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LU5 COMPRE > OB GYNE > Flashcards

OB GYNE Flashcards

1
Q

A 35 year old G2P1 (1001) 28 weeks AOG with chronic hypertension has a fundic height of 25
cm. Which biometric measurement is the most helpful in monitoring fetal growth?
A. Biparietal diameter
B. Femur length
C. Abdominal circumference
D. Head circumference

A

C
This correlates with the timing of the biometry (during the second trimester), and the purpose of
monitoring fetal growth and NOT fetal age

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2
Q

A 19 year old G1 came in at 32 weeks AOG with BP of 160/120. Previous BP were in the
range of 100-140/60-80. PE was essentially normal. Abdominal examination shows FH 22 cm,
EFW 0.4-0.6 kg, FHT 150s/RLQ. Lab examinations show the following:
Hb 111 mg/dl, Hct 0.7, platelet 98 000, AST 372 U/L, ALT 555 U/L, LDH 1080 U/L, creatinine 1.1
mg/dl, BUN 17 mg/dl. Urinalysis shows +1 protein, internal examination shows her cervix to be 1
cm dilated, intact membranes and presenting part at station -2. CTG showed a category 1 trace.
What is the appropriate management?
A. Tocolytic therapy with MgSO4 and delivery at 34 weeks
B. Emergency Cesarean delivery after control of hypertension
C. Delivery after corticosteroid administration
D. Expectant management

A

C
D is out since our patient is already preeclamptic with severe features. We just have to determine
how urgent the situation is. A is too conservative since the patient is already showing signs of
HELLP syndrome and 2 weeks is a long time to have the patient remain in this state. Between B
and C, C is more helpful to the baby since at 32 weeks fetal lung maturation is still lacking

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3
Q

What is the daily elemental iron requirement (in mg) in a 20 year old G1P0 23 weeks AOG with
hemoglobin of 12.5 gm/dl, hematocrit 0.35, MCV 97?
A. 15
B. 30
C. 60
D. 120

A

B

Patient is a healthy primigravid. Go for the recommended dose of 27 mg/day, rounded up to 30.

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4
Q

A 30 year old G1P0 with a twin pregnancy at 24 weeks AOG has a hemoglobin of 10 gm/dl.
How much daily iron (in mg) should she receive?
A. 30
B. 60
C. 90
D. 120

A

B

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5
Q 
Which of the following fetal heart rate features is the earliest reliable sign of fetal compromise?
A. Fetal tachycardia
B. Loss of FHR variability
C. Absence of FHR accelerations
D. Presence of late decelerations
A

B

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6
Q

A pale and weak-looking 12 year old was brought to the ER because of menstrual bleeding of
7 days. She narrates the same pattern of flow since menarche, associated with easy bruisability
and gum bleeding. What is the probable cause of abnormal vaginal bleeding?
A. Dysfunctional uterine bleeding
B. Pregnancy-related
C. Reproductive tract disease
D. Blood dyscrasia

A

D – the easy bruisability and gum bleeding are clinchers, pointing to a more systemic
cause

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7
Q 
In a 20 year old G1P0 40 weeks AOG with AFI=4.0, which test will best predict the fetal
capability to tolerate labor?
A. Non-stress test (NST)
B. Biophysical profile (BPP)
C. Umbilical artery Doppler velocimetry
D. Contraction stress test (CST)
A

D – this test determines uteroplacental sufficiency. The presence of late decelerations
following 50% or more of contractions is a positive (that is abnormal) CST.

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8
Q 
What is the minimum pressure in mmHg of uterine contractions required to dilate the cervix
during labor?
A. 5
B. 15
C. 25
D. 35
A

B

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9
Q 
Which of the following statements suggests midpelvic contraction?
A. Transverse diameter is 10.5 cm
B. Sacral curvature is hollow
C. Pelvic side walls are parallel
D. Sacrosciatic notch is narrow
A

D
A is still within normal. I’m not sure what a “hollow” curvature is but if that means that it’s deep,
then that’s good for vaginal delivery. Parallel or divergent pelvic side walls are also good.

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10
Q

MR 34 year old G1P0 PU 8 weeks went to the ER today because of palpitation. She said that
despite her good appetite, she is not gaining weight. She also finds it difficult to sleep at night.
You noticed a 4 x 5 cm anterior neck mass. She has finger tremors and her eyes are bulging.
What of the following laboratory tests is expected to reveal decreased result at this time?
A. TRH
B. FT4
C. TSH
D. FT3

A

C
She has signs and symptoms of hyperthyroidism. Expected labs are increased FT4/FT3 and
decreased TSH.

