E2 Flashcards
1) Dysfunctional labor can lead to which complication? A. Septic pelvic thrombophlebitis B. Splenic crisis C. Pericardial effusion D. Rectovaginal fistula
Answer: D
2) Caesarean sections A. Cause abnormal placentation B. Reduce incidence of fetal tachypnea C. Decrease blood loss D. Lessen trauma to bowel and bladder
Answer: A
3) According to Friedman’s curve, descent disorders are diagnosed A. During the latent phase B. During the acceleration phase C. During the second stage of labor D. At any phase of labor
Answer: C
4) Progress of active labor is affected by A. Anesthetic B. Temperature C. Sedation D. Anxiety
Answer: A
5) The WHO partogram has which of the following as a feature A. Internal examinations every two hours B. Fetal blood gas determination C. Fetal heart rate D. Maternal VAS pain score
Answer: C
6) Abnormalities in the passenger that can cause obstructed labor A. Hydrocephalus B. Microsomia C. Arrhythmia D. Asphyxia
Answer: A
7) According to the Zhang study, active phase starts at a cervical dilatation of
A. 1 cm with adequate uterine contractions
B. 2 cm as long as membranes are ruptured
C. 3 cm with even with inadequate uterine contractions
D. 6 cm with adequate uterine contractions
Answer: D
8) The Catherine Spong paper on preventing the first Caesarean delivery requires which indication for abdominal delivery if no descent has occurred for:
A. 4 hours or more in nulliparous women without an epidural
B. 3 hours or more in nulliparous women without an epidural
C. 3 hours or more in multiparous women with an epidural
D. 2 hours or more in multiparous women without an epidural
Answer: B, C, D
Only A is wrong.
9) The goal of the revised dystocia diagnosis is to A. Increase the Caesarean section rate B. Promote breastfeeding C. Decrease neonatal asphyxia D. Decrease abnormal placentation
Answer: A
This should actually be decrease the Caesarean section rate. The increase in the Caesarean section rate is what lead to the revised dystocia diagnosis.
10) The following partograph shows which of the following features A. Precipitous labor B. Prolonged latent phase C. Protracted active phase D. Failure of descent
Answer: D
11) The patient with the following partograph has a curve following the solid line. A valid reason for immediate delivery at the 48th hour A. Prolonged latent phase B. Arrest of dilatation C. Uncontrolled hypertension D. Maternal dehydration
Answer: A
12) Follows the definition of failed induction
A. Ruptured membranes
B. Cervical dilatation improved from 1 cm to 4 cm
C. Contractions equal to 100 Montevideo units in 5 contractions
D. Oxytocin administered for at least 18 hours
Answer: A
13) Breech presentation is best delivered by
A. Abdominal route if the presentation is footling breech
B. Vaginal route regardless of position
C. Vaginal route if the baby is term
D. Abdominal route regardless of position
Answer: A
16) Lucia is a 35 y/o G2P2 (2002) known asthmatic who is taking oral and inhalational anti-asthma drugs. Which of the following statements is true?
A. Lucia should stop taking her medications
B. Lucia should start dieting and should not exercise to prevent abortion
C. Untreated asthma may give rise to poor maternal and fetal outcome
D. All of the above
Answer: C
17) Anti-asthma treatment in pregnancy is ____________ from non-pregnant
A. Different
B. Same
Answer: B
18) Which of the following is a correct pairing? A. Multivitamins - B B. Captopril - A C. Amoxicillin - B D. Isotretinoic acid - C
Answer: C
19) Which of the following is NOT TRUE? A. Lithium – cardiac defects B. Thalidomide – kemicterus C. Streptomycin – ototoxicity D. Captopril – renal dysgenesis
Answer: B
20) Period of development where exposure to toxicant may be lethal or have no effect at all A. Peri-implantation B. Organogenesis C. Fetal development D. All of the above
Answer: A
21) A 15 y/o primigravid on her 16th week of pregnancy noticed curd-like discharge on her underwear. She reports itchiness. Microscopy showed yeast infection. Treatment of choice: A. Oral oseltamivir B. Topical metronidazole C. Clotrimazole vaginal suppository D. Topical prednisolone
Answer: C
22) This hormone is responsible for decreasing gut motility in pregnancy thus affecting absorption A. Estrogen B. Progesterone C. Relaxin D. hCG
Answer: B
23) Changes that may affect drug distribution in a pregnant patient A. Decreased cardiac volume B. Decreased minute ventilation C. Increased glomerular filtration rate D. All of the above
Answer: C
24) FDA drug classification that reports pre-clinical and clinical safety in pregnancy (Category) A. A B. B C. C D. D
Answer: A
25) Anti-TB drug that is NOT safe in pregnancy A. Isoniazid B. Streptomycin C. Rifampicin D. Ethambutol
Answer: B
26) In prescribing drugs in pregnancy
A. Choose the older drug that has proven track record of safety
B. Prioritize pharmacologic therapy as complementary medicine has no role
C. Topical route of administration is always less efficacious
D. All of the above
Answer: A
27) All of the following drugs may be given for hypertension in pregnancy EXCEPT: A. Metropolol B. Atenolol C. Hydralazine D. Methyldopa
Answer: A
Beta blockers except Atenolol are harmful in pregnancy.
