from 120/80 mm Hg. Cardiopulmonary
arrest rapidly ensued. What is the probable cause?
A. cerebrovascular accident
B. eclampsia
C. amniotic fluid embolism
D. postpartum cardiomyopathy
MPL 0.33 p. 660
379.
A G5P4 pregnant uterine 39 weeks was in active labor for 3 hours. IE
showed cervix 7 cms dilated, fetal head at station -1 to 0. Suddenly, fetal
heart rate decelerated and maternal blood pressure dropped from 120/80
to 90/60 mm Hg. On doing IE, the presenting part appeared to retract.
What is the most probable diagnosis?
A. abruption placenta
B. spontaneous uterine rupture
C. acute cord torsion
D. uterine atony
MPL 0.5 p. 650
380.
A G2P1 PU 31 weeks came to the clinic with complaints of watery vaginal
discharge. After noting some fluid pooling at the culdesac, the clinician
requested for an ultrasound. What information can be derived from an
ultrasound pertinent to management?
A. demonstration of site of bag rupture
54
B. confirmation of fetal maturity
C. assessment of amniotic fluid volume
D. detection of fetal meconium staining
MPL 0.33 p: 526
381.
During clinical pelvimetry, the ischial spines were noted to be prominent,
the sidewalls convergent and the sacraosciatic notch is narrow. Of the
following, what is the most common consequence of these findings?
A. this promotes cord prolapse
B. there is increase likelihood for transverse arrest of
fetal head
C. extreme posterior asynclitism is favored
D. production of abnormal presentation is facilitated
MPL 0.25
p: 756
382.
Anticipating a large baby, the patient’s legs were removed from the
stirrups and sharply flexed upon her abdomen. What will be the effect of
this maneuver?
A. increase pelvic dimension
B. facilitate bearing down effort
C. rotates symphysis pubis toward maternal head
D. dislodges the posterior shoulder
MPL 0.25
p: 461
383.
A primigravida was brought to the ER by the attending midwife after 10
hours of labor. Apparently she has been bearing down for 2 hours
already. Exam showed that the fetal scalp is visible at the introitus without
separating the labia. The sagittal suture was at AP diameter. The mother
appeared weakened by her efforts to bear down. What is the best
management?
A. strong fundal pressure
B. oulet forceps extraction
C. cesarean section
D. await vaginal delivery
MPL 0.25
p: 487
384.
A 20 year old, primigravid, PU 39 weeks presented at the ER in labor for 3
hours. PE revealed multiple vesicular lesions in the vulva and perieal
area. IE showed 3 cm cervical dilatation, 50 % effaced, intact bag of
waters, cephalic, station -1. Clinical pelvimetry was adequate. What is
the best route of delivery?
A. cesarean section
B. vacuum extraction
C. outlet forceps extraction
D. spontaneous vaginal delivery
MPL 0.5 p: 1496
385.
A
53 A 29 year old, Gravida 5 Para 4 (4-0-0-4), Pregnancy uterine
37 weeks, complaining of hypogastric pain of 2 hours, came in the
emergency room. Her vital signs were normal. Fundic height was 35
cms. Fundus is occupied by a hard, round, ballotable mass, fetal back
palpated at the left, as well on the right, another hard, round mass on the
hypogastric area, fetal heart tones of 143/min heard at the left periumbical
area and 152/min heard at the right lower quadrant. On internal
examination, the cervix was 5 cms. Dilated, 1 cm long, ruptured bag of
waters, cephalic, station -2. All her previous pregnancies were delivered
at home. What is the recommended mode of delivery?
55
A. an outright cesarean section
B. a vaginal delivery for both
C. a vaginal delivery for the first of twin then a cesarean
section for the second
D. a vaginal delivery for the first of twin then an internal
podalic version for the second of twin
MPL 0.25
p: 941
386.
Which of the histological presentation is a characteristic of complete molar
pregnancy?
A. hydropic degeneration and swelling of the villous
stroma
B. presence of blood vessels in the swollen villi
C. proliferation of trophoblastic epithelium with equal degree
D. presence of fetus and amnion
MPL 0.25
p: 274
387.
When the fetal breech presents with both legs extended and the hips
flexed, it is classified as
A. complete breech
B. incomplete breech
C. frank breech
D. footling breech
MPL 0.5 p: 567
388.
Procedure where the cephalic presented fetus is converted to a footling
breech presentation by grasping the fetal legs and turning the position is
called
A. external cephalic version
B. internal podalic version
C. partial breech extraction
D. piper’s forceps
MPL 0.5 p: 583
389.
Which of the following is associated with Abruptio placenta?
A. Long cord
B. Hypertension
C. Cord prolapse
D. High levels of B-hCG
MPL 1.0 p: 813
390.
Which of the following conditions in NOT an indications for classical
cesarean section?
A. Myoma occupying the fundus of the uterus
B. Invasive carcinoma of the cervix
C. Placenta previa with posterior implantation
D. Transverse lie of a large fetus
MPL 0.5 p: 598
391.