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11
Q

To arrive at the diagnosis of hyperthyroidism, what result of the thyroid function tests are
expected?
A. Elevated TSH, elevated FT4 and FT3
B. Decreased TSH, elevated FT4 and FT3
C. Elevated TSH, decreased FT4 and FT3
D. Decreased TSH and TRH, decreased FT4 and FT3

A

B

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12
Q 
Which among the antero-posterior diameters is clinically measurable by pelvic examination?
A. Obstetric conjugate
B. True conjugate
C. Conjugate vera
D. Diagonal conjugate
A

D
Measured from the sacral promontory to the inferior margin of the pubic symphisis, the diagonal
conjugate is used to estimate the obstetric conjugate which is of clinical importance.

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13
Q

What is the presentation when the portion of the fetal head between the orbital ridge and the
anterior fontanel presents at the pelvic inlet?
A. Brow
B. Mentum
C. Sinciput
D. Occiput

A

A

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14
Q

A 30 year old G3P2 (2002) 28 3/7 weeks by LMP came in for prenatal visit. Her findings are
unremarkable. When will you advise her to follow up?
A. After 1 week
B. After 2 weeks
C. After 1 month
D. After 4 days

A

B
OB normal case of every 4 weeks until 28 weeks,
every 2 weeks until 36 weeks, then weekly thereafter.

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15
Q

A 22 year old G1P0 on her 10th week AOG came in for prenatal visit. Her course is
unremarkable with no history of neural tube defects. She inquires about which supplements she
has to take daily during her pregnancy. You advise her
A. Not to take anything as a well-balanced diet will provide the RDA she needs
B. 500 mg calcium and 27 mg iron
C. 400 ug folic acid and 27 mg iron
D. 500 mg calcium, 27 mg iron, and 4 mg folic acid

A

C
0.4 mg folic acid and 27 mg iron are the recommended nutritional supplementation for a pregnant
woman without risk factors. If the risk of neural tube defects is increased, 4 mg folic acid is
recommended. Actually Williams doesn’t recommend active calcium supplementation but the
residents seem to give it anyway.

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16
Q

A 19 year old primigravid came in at the OBAS with vaginal bleeding. Her amenorrhea is 12
weeks. On pelvic examination, the cervix is open and the corpus is 8 wks size. Your diagnosis is:
A. Incomplete abortion
B. Completed abortion
C. Threatened abortion
D. Septic abortion

A

A
Because the corpus is still enlarged to 8 weeks, it’s likely that there are retained products of
conception. Conversely, the abortion isn’t just threatened since the corpus is smaller than
expected. There is no mention of instrumentation or signs such as fever that may point to septic
abortion.

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17
Q 
Which of the following is the most significant risk factor for postpartum endometritis?
A. Cesarean section
B. Internal uterine pressure monitor
C. Multiple internal examinations
D. Prolonged rupture of membranes
A

A
See chapter 37 on puerperial complications in Williams. B to D are also risk factors, but are
particularly associated with CS (as in women who underwent CS have increased risk for
endometritis when B to D are present in the course of their labor and delivery). Other independent
risk factors include low socioeconomic status, GA, CS for multifetal gestation, young maternal
age and nulliparity, prolonged labor induction, obesity, and meconium-stained amnionic fluid.

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18
Q 
A 25 year old postpartum develops breast engorgement, pain, and whitish nipple discharge.
What is the appropriate management?
A. Amoxicillin
B. Nystatin
C. Paracetamol
D. Bromocriptine
A

C

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19
Q

A 4 cm vaginal hematoma was diagnosed three hours postpartum in a 30 year old G1P1
(1001). The patient has stable vital signs, no pallor, and complains of bearable pain. What is the
management?
A. Close observation
B. Tranexamic acid
C. Vaginal pack
D. Ligation of bleeders

A

D

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20
Q 
A G1P0 42 5/7 weeks AOG BPS 10/10, IE 1 cm 80% effaced, anterior, soft, station 0. What is
the management?
A. Expectant
B. Cervical ripening
C. Induction of labor
D. Cesarean section
A

C

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21
Q 
What is the most accurate predictor of preterm birth?
A. Cervical length
B. Cervical funneling
C. Salivary estriol
D. Fetal fibronectin
A

