Ob -Gyne Final

OBSTETRICS & GYNECOLOGY 1.

Which Which of the the foll follow owin ing g is the the corr correct ect flow flow of blood blood fro from m the the uteri uterine ne wall wall to the the end endom ometr etrium ium? ?

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 hat is is th the fun funct ctio iona nall lif life e sp span of the the cor corp pus lute luteum um? ?

A. 7 + 2 days B. 14 + 2 days C. 21 + 2 days D. 28 + 2 days 3.

What What horm hormon one e is is sec secre rete ted d by by the the domi domina nant nt ovar ovaria ian n fol folli licl cle? e?  A. estriol

B. estrone C. D.

estradiol progest gester ero one

4.

Durin During g the the emb embry ryon onic ic perio period, d, wher where e is is the the form format ation ion of blood blood first first demo demons nstr trabl able? e?  A. bone marrow marrow B. yolk sa sac C. liver   D. spllen

5.

Durin During g the the sec secre reto tory ry phase phase,, wha whatt is is the the uppe upperm rmos ostt laye layerr fro from m the the uter uterine ine cavit cavity y? A. Zona ona co compact acta B. Zona ba basalis C. Zona ona spo spongios iosa D. Decid ecidua ua basal asalis is What What stag stage e of of hum human an deve develo lopm pmen entt is impl implan ante ted d in in the the uter uterin ine e cav cavit ity? y?  A. blastomeres blastomeres B. embryo

6.

C. blastocyst 7.

8.

9.

10.

D. morula How many any new new prim primar ary y ooc oocy ytes tes ar are the there re duri durin ng pub puber erty ty? ? A. 0 B. 1,000 C. 10,000 D. 100,000 What What is the the imp impor orta tant nt even eventt tha thatt occ occur urs s pri prior or to impl implan anta tati tion on? ?  A. Formation Formation of daughter daughter cells B. Extr Extrusi usion on of the the pola polarr body body C. Accumu Accumulati lation on of of fluid fluid betw between een blastom blastomeres eres D. Disa Disappe ppear aranc ance e of the zon zona a pelluc pellucid ida a At wh what phas phase e doe does s reg regre ress sson on of the the corp corpus us lute luteum um occ occur? ur?  A. At the end of the proliferative proliferative phase B. At the the end end of of the the secr secreto etory ry pha phase se C. Duri During ng mens menstr trua uati tion on D. After fter ovula vulati tion on A 34 year year old old G4P4 G4P4 deliv delivere ered d vagina vaginally lly an an 8 lb baby baby at home home assist assisted ed by by a hilot hilot.. The The placen placenta ta was was deliv delivered ered 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. 11.

uter terine ine at atony ony

A 33 year year old old G3P2 G3P2 PU PU 18 18 weeks weeks consult consulted ed at at the the ER ER becau because se of of watery watery vaginal vaginal discha discharge rge accomp accompani anied ed 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 Recurrent abortion abortion

B. Incomplete abortion C. D. 12. 12.

Inev Inevit itab able le abor aborti tion on Thre Threat aten ened ed abor aborti tion on

At what what part part of the the fall fallop opian ian tube tube doe does s tuba tuball rup ruptur ture e occ occur ur earli earlies est? t?  A. Interstitial Interstitial

B. B. Ampullary C. D. 13.

Isthmic Fimbria

What What is is the the mos mostt com commo monly nly asso associa ciate ted d con condit dition ion for for abr abrup uptio tion n plac placen enta ta? ?  A. External External trauma trauma

B. Pregnancy- induced hypertension C. D. 14.

alco alcoho holl con consu sump mpti tion on Short co cord

Which Which of of the the follow following ing tran transva svagina ginall utrason utrasonogr ograph aphic ic cervi cervical cal findi findings ngs correla correlate te posit positivel ively y with with prete preterm rm deliver delivery? y?

