1-50

1. The preferred management of a parturient whose cervical dilatation for 24 hours without signs of maternal and fetal compromise is? a. Sedation b. Oxytocin c. Caesarean section d. Induction of labor with misoprostol 2. A 20 y/o G1P0 was admitted at 8 cm cervical dilatation, cephalic, station -1, intact membranes, with contractions every 6 minutes, 30 seconds duration, moderate intensity, adequate pelvimetry and with estimated fetal weight of 2800 grams. After 1 hour, the IE findings remained the same. The appropriate inital management at this points is? a. Oxytocin drip b. Amniotomy c. Sedation d. Caesarean section 3. If the lower extremities of the fetus are flexed at the hips and extended at the knees so that the feet lie in close proximity to the head, the presentation is? a. Complete breech b. Incomplete breech c. Footling breech d. Frank breech 4. Which of the following regarding episiotomies is correct? a. Routine episiotomy should be performed on all parturients b. An episiotomy is proven to be effective in preventing pelvic relaxation and incontinence c. With a median episiotomy, healing is fast, blood loss and pain are lesser and repair is easier d. The timing of episiotomy is important and must be performed before crowning 5. Myometrial contractions during active labor are best described by which of these statements: a. The contractions are unpredictable, lack intensity and short in duration b. The myometrium during this stage is highly responsive to tocolytic agents c. The contractions are produced by the skeletal muscles of the uterus d. The contractions cause discomfort initially on the back and radiate to the lower abdomen and groin 6. This division/phase of labor is most sensitive to analgesia and maternal sedation: a. Preparatory division b. Dilatational division c. Pelvic division d. Deceleration division 7. Traumatic vaginal delivery of a large for gestational age baby most likely will tear the following perineal muscles except: a. Bulbocavernosus muscle b. Ischiocavernosus muscle c. Superficial transverse perineal muscle d. External anal sphincter 8. Which of the following statements about obstetric anesthesia is not true a. The most important single factor associated with anesthesia related maternal mortality is the experience of the anaesthesiologist b. The essentials of obstetrical pain relief are simplicity, safety and preservation of fetal homeostasis c. without exception, all anesthetic agents that depress the maternal central nervous system cross the placenta and depress the fetal central nervous system d. Fasting for 6 hours is enough to prevent aspiration during general anesthesia 9. Maternal hypotension as a complication of subarachnoid block is primarily a consequence of: a. Sympathetic blockade compounded by obstructed venous return due to aortocaval compression b. Excessive dose of anesthetic c. Cerebrospinal fluid hypotension d. All of the above 10. Pain during the second stage of labor results primarily from: a. Cervical dilatation b. Uterine contraction c. Distention of the pelvic floor, vagina and perineum d. All of the above 11. An asymmetrically growth restricted fetus has an abnormally increased relative brain size compared with the a. Heart b. Liver c. Adrenals d. lungs

12. Oligohydramnios in postterm pregnancies may result in antepartum and intrapartum fetal compromise as a consequence of a. cord compression b. decreased uteroplacental blood flow c. fetal head compression d. inadequate fetal nutrition 13. In persistent breech presentation an increased frequency of the following complications can be anticipated a. prolapsed cord b. low birthweight c. operative delivery d. all of the above 14. In a face presentation, the head is a. Hyperflexed b. Hyperextended c. in occiput posterior position d. in occiput anterior position 15. Which of the following contraceptive methods has the highest method effectiveness a. Condom b. intrauterine device c. oral contraceptives d. spermicidal cream 16. Intrauterine devices (IUDs) may prevent pregnancy by which of the following mechanism a. inhibiting ovulation b. inducing endometrial atrophy c. thinning of cervical mucus d. all of the above 17. A 25 year old woman and her husband use natural family planning as their contraceptive method. Her menstrual cycle length range from 26 to 32 days. She does not measure her basal body temperature. The time of her maximum (peak) fertility, with the first day of menses defined as day 1, would be between cycle days a. day 1 – 14 b. day 8 – 14 c. day 8 – 21 d. day 14 - 21 18. Which of the following statements regarding progestin-only pills as a contraceptive true? a. It is as effective as combination oral contraceptive pills b. It is often associated with irregular vaginal bleeding c. It cannot be used by breastfeeding women d. It has a protective effective against ectopic pregnancy 19. Which of the following has the higher risk of contraceptive failure? a. Condoms b. Oral contraceptive pills c. Coitus interruptus d. All of the above 20. Oral contraceptive pills may be contraindicated among women with the following disorders EXCEPT? a. Endometriotic cysts b. Endometrial carcinoma c. Undiagnosed abnormal uterine bleeding d. Breast carcinoma 21. The use of oral contraceptive pills reduces the risk of all of the following conditions EXCEPT? a. Ectopic pregnancy b. Endometrial cancer c. Hepatic adenoma d. Salpingitis 22. After delivering our babies by forceps extraction, vaginal lacerations are usually or most commonly see at the a. Posterior middle third b. Lateral middle third c. Posterior upper third d. Anterior upper third 23. What is the type of forceps that is primarily used for traction with ample pelvic and cephalic curves, an English style lock and parallel shanks a. Kielland’s b. Simpson’s c. Tucker Mclane d. Elliot’s 24. An obstetrician who attempts to do forceps extraction with the knowledge that there is certain degree of disproportion at the level of the midpelvis is doing a