28) Phocomelia and Amelia are hallmark malformations caused by this agent: A. Lithium B. Fluoroquinolone C. Thalidomide D. None of the above
Answer: C
29) The fetal heart starts to beat at \_\_\_\_ weeks A. 2 B. 4 C. 6 D. 8
Answer: B
30) This drug is given to prevent neural tube defects A. Folic acid B. Ferrous sulfate C. Zinc D. Calcium
Answer: A
31) A 7 y/o patient was brought in by her mother for a gynecologic check-up. The mother noted a vulvar mass. On PE, there was note of a 3 x 3 cm reddish mass at the left labia majora. What is the mostly likely diagnosis? A. Hematoma B. Melanoma C. Hemangioma D. All of the above
Answer: C
32) In which of the following drugs of endometriosis is bone pains a common complaint? A. GnRH agonist B. Danazol C. DMPA D. Oral contraceptive
Answer: A
33) Which of the following must be included to make a histologic diagnosis of endometriosis
A. Atypical cells invading the myometrium
B. Presence of trophoblasts
C. Dysplastic cells at the bas
D. Presence of endometrial glands
Answer: D
34) A 30 y/o came in with an ultrasound finding of a cystic structure at the adnexal area measuring 3 x 4 x 3 cm. This was done on the 17th day of her cycle. What is the most likely diagnosis? A. Ovarian fibroma B. Corpus luteum cyst C. Serous cystadenocarcinoma D. Mucinous cystadenoma
Answer: B
35) What is the best management for a 16 y/o G0 patient who complains of a mass at the vulva? On PE, there was a note of a 2 x 2 cm movable, cystic, non-tender mass at the 7 o’clock position. A. Observe the mass B. Do excision C. Marsupialization D. Any of the above
Answer: D
36) A 30 y/o G2P2 (2002) amenorrheic for 6 weeks complained of severe hypogastric pains. Pregnancy test was not available. IE showed (+) cervical motion tenderness, (+) right adnexal tenderness, (+) right adnexal mass 3 x 3 cm. What is the diagnosis? A. Ruptured ectopic pregnancy B. Corpus luteum hemoprrhagcium C. Appendiceal abscess D. Any of the above
Answer: A
37) Which of the following myomas is heavy menstrual flow a prominent symptom? A. Parasitic B. Intraligamentary C. Intramural D. Submucous
Answer: D
38) The most common complication of a cystic teratomas is A. Infection B. Torsion C. Rupture D. Hemorrhage
Answer: B
39) A 38 y/o G3P3 (3003) complained of secondary dysmenorrhea. LMP August 25-31, 2010. Internal examination showed a corpus enlarged to 12-14 weeks AOG. Transvaginal scan showed a thickened myometrium with coarse echoes. What is the most likely diagnosis? A. Myoma B. Ovarian fibroma C. Endometrioma D. Adenomyosis
Answer: D
40) A 30 y/o complained of post coital bleeding. On speculum examination, a polypoid sessile mass measuring 1x1 cm attached at 12 o’clock position of the cervix was seen. What is the most probable diagnosis? A. Cervical cancer B. Nabothian cyst C. Endocervical polyp D. Cervical laceration
Answer: B
41) 68 y/o previously diagnosed with myoma consulted for rapid abdominal enlargement. She has postmenopausal bleeding 3 months ago. What is the most likely diagnosis? A. Endometrial carcinoma B. Myoma uteri C. Uterine sarcoma D. Ovarian carcinoma
Answer: C
Endometrial carcinoma won’t present with abdominal enlargement.