1

 A.

negative transfundal transfundal pressure pressure

B. funneling C. 2.7 cm cervical length D. 15.

T- shap shaped ed cerv cervix ix

Prete eterm infant ant is is an an inf infant wh who is is:  A. less than than 2000 grams at birth birth

B. less than 2500 grams at birth 16.

C. less less than than 37 week weeks s AOG AOG D. less less than than 38 week weeks s AOG AOG A 35 year year old G1P0 G1P0 had had an infe infertili rtility ty work work-up -up fro fro which which she she was was presc prescrib ribed ed clomi clomiphe phene ne citrat citrate. e. She She got got pregn pregnant ant and was diagnosed to have twin pregnancy. What is the most probable type of twinning?  A. Monozygotic Monozygotic

B. Dizygotic C. D.

Conjoined Locked

17.

Which Which of of the the follow following ing is is  A. B. C. D.

the the most most impor importan tantt param parameter eter in the the asses assessme sment nt of of patie patient nt in in true true labo labor? r? intactness intactness of the amniotic amniotic membra membrane ne cervic cervical al dilatat dilatation ion and efface effacemen mentt pres presen enti ting ng part part bony pelvis

18.

The level level of the the pres presenti enting ng part part in the birth birth canal canal descri described bed in in relati relations onship hip to to the the ischial ischial spines, spines, whic which h is halfw halfway ay between the pelvic inlet and the pelvic outlet is called  A. position B. B. ef effaceme ement C. Dilatation D. station

19. 19.

The The chara charact cteri eristi stic c curve curve patt pattern ern of cerv cervic ical al dilat dilatati ation on in a norm normal al labo laborr is desc descri ribe bed d as:  A. A. hyperbolic hyperbolic B. sigmoidal C. diag diagon onal al str strai aigh ghtt D. horizontal

20.

A 30 year year old G1P0, G1P0, term term was admitte admitted d for labor labor pains. pains. FH- 34 34 cm, cm, FHTFHT- 140 140 bpm. bpm. IEIE- cerv cervix ix is 4 cm dilated, dilated, 60% effaced, cephalic, station -2, rupture BOW. Uterine contractions every 2-3 mins, moderate. After 2 hours, IEcervix 4-5 cm dilated, 70 % effaced, station -2. After 2 hours, IE- cervix is 5-6 cm dilated, 80% effaced, station -1.Describe the progress of labor.  A. Normally Normally progressing progressing

B. Protracted cervical dilatation C. Protracted descent D.

Arres rrestt in in des desc cent ent

21. 21.

What What phase phase of the the act active ive labor labor refle reflect cts s the the feto-p feto-pelv elvic ic relat relation ionsh ship? ip?  A. latent phase phase B. B. acce accele lera rati tion on phas phase e C. phas phase e of maxi maximu mum m slo slope pe D. dece decele lera rati tion on phas phase e

22.

A 19 19 year year old old G1P0 G1P0 PU PU 40 weeks, weeks, not in labor labor,, was was seen seen at at the the OPD OPD for for decre decrease ased d fetal fetal moveme movement. nt. 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-r n-react active

C. positive D.

negative

23.

Feta Fetall tach tachyc ycard ardia ia is defin defined ed as a base baselin line e hear heartt rate rate great greater er than: than:  A. 140 bpm bpm B. 150 bpm C. 160 bpm D. 170 bpm

24.

What What is the presen presentati tation on presenting?  A. B. C. D.

25.

type type when when the the fetal fetal head head is artially artially flexed flexed with with the the ante anterior rior fontane fontanell or bregma bregma is face vertex brow sinciput

You were were the the intern intern on duty duty in in the the ER and you did an abdomi abdominal nal exam exam on a 22 22 year year old G2P1 G2P1 PU PU 37 37 weeks 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. C. D. 26.