What is considered as the major vestibular glands that lie under the
constrictor muscles of the vagina
A. Paraurethral glands
B. Skene’s glands
C. Sebaceous glands
D. Bartholin’s glands
MPL 0.5 p: 17
56
392.
A 28 year G1P0 sought her first prenatal check up at 12 weeks gestation.
Family history is positive for diabetes mellitus (father). When should she
have her GCT?
A. 16 – 20 wks
B. 24 – 28 wks
C. 32 – 36 wks
D. at term
MPL 0.33 p: 1171
393.
What is the most accurate ultrasonographic parameter for fetal aging in
the first trimester ?
A. femur length
B. biparietal diameter
C. head circumference
D. crown – rump length
MPL 0.5 p: 391
394.
What do you call a woman who had 3 pregnancies, all of which were
aborted?
A. nulligravida
B. nullipara
C. multipara
D. primipara
MPL 0.5 p: 207
395.
What is the earliest age of gestation when fetal sex can be identified by
gross examination of the external genitalia?
A. 6 weeks
B. 10 weeks
C. 14 weeks
D. 20 weeks
MPL 0.33 p: 113
396.
What is most common type of the female pelvis?
A. android
B. anthropoid
C. platypelloid
D. gynecoid
MPL 1.0 p: 35
397.
When does the 2nd stage of labor end?
A. when the cervix is fully dilated
B. when the baby is fully delivered
C. when the placenta is delivered
D. right after episiotomy
MPL 0.5
p: 423
398.
How much weight does a average weighted woman gain throughout her
pregnancy?
A. 10 lbs
B. 18 lbs
C. 24 lbs
D. 30 lbs
MPL 0.5 p: 452
57
399.
On histopathology, a placenta is found to have dense stroma containing
round cells with granular and vacuolated cytoplasm with vascular and
eccentric nuclei. What is age of this placenta?
A. 8 weeks
B. 14 weeks
C. 24 weeks
D. 40 weeks
MPL 0.33 p: 612
400.
What CTG finding is indicative of head compression?
A. sinusoidal pattern
B. absent beat to beat variability
C. early deceleration
D. late deceleration
MPL 0.25 p: 452
401.
A woman on her 41st week of pregnancy had a BPS with the following
findings during the 30 minutes test-sustained breathing movement of 45
secs, five simultaneous limb and trunk movements, 2 episodes of arm
flexion and extension, 3 episodes of fetal heart rate accelerations each for
5 secs with fetal movement, amniotic fluid pocket of 3 cms in
perpendicular planes. What should be done for this patients based on the
BPS score?
A. Do a outright cesarean section
B. Induce labor first
C. Repeat the BPS on the same day
D. Repeat the BPS after a week
MPL 0.5 p: 1104
402.
When can a puerperal patient start using a hormonal contraceptive
method if does not intend to breast feed?
A. 2 - 4 weeks postpartum
B. 4 - 6 weeks postpartum
C. 6 – 8 weeks postpartum
D. when she starts menstruating again
MPL 0.33 p: 412
403.
On performing the third’s Leopold’s maneuver, the cephalic prominence is
palpated on the left lower quadrant and the fetal heart tones is maximally
heard at the right lower quadrant, which of the following can be
concluded?
A. the head is already engaged
B. the vertex is presenting
C. the head is extended
D. the presenting part is the sinciput
MPL 0.33 p: 299
404.
On the 2nd postpartum day, a parturient developed a temperature of 39.0
C. Pertinent PE included breast that were edematous, tender, firm, and
nodular. What must be done for this patient?
A. give analgesic and breast support
B. stop breastfeeding immediately
C. give antibiotics
D. give bromocriptine for 7 days
MPL 0.25 P: 413
58
405.
On physical examination of a pregnant woman, the clinician detected a 2/6
systolic murmur intensifying during inspiration. What should be done for
this patient with regards this finding?
A. cardiology referral
B. ECG
C. No intervention needed
D. Echocardiogram
MPL 0.5 p: 1168
406.
A 21 year old primigravida in labor for 10 hours presented with a 6 cm
cervical dilatation. The bag of waters was ruptured and the presenting
fetal head was palpated at station 0. What conclusion regarding the pelvis
can be made?
A. pelvic inlet is adequate
B. pelvic midplane is adequate
C. pelvic inlet is inadequate
D. pelvic midplane is inadequate
MPL 0.5 p: 423
407.
What maneuver will the fetal head undergo right after engagement?
A. internal rotation
B. extension
C. flexion
D. descent
MPL 0.5 p: 416
408.
What part of the uterus forms the lower uterine segment during labor?
21
A. external cervical os
B. cornua
C. fundus
D. isthmus
MPL 0.5 p: 21
409.
What diameter of the pelvic inlet can be assessed clinically?
A. Obstetric conjugate
B. Diagonal conjugate
C. Greatest transverse diameter
D. Posterior midsagittal diameter of the inlet
MPL 0.33
p: 34
410.