A

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22
Q

A 19 year old G1P0 admitted for eclampsia had a second episode of generalized tonic-clonic
seizures. She already received the complete loading dose of magnesium sulfate. Which of the
following is the most appropriate treatment?
A. Diazepam 5 mg
B. Lorazepam 10 mg
C. Magnesium sulfate 2 g
D. Phenytoin 50 mg

A

C

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23
Q

A 35 year old G2P1 at 21 weeks AOG with 75 g OGTT values (mmol/L): fasting 5.2, 1st hour
11.5, 2nd hour 8.0. What is the diagnosis?
A. Negative for DM
B. Impaired glucose tolerance
C. Pregestational diabetes
D. Gestational diabetes

A

D

You need at least 2 out of the 3 values to be abnormal to diagnose GDM.

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24
Q

A 20 year old G1P0 24 weeks AOG with tachycardia, hypertension, lid lag, anterior neck
mass, and weight loss. What is the best treatment?
A. Propylthiouracil
B. Methimazole
C. Radioiodine
D. Beta-blocker

A

A

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25
Q

A 24 year old G1P1 (1001) presents with tender, erythematous, engorged right breast 2
weeks postpartum. Temp 38.9 C. What is the first line of treatment?
A. Cefuroxime
B. Azithromycin
C. Cloxacillin
D. Co-trimoxazole

A

C
Classic presentation of mastitis. Go for cloxacillin, the antibiotic of choice for soft tissue and skin
infections.

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26
Q

A 19 year old G1P0 at 41 weeks AOG wants to have an immediate CS because her parents
think she is overdue. As the ICC in charge (hahaha what a joke) what would you advise?
A. Immediate delivery
B. Contraction stress test
C. BPP to assess fetal status
D. Wait one week before intervention

A

C

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27
Q

The following best describes non-stress test (NST):
A. It is reactive if two or more accelerations are present in a period of twenty minutes
B. It is a test of uteroplacental function
C. If there are insufficient fetal accelerations, it predicts fetal compromise
D. It is performed once weekly in high risk pregnancies

A

A

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28
Q

An 18 year old primigravid at 39 weeks AOG is sent to labor and delivery room for induction
of labor secondary to preeclampsia. She had an uncomplicated prenatal course until yesterday,
when she began to feel like she had the flu. On evaluation at a prenatal visit today, her BP was
150/100, with 2+ proteinuria. Examination reveals her cervix to be 3 cm dilated and 75% effaced.
After initial evaluation in the labor and delivery room, induction of labor is begun with oxytocin and
IV magnesium sulfate is started. For which of the following reasons is the magnesium sulfate
given to this patient?
A. To control hypertension
B. To control proteinuria
C. To prevent hemorrhage
D. To prevent seizures

A

D – mag sulfate is both therapeutic and prophylactic for ecclamptic seizures

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29
Q

A G1P0 38 weeks AOG with watery vaginal discharge for 3 hours, with irregular hypogastric
pains. Vital signs normal, afebrile, FH 32 cm, FHT 150/min. Speculum exam, pooling of clear
fluid. IE closed, 50% effaced, station -1. What is the management?
A. Antibiotics
B. Cervical ripening agent
C. Induction of labor
D. Cesarean section

A

C

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30
Q

A 34 year old G3P2 (2002) presented with vaginal bleeding on her 29th week AOG. No uterine
contractions. Good FHTs. What is the next BEST step?
A. Speculum examination
B. Careful internal examination
C. Transvaginal ultrasound
D. Abdominal ultrasound

A

A

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31
Q

A G1P0 35 weeks AOG came in with watery vaginal discharge of 8 hours duration with labor
pains for 2 hours. Normal vital signs, afebrile. FH 32 cm, FHT 150/min. Speculum reveals pooling
of clear fluid. IE 2 cm, 50% effaced, cephalic, station -1. What is the initial management?
A. Dexamethasone
B. Ampicillin
C. Oxytocin drip
D. Prostaglandin

A

B

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32
Q

A 22 year old G1P1 (1001) delivered vaginally 30 minutes ago. She had moderate to profuse
vaginal bleeding with a 16 week-sized firm uterus. What is the most probable clinical diagnosis?
A. Retained blood clots
B. Blood dyscrasia
C. Genital tract laceration
D. Uterine rupture