LM 2 LM 3 LM 4

There There is an incr increase ease in the the size size of cardiac cardiac silhouet silhouette te in in X-ray X-ray durin during g pregnan pregnancy cy beca because use the the heart heart is displa displaced ced to to the: A. left an and upw upwa ard B. left left and and dow downw nwar ard d C. righ rightt and and dowm dowmwa ward rd D. righ rightt an and upw upwar ard d

2

27. 27.

Durin uring g pre pregn gnan ancy cy,, the the diap diaph hragm ragm rise rises s by

A. 2 cm B. C. D. 28. 28.

4 cm 6 cm 8 cm

Impa Impair ired ed gal galll blad bladde derr cont contra ract ctio ion n duri during ng pre pregn gnan ancy cy is is due due to  A. estrogen estrogen

B. estrogen and progesterone C. D.

proge ogester terone one anato anatomi mica call chan change ge in gall gall blad bladde der  r 

29. 29.

Naeg Naegele ele’s ’s rule rule is use use to to estim estimat ate e the the expe expect cted ed date date of deliv deliver ery y by by ____ ____..  A. adding 3 days to to the first first day day of PMP PMP and count back back 7 months months B. adding adding 7 days days to the the first first day of PMP PMP and and count count back back 3 months months C. adding adding 7 days days to the the first first day of bleed bleeding ing and and count count back back 3 months months D. adding adding 7 days days to the first first day day of LMP LMP and count count back back 3 month months s

30. 30.

Whic Which h of of the the follo ollowi win ng is is pro prov ven tera terato toge gen? n? A. Vita Vitami min n A der deriv ivat ativ ives es

B. Metronidazole C. D. 31.

Cepha ephalo losp spor orin ins s Ampicillin

Which Which of the the foll follow owin ing g vac vaccin cines es is cont contrai raindi ndica cated ted duri during ng pregn pregnan ancy cy? ?  A. Pneumococus Pneumococus

B. Hepatitis B C. D. 32.

The The pref preferr erred ed meth method od for for  A. B. C.

Influenza Mump Mumps, s, mea measl sles es,, rubel rubella la the the deliv delivery ery of the the afte afterc rcom omin ing g head head is Piper’s forceps forceps extraction extraction Mauric Mauriceau eau-Sm -Smell ellie-V ie-Veit eit Manueve Manuever  r  Brac Brach ht man maneu euv ver 

D. Prague maneuver  33.

You were were assign assigned ed to to deliver deliver the baby baby of a 25 year year old old G1P0 G1P0 PU PU 38 week weeks. s. You You applie applied d the the forcep forceps s on the the fetal 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 forceps delivery B. low low for force ceps ps deli delive very ry C. midf midfor orce ceps ps deli delive very ry D. high high forc forcep eps s del deliv iver ery y

34.

A 22 year year old G1P0 G1P0 patien patientt at 39 39 weeks weeks AOG was admitte admitted d for elective elective Cesare Cesarean an Sect Section ion for for breec breech h presen presentati tation. on. 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 Which of the followi following ng is one of of the the requir requireme ements nts that that must must be presen presentt before before obst obstetri etric c forcep forceps s must must be be used? used?  A. The membran membranes es should should be intact intact B. Ceph Cephal alic ic pre prese sent ntat atio ion n C. The The feta fetall head head must must be floa floatin ting g D. The cervi cervix x must must be full fully y dilate dilated d and retrac retracted ted

36.

The single single most most signific significant ant risk factor factor in the the develop developmen mentt of post-p post-part artum um pelvic pelvic infec infection tion is  A. early rupture rupture of of membranes membranes B. Prolo rolong nged ed labo labor  r  C. Cesa Cesare rean an deli delive very ry D. Multi ltipari arity

37.

The process process by whic which h the the uterus uterus returns returns to its its norm normal al size, size, tone tone and and positi position on afte afterr delive delivery ry is is called called A. involution

B. puerperium C. subinvolution D.

atony

38.