42) Established Screening test for ovarian cancer: A. Ultrasound B. CA-125 C. CEA D. None of the above
Answer: D
43) Permitted examinations in the staging of cervical cancer: A. Palpation B. Ultrasound C. Hysteroscopy D. Intravenous urography
Answer: A, C, D (dapat siguro may EXCEPT)
44) Endometrial carcinoma is primarily treated with surgery in the form of A. Simple hysteroscopy B. Total hysterectomy C. Extrafascial hysterectomy D. Radical hysterectomy
Answer: C
45) Most common malignant tumor of the ovary: A. Dysgerminoma B. Immature cystic teratoma C. Mucinous cystadenocarcinoma D. Granulosa cell tumor
Answer: A
46) Most common histology of endometrial carcinoma A. Serous B. Mucinous C. Endometrioid D. Clear cell
Answer: C
47) The following factors increases the risk for ovarian epithelial cancers EXCEPT: A. Age B. Family History C. Infertility D. Pregnancy
Answer: C
48) The following gynecologic malignancies have precursor lesions EXCEPT: A. Ovarian B. Cervical C. Endometrial D. Vaginal
Answer: D
49) Greatest relative risk for endometrial carcinoma A. PCOS B. Diabetes melitus C. Obesity D. Atypical hyperplasia
Answer: D
50) The most common histology of cervical carcinoma A. Small cell B. Clear cell C. Squamous cell D. Adenocarcinoma
Answer: C
51) A 28 y/o G2P2 patient was brought to the OBAS for profuse vaginal bleeding after delivering to an 8-pound baby at home, assisted by a midwife. On abdominal examination, the uterus was well contracted. What is the most probable diagnosis? A. Uterine atony B. Retained placental fragments C. Perineal lacerations D. Uterine invasion
Answer: C
52) What is included in the active management of the third stage of labor?
A. Administration of uterotonics after the delivery of the placenta
B. Late cord clamping
C. Controlled cord traction
D. Insertion of rectal misoprostol
Answer: C
53) What will be an advantage in doing amniotomy in a patient whom you suspect in having Abruptio placenta?
A. It will ensure vaginal delivery
B. It can be diagnostic of Abruptio placenta
C. It can decrease the incidence of Couvelaíre uterus
D. It will restore function of the part of the placenta that is still implanted
Answer: B
54) A 30 y/o G2P1 patient on her 30th week AOG consulted the OBAS for complaint of vaginal bleeding noted upon waking up. She has had no prenatal check-ups. Vital signs are within normal and bleeding has ceased but there was note of irregular uterine contractions. What is the most probable diagnosis? A. Placenta Previa B. Abruptio placenta C. Placenta Accreta D. Vasa Previa
Answer: A
55) In the patient in #54, what will you request to verify your diagnosis most accurately? A. Transvaginal ultrasound B. Pelvic ultrasound C. CT Scan D. MRI
Answer: A
56) What will be the most appropriate management for the above patient in #54?
A. Immediate Cesarean section
B. Give tocolytics and antenatal steroids
C. Do Cesarean Section after you have completed the antenatal sounds
D. Augment labor and do vaginal delivery
Answer: B
57) A G1 patient who has just been delivered at the recovery room complained of severe pain in the vaginal area. Her vital signs are normal and there was no note of undue vaginal bleeding. What will be your primary consideration? A. Retained placental fragments B. Uterine atony C. Vaginal hematoma D. Uterine rupture
Answer: C
58) Among these patients, who will be at highest risk of having Placenta Accreta?
A. A G2 patient who underwent a Cesarean Section for her first pregnancy last year.
B. A G1 patient diagnosed to have placenta previa and preeclampsia.
C. A G3 patient with 2 previous Cesarean section with an ultrasound of placenta previa.
D. A G5 patient with Chronic hypertensive vascular disease.
Answer: C
Presence of placenta previa, previous C-sections, and higher gravida are risk factors for placenta accrete.
59) What will be a feature of dehiscence of uterine scar vs. a complete rupture?
A. Intact fetal membrane
B. Fetus in the abdominal cavity
C. Separation of the whole length of the uterine scar
D. Finding of a contracted uterus alongside palpable fetal parts
Answer: A
60) What findings will be suggestive of uterine rupture?
A. Tetanic uterine contractions
B. Note of bloody mucoid discharge at the onset of labor
C. Loss of presenting part on internal exam previously noted to be at station +1
D. Arrest in cervical dilatation at 5 cm dilatation
Answer: C
Fetus will be found in the abdominal cavity in uterine rupture.
61) Conditions during immediate postpartum period that may necessitate drug therapy includes the following EXCEPT: A. Uterine atony B. Eclampsia C. Infections D. None of the above
Answer: B
Eclampsia resolves through birth.
62) A 32 y/o G3P2 patient on her 32nd week AOG consulted the OBAS for complaint of painful uterine contractions. She is a known hypertensive and has not been compliant with her medications. She is pale and BP on admission was 180/100. FHT is low at 110/min and uterine contractions are noted to be strong and frequent. There is no note of vaginal bleeding. What is the most likely diagnosis? A. Placenta Previa B. Placenta Accreta C. Abruptio placenta D. Vasa Previa
Answer: C
Abruptio placenta may not present with bleeding if concealed. Preeclampsia and chronic hypertension are risk factors.
63) A 35 y/o G4P3 patient on her 33rd week AOG who had 3 previous Cesarean sections consulted you at the clinic with an ultrasound showing placenta previa totalis. She wanted to find out what else she should be worried about since she was told that a Cesarean section is inevitable and that was really the type of delivery she was expecting anyway. What will be your advise?