A

C

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33
Q

A 36 year old G4P3 (3003) previous 3 ceserean sections in second stage of labor for 2.5
hours with FH 38 cm, FHT 140, cephalic, station 0, suddenly presents with severe abdominal
pain and vaginal bleeding, FHT is 110, station -3. What is the diagnosis?
A. Abruptio placenta
B. Uterine rupture
C. Placenta previa
D. Vasa previa

A

B

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34
Q 
What diagnostic test is best done in a patient who is 3 weeks postpartum with profuse vaginal
bleeding and a uterine size of 12 weeks?
A. Serum beta HCG
B. Blood coagulation studies
C. Transvaginal ultrasound
D. MRI
A

C

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35
Q 
What is the physiologic increase in plasma volume in liters (L) during a normal pregnancy?
A. 0.5 to 1.0
B. 1.5 to 2.0
C. 2.5 to 3.0
D. 3.5 to 4.0
A

B

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36
Q 
At which age of gestation (in weeks) is the fetus at highest risk for acquiring congenital
varicella?
A. Before 13
B. 13 to 20
C. 21 to 28
D. Beyond 28
A

B

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37
Q 
In which period of pregnancy is vertical transmission of HIV highest?
A. Antepartum
B. Intrapartum
C. Postpartum
D. Lactation
A

B

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38
Q

A 19 year old G1P0 10 weeks AOG presents with cough, hemoptysis, night sweats, with (+)
sputum AFB. What is the recommended treatment?
A. Isoniazid, rifampicin
B. Isoniazid, rifampicin, streptomycin
C. Isoniazid, rifampicin, ethambutol
D. Isoniazid, rifampicin, ethambutol, pyrazinamide

A

C

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39
Q

A 22 year old G1P0 32 weeks AOG presents with mild epigastric pain BP 160/110.
Subsequent evaluation revealed the following: Hgb 11 gm/dl, platelet 60000, RBS 120 mg/dl, 1.0
mg/dl, creatinine 1.0 mg/dl, serum AST 240 IU/L, total bilirubin 1.4 mg/dl, LDH 650 IU/L, urine
albumin (+++). What is the diagnosis?
A. Acute fatty liver
B. Hemolytic uremic syndrome
C. HELLP syndrome
D. Thrombotic thrombocytopenic purpura

A

C

40
Q

A 4 year old child has recurrent purulent bloody foul discharge which would temporarily
resolve with antibiotics. What is the diagnosis?
A. Bacterial vulvovaginitis
B. Foreign body
C. Parasitism
D. Tumor

A

B

41
Q

Which of the following tests is confirmatory for syphilis?
A. Culture and sensitivity
B. Fluorescent treponemal antibody absorption (FTA-ABS)
C. Rapid plasma reagin (RPR) test
D. Venereal disease research laboratories (VDRL)

A

B

42
Q

A 35 year old complains of “fishy odor” vaginal discharge with burning sensation on urination.
Cervix is normal. What diagnostic test should be done?
A. Pap smear
B. Wet mount
C. KOH
D. Culture

A

B

43
Q

An 18 year sexually active [woman] complains of three week history of vulvar itch. Vulva,
vagina, and cervix are erythematous with yellowish, frothy foul discharge with pH of 6.5. What
findings will be seen on wet mount?
A. Epithelial cells covered with bacteria
B. Branching hyphae
C. Flagellated motile organisms
D. Multinucleated giant cells

A

C

44
Q

A patient with dyspareunia presents with hyperemia of the vulva and vagina and adherent
thick white discharge. What is the expected microscopic finding?
A. Donovan bodies
B. Gram-negative rods
C. Clue cells
D. Hyphae

A

D

45
Q

A patient seeks consult for a genital ulcer that started as a painless papule 3 weeks ago. PE
revealed 1.5 cm vulvar ulcer with raised indurated margin, non-tender, (-) exudate, with bilateral
inguinal lymphadenopathy. What is the management?
A. Acyclovir
B. Azithromycin
C. Benzathine penicillin G
D. Doxycycline

A

C

46
Q

A 38 year old G3P3 (3003) complains of increasingly painful and heavy periods. PE reveals
slightly enlarged, tender uterus. What is the diagnosis?
A. Adenomyosis
B. Submucous myoma
C. Endometriosis
D. Pelvic inflammatory disease

A

A
Adenomyosis is the likely diagnosis because of the tender, enlarged uterus. A submucous
myoma is not usually painful. Endometriosis is painful, but this pain is not due to a tender uterus
and may be more visceral. PID is more usually associated with cervical motion tenderness