What What is is the the mech mechan anism ism behin behind d the the incr increas ease e in card cardiac iac outpu outputt righ rightt afte afterr deliv deliver ery? y?  A. maternal maternal exhaustion exhaustion increase caval compression B. sympathetic stimulation C. D. auto autotr tran ansf sfus usio ion n

39.

Conge Congeni nital tal rubell rubella a syn syndr drom ome e is is more more likely likely comm common on during during whic which h AOG AOG? ? A. 8-10 we weeks B. 12-14 weeks C. 16-18 weeks D. 36-38 weeks

40.

What What is is the the diagn diagnost ostic ic proc proced edur ure e of cho choic ice e for iden identif tifyin ying g gallst gallston ones es in in pregn pregnan ancy cy? ?  A. CT Scan Scan B. X-Ray C. Ultrasound D. MRI

3

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 Depo-Provera C. 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 ectopic endometrial tissue B. 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 Organic C. 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 Sheehan’s syndrome B. C. Simmond’s syndrome D. Polycystic ovarian syndrome

47.

Menometrorrhagia is defined as:  A. Abnormal uterine bleeding occurring at regular intervals B. Prolonged uterine bleeding at irregular intervals C. Normal amount of vaginal bleeding at frequent intervals D. Decreased amount of vaginal bleeding at frequent intervals

48.

Which of the following statements is true of DUB?  A. Anovulatory bleeding is the most common cause in the premenarcheal years B. There is continuous estrogen production without corpus luteum formation C. Halban’s syndrome is a common cause of DUB D. It is usually associated with severe dysmenorrhea

49.

The most common histologic type of vaginal cancer is:

A. Squamous carcinoma B.  Adenocarcinoma C. D.

Malignant melanoma 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 Steroid topical cream B. Excision biopsy of the mass C. 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. D. 52.

Histologic endocervix Isthmus

Which of the following HPV Types is associated with high oncogenic potential?  A. HPV Type 1

B. HPV Type 5 C. D.

HPV Type 6 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

4

54.

A 68 year old woman has a biopsy result of atypical complex hyperplasia. What is the most appropriate treatment for her?  A. Judicious observation B. Repeat fractional D&C after 6 months C. Give cyclic progestin therapy to promote monthly withdrawal bleeding D. Perform TAHBSO

55.

This granulose-theca cell tumor has this characteristic inclusion body.  A. Psamomma bodies B. Call-Exner bodies C. Schiller Duvall bodies D. keratin pearls

56. A 33 year old nulligravid patient consulted in your clinic because of cervical mass. She was diagnosed as a case of  prolapsed myoma . What is the best management for her case?  A. Do myomectomy by laparotomy B. Do subtotal hysterectomy C. Do transcervical resection of the myoma D. Do total abdominal hysterectomy only 57. A 28 year old, single, nulligravid patient consulted in the OPD for the result of her pelvic ultrasound. It revealed a 18mm x 10mm x 14mm and a 13mm x 16mm x 10 mm intramural myomatas. She is asymptomatic. 58.  A. B. C. D. 59.

60.  A. B. C. D.

How will you manage the patient? Work up the patient , then schedule her for myomectomy Give her GnRH agonists Reevaluate the patient at 6-month interval to determine the rate of growth Perform fractional D & C This is the diagnostic procedure of choice for endometrial cancer.  A. Progesterone challenge test B. Ul trasound C. Pap smear   D. Fractional D&C This is the drug of choice for syphilis. Oral doxycycline Oral tetracycline Oral Penicillin 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. C. D. 62.  A. B. C. D. 63.

Granuloma inguinale LGV Genital herpes What are the most important goals of the medical therapy of acute PID? prevention and treatment of the disease early diagnosis and prompt treatment of the disease prevention of the disease and preservation of tubal function resolution of symptoms and preservation of tubal function 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. D. 64.

genuine stress incontinence true incontinence

This occurs when a bladder is overdistended because of its instability to empty.  A. true incontinence

B. overflow incontinence C. D.

genuine stress incontinence 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

5

C. ovulatory factors D. 69.

tubal/peritoneal factors

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

71.