A. Placenta can still “migrate” upwards since she is only 33 weeks.
B. Repeat Cesarean section at 39 weeks AOG
C. Repeat imaging to rule out the possibility of Placenta Accreta
D. Await labor and do repeat Cesarean Section
Answer: C
64) What will be a risk factor for Abruptio Placenta? A. Oligohydramnios B. Prematurity C. Abdominal trauma D. Congenital anomalies
Answer: C
75) The most common cause for indicated premature delivery A. Abruptio placenta B. Diabetes mellitus C. Preeclampsia D. Fetal growth restriction
Answer: C
76) Postterm pregnancy refers to:
A. Gestation beyond the expected date of delivery as calculated by Naegele’s rule
B. Gestation > 42 weeks from the first day of the last menstrual period
C. Gestation after 292 days from the first day of last menstrual period
D. Gestation on the 42nd week from the first day of the last menstrual period
Answer: B
77) Management of postterm pregnancy includes the following EXCEPT A. Early amniotomy B. Expectant management C. Induction of labor D. Caesarean section
Answer: A
78) Mechanism through which betamethasone reduces hyaline membrane disease A. Increased prostaglandin production B. Delays premature birth C. Increased surfactant production D. Increased cytokine production
Answer: C
79) Which of the following is NOT associated with increased perinatal morbidity/mortality in postterm pregnancies: A. Meconium aspiration B. Fetal growth restriction C. Down syndrome D. Oligohydramnios
Answer: C
80) Mechanism through which magnesium sulfate controls premature labor A. Calcium antagonist B. Blocks cyclic AMP C. Increases intracellular calcium D. Stimulates beta-receptors
Answer: A
81) A monochorionic diamnionic placenta implies A. Monozygosity B. Dizygosity C. Fraternal twins D. Not related to zygosity
Answer: A
82) The main cause for blood pressure elevation seen in pregnancy induced hypertension is
A. increase in peripheral vascular resistance
B. increase in cardiac output
C. alterations in vascular sensitivity to endogenous hormones
D. increased production of prostacyclin and thromboxane A2
Answer: A
83) Several antihypertensive drugs have been used in the treatment of preeclampsia. All of the following may be given EXCEPT A. Beta blockers B. Calcium channel blockers C. Vasodilators D. ACE inhibitors
Answer: D
85) The definitive treatment of eclampsia consists of the following EXCEPT
A. Control of convulsions
B. Assuring ventilation and correction of hypoxia and acidosis
C. Control of blood pressure to a diastolic of 60-90 mmHg
D. Expeditious delivery of the fetus and placenta
Answer: B
86) How is the pathophysiology of preeclampsia characterized? A. Vasodilation B. Vasospasm C. Hemodilution D. Hyperuricemia
Answer: B
87) The diagnosis of superimposed preeclampsia is NOT likely in the following findings
A. Hypertension and no proteinuria prior to 20 weeks gestation
B. New onset proteinuria
C. Thrombocytopenia
D. Increase in blood pressure
Answer:
All these are characteristics of superimposed preeclampsia. Maybe the choices included E. NOTA
88) The most frequent symptom preceding eclampsia is A. headache B. hyperreflexia C. proteinuria D. visual signs
Answer: C
89) A 35 year old consulted for headache on her 14th week AOG. BP was noted to be 150/100. The corpus was enlarged to AOG with fetal heart rate of 160 BPM. Urine albumin was +3. Diagnosis?
A. Preeclampsia mild
B. Preeclampsia severe
C. Chronic hypertension with superimposed preeclampsia
D. Chronic hypertension
Answer: C
90) The pathognomonic microscopic finding in renal biopsy among women with preeclampsia A. Fibrinogen deposits B. Glomerular capillary endotheliosis C. Glomerular edema D. Renal capsular edema
Answer: B
91) The following are true of methyldopa EXCEPT
A. Causes drowsiness
B. Central acting anti-adrenergic agent
C. Incompatible with breastfeeding
D. Crosses the placenta and achieves fetal concentrations
Answer: B
92) Certain medical disorders and conditions in pregnancy predispose a patient to preeclampsia and these include the following EXCEPT A. Multiple gestation B. Fetal hydrops C. Hydatidiform mole D. Cardiac disease
Answer: D
The first three have excess trophoblasts which is the problem in preeclampsia.
93) What is the magnesium level necessary to prevent convulsions? A. 1-3 mEq/L B. 4-7 mEq/L C. 8-10 mEq/L D. 10-12 mEq/L
Answer: B
94) High risk factors for gestational diabetes mellitus A. Hypertension B. Prior baby weighing 2500 grams C. Family history of diabetes D. BMI of 25
Answer: C