47
Q 
What is the origin of most neoplastic ovarian masses found among children?
A. Epithelium
B. Gonadal stroma
C. Germ cell
D. Sex cord
A

C

48
Q 
What is the most common complication of a 10 cm cystic ovarian tumor during the 1st
trimester of pregnancy?
A. Rupture
B. Intracystic bleed
C. Torsion
D. Luteinization
A

C

49
Q 
Which of the following findings will need colposcopy?
A. Squamous metaplasia
B. ASC-H
C. Cauliflower-like cervical lesion
D. Strawberry cervix
A

B

50
Q 
Where should the cervical biopsy be taken after the application of 3% acetic acid and Lugol’s
iodine solutions respectively?
A. White epithelium; yellowish stain
B. White epithelium; dark brown stain
C. Pink epithelium; yellowish stain
D. Pink epithelium; dark brown stain
A

A

Acetowhitening and the lack of staining with Lugol’s indicates an abnormal area needing biopsy.

51
Q

A 47 year old G4P4 brought a colposcopy-guided cervical and endocervical biopsy report
which showed “CIN III with endocervical gland extension, cannot rule out invasive cancer.” What
should be the next step?
A. Repeat biopsy after 4 months
B. Multiple punch biopsies
C. Cone biopsy
D. Hysterectomy

A

C

52
Q 
Which age group (in years) will benefit most from HPV vaccination for cervical cancer
prevention?
A. 9-17
B. 18-29
C. 30-45
D. 45-60
A

A

53
Q 
Where are the atypical cells located in CIN II?
A. Superficial 2/3 of epithelium
B. Lower 2/3 of epithelium
C. Superficial 2/3 of dermis
D. Lower 2/3 of dermis
A

B

54
Q

A 60 year old G1P1 with post-menopausal bleeding was found to have thickened
endometrium and a predominantly solid ovarian mass. What is the likely nature of the adnexal
mass?
A. Functional and physiologic
B. Epithelial
C. Germ cell
D. Sex cord stromal

A

D

55
Q

A 16 year old with a unilateral ovarian mass has an elevated serum alpha feto-protein. Aside
from PFC and infracolic omentectomy, what is the management?
A. Oophorocystectomy
B. Oophorectomy
C. Salpingooophorectomy
D. THBSO

A

C

56
Q 
In a 4 year old girl, which is the best position to identify injuries of the hymen, vestibule, and
fossa navicularis?
A. Frog leg
B. Modified frog leg
C. Knee chest
D. Dorsal lithotomy
A

C

57
Q

A 15 year old complained of disturbing breast pain which occurs one week prior to her
menses and disappears after. Which of the following is recommended?
A. Education and reassurance
B. Reduce caffeine and soda intake
C. Vitamin E
D. Analgesics

A

A

58
Q

A 29 year old G2P1 (1011) consulted because of amenorrhea for 8 months duration. BMI 28,
BP 120/80, with acne on the face and back. Pelvic examination is normal. Cytohormonal
evaluation maturation index = 0/40/60. What is the diagnosis?
A. Primary ovarian insufficiency
B. Sheehan’s syndrome
C. PCOS
D. Cushing’s syndrome

A

C

59
Q

A 28 year old G0 married for 2 years had ultrasound revealing anovulatory cycles for 3
consecutive months. The hysterosalpingogram, hysteroscopy, laparoscopy are all normal. Semen
analysis is normal. What is the initial drug of choice?
A. Clomiphene citrate
B. GnRH
C. Pure FSH
D. Combined OCP

A

A

60
Q

A 15 year old came in due to heavy menstrual bleeding for 2 months, with irregular menses
since menarche. PE (+) acne, normal findings for age. What is the treatment of choice?
A. Tranexamic acid
B. Combined OCPs
C. NSAID
D. Progesterone

A

B

61
Q 
Which of the following is TRUE of hormonal assay in menopausal transition?
A. Increased FSH
B. Normal LH
C. Increased inhibin
D. Increased estradiol
A

A

LH may be increased, inhibin and estradiol would be decreased.