Mefenamic acid taken by pregnant women may result in the closure of what structure? (Baja-Panlilio, Vol I pp. 8283)  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: (BajaPanlilio, 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 C. biophysical profile D. liver enzymes

79.

 A 35 year old, G6P5 (5005) on her 12 th 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.  A.

B.

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) 2 nd ed, Page 210) transverse longitudinal

C. cephalic D. breech 81.

The tracings showed that the fetus: (Baja-Panlilio, Chapter 21 pp. 237

6

 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: (Baja-Panlilio, Chapter 21 pp. 236  A. giving oxygen inhalation at 3-4 L/mins. B. infusion of intravenous fluids C. immediate termination of pregnancy D. placing patient at left lateral decubitus

83.

A 25 year old G1P0, 38-39 wks. AOG consulted at the emergency room due to labor pains. She has no prenatal check-ups and family history revealed diabetes mellitus in sister and mother. Abdominal exam revealed fundic height = 40 cm, uterine contractions every 2-3 mins, 45-50 secs. duration. Internal exam has remained unchanged at 6 cms dilated, fully effaced, station -2, cephalic, (-) BOW for the past 2 ½ hrs. The serious complication during vaginal delivery of this baby where there is arrest in delivery of the shoulder is: (BajaPanlilio, . 421-422) A. Shoulder dystocia B. Deep transverse of the head C. Erb’s palsy D. Prolonged second stage of labor 

84.

 A well-nourished patient on her third trimester of pregnancy has a Hemoglobin value of 10.5 gms/dl. This low value could be explained by: (Baja Panlilio 2 nd 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 2 nd 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) 2 nd 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)  A. Doppler velocimetry

7

B. C. D.

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

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, 4 th 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

102.

8

D.

Transvaginal ultrasound

103.

A 25 year old, G6P0 (0060) consulted at the emergency room due to postcoital bleeding x 3 months duration. She’s a victim of child prostitution. On pelvic exam, there was a 2 cm cauliflower – like lesion on the anterior lip of  the cervix. The vagina and parametria are smooth. What is the most appropriate diagnostic test? (Compre Gyne, p. 844)  A. pap smear  B. colposcopy with biopsy C. direct punch biopsy D. cone biopsy

104.

A 20 year old commercial sex worker presented at the clinic due to painful shallow ulcers in the vulva associated with burning sensation during urination. She also has multiple oral ulcers at the time of consultation. The most likely diagnosis is: (Compre Gyne, , Chapter 22, page 656) A. Herpes simplex infection B. granuloma inguinale C. Lymphogranuloma venereum D. Syphilis

105.

A 38 year old diabeteic patient presented at the clinic due to vaginal pruritus and whitish vaginal discharge. On examination, the vulva is beefy red in appearance with whitish curdled discharge. The most likely diagnosis is: (Compre Gyne, Chapter 22, page 669)  A. Trichomoniasis B. Candidiasis C. Bacterial vaginosis D. Mucopuruloent Cervicitis

106.

The presence of heavy concentration of coccobacilli surrounding vaginal epithelial cells with loss of distinct cell margins is the appearance of; (Compre Gyne, Chapter 22, page 671)  A. Donovan bodies B. Clue cells C. chancre D. inclusion cells

107.

A patient with chronic ulcers in the vulva had smears done taken from the ulcers. Findings shows presence of  dark staining bacteria with a bipolar appearance found in the cytoplasm of large mononuclear cells .These are diagnostic of ; (Compre Gyne, Chapter 22, page 660 A. Granuloma inguinale B. Lymphogranuloma venereum C. Chancroid D. Syphilis

108.