a. failed forceps b. elective forceps c. prophylactic forceps d. trial forceps 25. The type of breech presentation where the thighs are flexed to the abdomen and the legs is extended is called? a. Frank b. Incomplete c. Complete d. Footling 26. A positive response to NST is a. FHR acceleration of 5 bpm with 15 second duration b. FHR decceleration of 15 bpm with 15 second duration c. FHR acceleration of 15 bpm with 15 second duration d. FHR deceleration of 5 bpm with 5 second duration 27. Which of the following factors is not measured as part of biophysical profile? a. Amniotic fluid volume b. Contraction stress test c. Non stress test d. Fetal breathing motion 28. CST and NST are used for evaluation of fetal well being. Which of the following is true? a. A positive non reactive CST contraindicates labor b. A positive CST is far more predictive of fetal well being c. A positive CST is an excellent predictor of fetal well being d. A CST is falsely negative less frequently than an NST is falsely reactive 29. Which of the following statement regarding the function of cervical mucus is false? a. It provides barrier to vaginal microorganisms b. It provides acid environment for prevention of uterine infection c. It provides glucose as energy substrate for spermatozoa d. It provides an environment for spermatozoa capacitation 30. Prior to labor, uterine contraction results in? a. No change in placental blood flow b. Decrease placental blood flow c. Increase placental blood flow d. Retrograde placental blood flow 31. In fetus, the most well oxygenated blood is allowed into the systemic circulation by the a. Foramen ovale b. Ductus arteriosus c. Right ventricle d. Ligamentum teres 32. The presence of which of the following is most reassuring that fetal lungs are mature? a. Phosphatidylinositol b. phosphatidylglycerol c. phosphatidylcholine d. phosphatidylethanolamine 33. The oxygen dissociation curve of the fetal blood loss lies to the right of the maternal blood. This implies that a. O2 should be transfer easily to the fetus b. There is more haemoglobin F than haemoglobin A c. The fetus needs a greater O2 34. A soft blowing sound that is a. Burborygmic b. Uterine suffle c. Funic suffle d. fetal 35. A 24 y/o GIP0 on her 19th week AOG came in at ER due to uterine contractions. Vitals signs are within normal limits. FHT 140 bpm. On IE, cervix is closed, beginning effacement, soft, midline, intact bag of waters, fetal head at station -2. You plan to induce labor. What is the bishop score? a. 2 b. 3 c. 4 d. 5 36. A 30 y/o G2P1 (1001) on her 40th week AOG came in labor. On initial observation, the uterine contractions were as follows: every 3 minutes with each contraction lasting more than 120 seconds strong. These contractions are?

a. Hypotonic b. Within normal c. Hypertonic d. NOTA 37. Fetal heart rate monitoring in an OB-normal case during the first stage of labor should be? a. Every 5-10 minutes b. Every 10-15 minutes c. Every 15-30 minutes d. Every 30-45 minutes 38. True about episiotomy a. Routine episiotomy is preferred over restricted episiotomy b. In either median or mediolateral episiotomy, 3 layered closure is better than 2 layers c. Polyglycolic acid derivative sutures recommended to reduce wound inflammation d. Interrupted suturing for perineal closure is associated with less pain 39. Of all the methods of pain relief available in clinical practice, the most effective in providing intrapartum relief is? a. Systemic opioids b. Nitrous oxide subanesthetic doses c. Pudendal block d. Epidural 40. with CS, the recommendation for placental delivery is? a. With controlled traction because of decreased risk of endometritis and decreased blood loss b. With manual removal because of decreased risk of risk of endometritis and decreased blood loss c. There is no difference whether one chooses manual removal or spontaneous with controlled cord traction d. The choice is a case to case basis 41. After a successful caesarean delivery for breech, the G1P1 mother asked her OB-GYN if she has a chance to have a vaginal delivery next time she gets pregnant. Which of the following conditions may make vaginal delivery possible? a. Mother has contracted pelvis b. Previous scar is a low segment caesarean c. Malpresented fetus d. Abnormal placentation 42. The group B streptococcus which is the most common cause of neonatal and post partum sepsis a. Streptococcus pyogenes b. Streptococcus agalactiae c. Streptococcus faecalis d. Streptococcus faecium 43. A 25 y/o G2P2 (2002) is taking OCP. She tells you that she went to vacation for 3 days and forgot to bring her pills so she was not able to take pills. Her LNMP was April 20, 2016. How will you advise her? a. She should take all pills on the same day b. She should take 1 active pill ASAP and continue taking pills daily c. She should have emergency contraception every time for this cycle d. She should not take the inactive pills 44. Which of the following is a third generation progestin used in more than one commercially available OCPs a. Mestranol b. Levonorgestrel c. Desogestrel d. AOTA 45. How many weeks postpartum is menstruation expected to return in a non-breastfeeding woman? a. 1-2 weeks b. 3-4 weeks c. 6-8 weeks d. 12-14 weeks 46. Distinct advantages of the Pfannenstiel incision include? a. Guaranteed healing and suitability for low spinal or caudal anesthesia b. Elimination of the risk of post operative rupture with closure of layers at right angle and guaranteed healing c. Ideal skin healing with minimal scar and elimination of the risk of postoperative rupture with closure of layers at right angles d. AOTA 47. Indications for caesarean section include all off the following EXCEPT a. Previous myomectomy b. Fetopelvic disproportion

c. Placenta previa d. Type I tracing 48. Classical caesarean section may be indicated in all of the following EXCEPT a. Placenta previa b. Transverse lie with an undeveloped LUS c. Elective repeat caesarean for a contracted midpelvis d. NOTA 49. Factors contributing to episiotomy breakdown include all of the following EXCEPT a. Type of suture material b. Inadequate hemostasis c. Aseptic technique d. NOTA 50. Which of the following forceps is used for rotation of transverse and posterior position a. Tucker McLane b. Simpson c. Piper d. AOTA