62
Q

A 38 year old G2P2 consulted with an endometrial biopsy result of complex hyperplasia with
atypia. A TAH was recommended but the patient wanted conservative management. What ethical
principle is applicable in this case?
A. Beneficence
B. Maleficence
C. Autonomy
D. Double effect

A

C

63
Q

A 25 year old primigravida on her 30th week AOG had convulsions, with BP 170/110 and
strong uterine contractions every 1-2 minutes, 50 seconds duration, FHT 90/min. IE: cervix
closed, long. An emergency CS was recommended. What ethical principle is applicable in this
case?
A. Beneficence
B. Maleficence (NOT non-maleficence, hindi ‘yan typo)
C. Autonomy
D. Double effect

A

D

64
Q

Which of the following statements about the bladder function is TRUE?
A. The normal post void residual urine should be less than 50 ml
B. The first urge to void in office cystometry occurs when the bladder is filled with 100 ml of saline
C. The maximal functional capacity of the bladder is at 600-800 ml
D. The daily bladder diary is an effective tool in diagnosing stress incontinence

A

A

65
Q 
A 17 year old sexually active patient is asking what is the best form of contraception for her?
A. Combined OCP
B. Withdrawal
C. Condom
D. Injectable progestin
A

A

66
Q

A couple wishes to use natural family planning. The woman’s periods are regular, occurring
every 28 to 30 days. When will be her fertile days?
A. 7-12
B. 10-19
C. 12-17
D. 17-19

A

B
Using the rhythm method, you determine the woman’s fertile period during which she should
avoid intercourse by subtracting 11 from her longest cycle and 18 from her shortest cycle.

67
Q

A G3P2 consults because of an enlarging abdomen. She has been amenorrheic since
delivery 7 months ago. On abdominal examination, uterine fundus cannot be appreciated
because of thick abdominal wall but fetal heart tones are audible on the RLQ. Patient claims fetal
movement a week ago. What is the estimated AOG in weeks?
A. 12
B. 18
C. 24
D. 30

A

B
Fetal movement is felt during 16-18 weeks AOG for multigravida and 18-20 weeks AOG for
primigravida.

68
Q 
A 22 year old primigravid recently lost her 7 week pregnancy. What is the most likely cause of
abortion?
A. Maternal age
B. Chromosomal abnormalities
C. Stress
D. Undiagnosed maternal infection
A

B
In Williams, 55% of abortuses and stillbirths during the 1st trimester have chromosomal
abnormalities. This decreases to 35% and 5% during the 2nd and 3rd trimesters respectively

69
Q

A 24 year old on her 16th week AOG comes for her regular prenatal check up. PE is
unremarkable. Routine urinalysis showed sp. gr. 1.020, pH 6.5, transparent, hazy, color yellow,
albumin trace, sugar negative, pus cells 10-15 hpf, moderate bacteria. What is the most likely
diagnosis?
A. Acute pyelopnephritis
B. Acute urethritis
C. Acute glomerulonephritis
D. Asymptomatic bacteriuria

A

D

70
Q 
In an 8 week primigravid with a family history of diabetes, when should the initial screening be
done?
A. First visit
B. 16-20 weeks
C. 24-28 weeks
D. 30-34 weeks
A

A

71
Q

What is the purpose of the fetal head flexion in the course of labor?
A. So that the fetal chin comes in contact with the fetal chest
B. So that the fronto-occipital diameter will present
C. So that the suboccipitobregmatic diameter will present
D. This is when the fetal head reaches the pelvic floor

A

C

72
Q 
What is the most common position of the fetal head as it enters the pelvis?
A. Right occiput transverse
B. Left occiput transverse
C. Right occiput posterior
D. Left occiput posterior
A

B

73
Q

32 year old G4P3 (3003) 37-38 weeks AOG comes in labor. FH 30 cm, FHT 140 bpm, IE
shows cervix fully dilated, station +3, LSA. What is the most appropriate maneuver for the
delivery of the after coming head?
A. Bracht
B. Zavarelli
C. Mauriceau
D. Prague

A

C

74
Q 
A 38 year old G2P2 consults for abnormal vaginal bleeding of 8 days duration. What is the
first diagnostic test?
A. Paps smear
B. Pregnancy test
C. CT, BT, prothrombin time
D. Endometrial biopsy
A

B

75
Q

Which of the following is included in the guidelines of Essentials of Intrapartum and Newborn
Care (EINC)?
A. Administer oxytocin once the baby’s head is delivered
B. Suprapubic pressure to prevent uterine inversion
C. Tug on the umbilical cord to hasten placental separation
D. Administer ergonovine maleate once the placenta has been delivered