 A patient with painless vulvar ulcers came with a positive screening test for syphilis. Confirmatory test that should be done can either be any of the following except: (Compre Gyne, Chapter 22, page 664) A. RPR B. TPI C. FTA-ABS D. MHA-TP

109.

According to CDC, treatment of patients diagnosed with HIV includes the following except: (Compre Gyne Chapter 22, page 686)  A. behavioral B. psychosocial C. emotional D. medical

110.

A patient diagnosed with gonorrhea should: (Compre Gyne, Chapter 22, page 692)  A. be treated with Chloramphenicol B. also be treated for Chlamydia infection C. have follow-up cultures done for asymptomatic women D. not have serologic test for syphilis if cultures for gonorrhea are positive

111.

Linda, 65 year old, G7P7 came to your clinic complaining of vaginal itching with burning discomfort. This condition may be due to a decrease in what hormone? (Compre Gyne, p.1223)  A. LH B. progesterone C. estrogen D. FSH

112.

Linda, 18 year old, delivered an 8 lbs baby. There was note of laceration on the lateral wall off the vaginal vault with profuse vaginal bleeding. There was a sudden drop of BP. Post partum there was note of amenorrhea. Lab examination shows destruction of the pituitary gland. Linda has what syndrome? (Compre Gyne p. 1116)  A. Simmonds syndrome B. Sheehan’s syndrome C. Edward’s syndrome D. Asherman’s syndrome

113.

Factors promoting puerpueral infection include: A. prolonged rupture of membranes B. limited number of vaginal examination C. normal hemoglobin levels D. normal labor  Textbook of Obstetrics (Baja-Panlilio, et al), p. 517-8

9

114.

The fetal heart tones can be best heard in this area if the following were the Leopold’s findings: L1- large nodular mass L2 – hard, resistant structure at the right side of the mother  Small, irregular, mobile parts on the left side of the mother  L3 – movable hard round mass L4 – tips of the fingers able to meet A. right lower quadrant B. left lower quadrant C. right upper quadrant D. left upper quadrant Textbook of Obstetrics (Baja-Panlilio, et al), p. 122-123

115.

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

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  A. B. C. D.

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:

markedly increased by about 28 weeks gestation? fetal movement plasma volume amniotic fluid human chorionic gonadotropin

10

 A. B. C. D.

Just below the umbilicus Above the symphysis At the level of the symphysis 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. B. C. D.

128.

The relation of the point of direction to the right and left of the maternal birth canal is called:  A. B. C. D.

: dilatation of the cervix descent of the fetus increase in Braxton Hicks contractions expulsion of bloody show

presentation posture position station

129.

Which ligament is considered as the strongest support of the uterus?  A. Cardinal B. broad C. utero-sacral D. round

130.

Average duration of the first stage of labor in primigravidas:  A. 24 hours B. 12 hours C. 8 hours D. 5 hours

131.

Average duration of the third stage of labor among multiparous patients:  A. 5 minutes B. 20 minutes C. One hour   D. Two hours

132.

Milk ejection is the result A. B. C. D.

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:

of the action of: Oxytocin prolactin estrogen human placental lactogen

A. absence of basal hypertonus B. C. D. 138.

usually respond to sedation distorted gradient pressure absence of fundal dominance

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. C. D.

139.

emergency low transverse cesarian section emergency classical cesarian section internal podalic version with complete breech extraction

Significant oligohydramnios is defined as an amniotic fluid index of ____ cm. or less:

A. 20 B. C.

15 10

11

D. 140.

5

Patient with heart disease without any obstetrical indication are best delivered by:

A. cesarian section under general anesthesia B. C. D. 141.

normal spontaneous delivery under pudendal block outlet forceps extraction under epidural anesthesia cesarian section under epidural anesthesia

Which antihypertensive is NOT recommended during pregnancy?