What is the major source of progesterone in early pregnancy?
A. placental cytotrophoblast
B. placental syncytiotrophoblast
C. corpus luteum
D. placenta
MPL 0.25 p:
124
411.
Which of the following antibiotics are contraindicated during pregnancy?
A. metronidazole
B. tetracycline
C. amoxicillin
D. erythromycin
MPL 0.5
p: 342
59
412.
Myrna, a primigravida, on her 32nd week AOG, came in for prenatal
check-up. Auscultation of the FHT yields negative result and the
ultrasound revealed fetal death in utero. How will you manage her?
A. hysterotomy
B. wait for spontaneous labor *
C. prostaglandins
D. curettage
MPL 0.5 p: 681
413.
In which part of labor does the descent of the presenting part of the fetus
is most marked?
A. preparatory division of labor
B. 1st stage of labor
C. pelvic division of labor
D. 3rd stage of labor
MPL 0.5 p:422
414.
Which of the following maternal changes are decreased during
pregnancy?
A. gastric emptying time
B. maternal circulating blood volume
C. maternal insulin
D. resting pulse rate
MPL 0.25
p: 140
415.
What conclusions can be made when meconium passage in-utero in a
term parturient is observed after amniotomy?
A. The GIT of the fetus is still immature
B. Can be a sign of fetal hypoxia
C. Fetal sympathetic system is stimulated
D. Esophageal atresia is a consideration
MPL 0.25 pp: 675-676
416.
What is the earliest histological evidence of progesterone action in the
endometrium
A. glandular mitoses
B. pseudostratification of nuclei
C. stromal edema
D. basal vacuolation
MPL 0.25 p: 451
417.
Which is the most biologically potent estrogen in the normal menstrual
cycle?
A. estrone
B. estradiol
C. estriol
D. androstenedione
MPL 0.33 pp: 43-44
418.
If her last menstrual period is last Jan 23, 2007, when is her expected date
of confinement?
A. April 30, 2007
B. June 26, 2007
C. Oct 23, 2007
D. Oct 30, 2007
MPL 1.0 p: 208-209
60
419.
Lochia serosa is expected to occur
A. immediately after birth
B. after 3 or 4 days
C. after 10 days
D. after 1 month
MPL 0.33 pp: 696-697
420.
Through what nerve is pain of uterine contractions transmitted?
A. S1 - S2
B. S4 - S5
C. T7 - T8
D. T10 - L1
MPL 0.25 p: 477
421.
What is the antidote for magnesium toxicity?
A. Calcium gluconate
B. Calcium channel blocker
C. Diazepam
D. Midazolam
MPL 0.5 p: 789
422.
Which of the following is utilized for medical treatment of ectopic
pregnancy?
A. Dexamethasone
B. Vincristine
C. Methotrexate
D. Adriamycin
MPL 0.25 p: 262
423.
Of the following, which is most associated with low birthweight infants?
A. Placenta previa
B. Diabetes mellitus
C. Maternal height of < 5 ft
D. Smoking in pregnancy *
MPL 0.25
p: 354
424.
A 5 year old was referred to you at the ER due to complaints of perineal
pain. What is the best way to examine the vagina of this child?
A. dorsal lithotomy
B. knee-chest position
C. lying on her mother’s lap
D. standing with one leg raised
MPL 0.25 p: 274
425.
Keanna, 32 y/o “sexy dancer” and ramp model complained of burning
sensation over her vulva after a lingerie fashion show where she wore
“thongs” and stringed nylon bikinis. There was pruritus so she used a
newly-launched vaginal wash. Immediately, the burning sensation
became worse but she thought it was normal. The next morning, she
found her vulva to be erythematous and inflamed. The redness now
reached the peri-anal area. What is the diagnosis?
A. Vulva vestibulitis
B. Mechanical intertrigo
C. Allergic dermatitis
D. Fungal vulvo-vaginitis
MPL 0.33 p: 487
61
426.
On cut-section of an ovarian mass in a 26 year old nulligravida, there were
ufts of hair, sebum and bony cartilage. What type of ovarian mass is most
likely in this case?
A. Follicular cyst
B. Dysontogenetic cyst
C. Cystic teratoma (dermoid)
D. Theca lutein cyst
MPL 0.33 p: 979
427.
What ulcerative lesion of the genital tract is characterized by the presence
of “groove sign”?
A. Granuloma inguinale
B. Lymphogranuloma venereum
C. Chancroid
D. Syphilis
MPL 0.33 p: 661
428.
What surgical procedure will prevent a woman from experiencing vaginal
coitus?
A. Manchester Fothergill
B. Colpocleisis
C. Vaginal hysterectomy
D. Perineorrhaphy
MPL 0.25 p: 580
429.
Which is the most common predisposing factor to ectopic pregnancy?
A. previous genital infection
B. smoking
C. contraceptive pills
D. douching
MPL 0.33 p: 254
62