A. methyl- dopa B. C. D.

ace inhibitors hydralazine 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. C. D. 144.

betamethasone is given at a dose of 12 mg. im every 24 hours X 2 doses it produces induction of fat cells that regulate fetal lunf maturity it affects biochemical systems within type II cells that produce surfactants

Complete expulsion of sperm stored in the reproductive tracr beyond the interrupted vas deferens takes about  _____ ejaculations:  A. 2 B. 10 C. 20 D. 30

145.

A form of gestational trophoblastic disease characterized by excessive trophoblastic proliferation and edema of  the villous stroma without excessive local invasion is: A. H. mole B. Invasive mole C. Choriocarcinoma D. Placental site trophoblastic tumor 

146.

Internal examination in cases of abruption placenta maybe done to determine:  A. location of placenta B. if bag of water has ruptured C. cervical dilatation D. All of the above

147.

In uterine atony, the source of bleeding is the:  A. uterine lacerations B. placental implantation site C. cervical lacerations D. myometrium

148.

What maneuver in shoulder dystocia involves flexing the maternal thighs on the abdomen?  A. B. C. D.

Woods Pinard Zavanelli 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:

12

 A. B. C. D.

polycystic ovaries failing ovarian function delayed,aynchronous hypothalamic maturation exogenous estrogen stimulation

155.

Most common cause of vaginal bleeding among postmenopausal women:  A. endometrial carcinoma B. endometrial hyperplasia C. endometrial polyp D. atrophic endometrium

156.

A woman with postmenopausal bleeding warrants: A. an endometrial biopsy B. observation and Pap’s smear yearly C. total hysterectomy D. total hysterectomy with bilateral salpingooophorectomy

157.

In Meig’s syndrome, the ovarian newgrowth is a: A. Fibroma B. mature teratoma C. immature teratoma D. cystadenoma

158.

Drug of choice for pregnant patients with Chlamydia infection:  A. Doxycycline B. azythromicin C. erythromycin D. ampicilin

159.

The so called tobacco pouch appearance of the fallopian tube is seen in:  A. gonorrhea infection with tubo ovarian abscess B. Chlamydia infenction with tubo ovarian abscess C. Pelvic tuberculos D. Old tubal ectopic gestation

160.

Type of endometrial hyperplasis which is mot likely to progress to endometrial carcinoma:

A. simple hyperplasis with atypia B. C. D.

cystic hyperplasia with atypia complex hyperplasia without atypia complex hyperplasia with atypia

161.

A post coital test is best done:  A. pre menstrual B. right after menses C. periovulatory period D. anytime during the cycle

162.

Hysterosalpingography is best done:  A. periovulatory period B. before menses C. after menses D. anytime during the cycle

163.

Which of the following Pap’s smear will definitely require colposcopic examination of the cervix:  A. AGUS B. ASCUS C. LSIL D. HSIL

164.

Which of the following is considered a precursor of cervical carcinoma:  A. Metaplasia B. dysplasia C. eversion D. severe eroisions

165.

Endometrial carcinoma is LEAST likely if endometrial thickness is:  A. 5 mm B. 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

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

29

355.

Which is an abnormal semen parameter?

A. white cell count of 10 5 per ml B.

sperm morphology 30 %

C. sperm count 40 x 10 6 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

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. penicil lin 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 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

30

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 29 th 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  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

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

31

C. D.

administer fluids and magnesium sulfate for uterine relaxation 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 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

32

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? 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

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

33

B. C. D.

anthropoid platypelloid 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

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 testsustained 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

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.

407.

 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 What maneuver will the fetal head undergo right after engagement?  A. internal rotation

34

B. C. D.

extension flexion descent MPL 0.5

p: 416

408.

What part of the uterus forms the lower uterine segment during labor?  A. external cervical os B. cornua C. fundus D. isthmus MPL 0.5 p: 21

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. amoxicil lin D. erythromycin MPL 0.5 p: 342

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

419.

Lochia serosa is expected to occur   A. immediately after birth

35