A

A

76
Q

A 21 year old G1P1 presents to the OPD for her yearly well woman examination. She had an
uncomplicated vaginal delivery last year. She has been sexually active for the past 4 years and
has had six different sexual partners. Her menses occur every 28 days and lasts for 4 days. She
denies any intermenstrual spotting, postcoital bleeding, or vaginal discharge. She denies tobacco,
alcohol, or illicit drug use. Which of the following are appropriate screening tests for this patient?
A. Pap test
B. Pap test and gonorrhea and chlamydia cervical cultures
C. Pap test and herpes simplex cultures
D. Pap test and hemoglobin level assessment

A

B

77
Q

According to the local cervical cancer screening recommendations, who among these women
will NO longer require Pap Test?
A. 23 year old single previously but not currently sexually active
B. 35 year old s/p TH for myoma uteri with previous negative Pap tests
C. 65 year old recently remarried previous negative Pap tests
D. 70 year old with history of HSIL

A

B

78
Q 
What is the best time to perform breast self-examination?
A. Any day of the menstrual cycle
B. Before expected menses
C. Mid cycle
D. Right after menses
A

D

79
Q

JA 29 year old G1P0 consulted due to amenorrhea of 8 weeks. She started to feel
hypogastric pain 4 weeks prior to consult. On IE, she has normal external genitalia, nulliparous
vagina, cervix is closed with no adnexal masses nor tenderness corpus enlarged to 6-8 weeks
size. What is your impression?
A. Threatened abortion
B. Missed abortion
C. Incomplete abortion
D. Completed abortion

A

A

80
Q 
On transvaginal ultrasound there was a fetal pole with no cardiac activity. What is your
diagnosis?
A. Threatened abortion
B. Missed abortion
C. Incomplete abortion
D. Completed abortion
A

B

81
Q

A 27 year old G3P2 (2002) who is 34 weeks AOG calls the OBAS on a Saturday night at 10
PM complaining of decreased fetal movement. She says that for the past several hours, her baby
has moved only once per hour. She is healthy, has had regular prenatal care, and denies any
complications so far during the pregnancy. How should the on-call physician counsel the patient?

A

Instruct the patient to go to OBAS for a nonstress test

82
Q

A 35 year old G5P4 (4004), currently at 34 weeks AOG, who came in at the OBAS with
profuse and painless vaginal bleeding. Vital signs reveal BP 90/50, HR 125, RR 25. What is the
most likely diagnosis?

A

Placenta previa

83
Q

Your patient is a 44 year old G4P4 with symptomatic uterine fibroids that are unresponsive to
medical therapy. The patient has severe menorrhagia to the point that when she menstruates,
she cannot leave the house. You recommend to her that she undergo a total abdominal
hysterectomy. You counsel her that she may need a blood transfusion if she has a large blood
loss during the surgical procedure. Her current hematocrit is 25.0. The patient is a Jehovah’s
Witness who adamantly refuses to have a blood transfusion, even if it results in her death. What
bioethical principle is at stake?

A

Justice

84
Q

The patient requests that you do not talk at all to her husband about her medical care. This
request falls under which of the following ethical concepts?

A

Confidentiality

85
Q

20 year old G1 at 41 weeks has been pushing for 2.5 hours. The fetal head is at the
introitus and beginning to crown. It is necessary to cut an episiotomy. The tear extends through
the sphincter of the rectum, but the rectal mucosa is intact. How should you classify this type of
laceration?

A

Third degree
1st degree lacerations involve only the vaginal mucosa, 2nd degree involves muscles of the
perineal body, 3rd degree involves the anal sphincter, 4th degree involves the rectal mucosa

86
Q

To get the best yield, what tool/s should you use in doing your Pap Smear?

A

Aylesbury spatula combined with endocervical brush OR Ayre’s spatula combined with
endocervical brush

87
Q

Crops of vesiculo-papular painful vulvar lesions were observed in a 21 year old student after
the Labor Day weekend in Boracay. What is the most likely diagnosis?

A

Herpes genitalis

88
Q

A 39 year old G5P5 complained of post-coital bleeding. Speculum exam showed a 2x3 cm
necrotic and fungating mass at the anterior cervical lip. Corpus is small with no adnexal mass or
tenderness. You will do a:

A

Punch biopsy

89
Q

48 year old nullipara complains of HMB of 6 months duration. Patient’s height is 60 inches
and she weighs 150 lbs. PE: cervix is smooth with scanty bleeding from cervical os, uterus not
enlarged, adnexa negative. The definitive office diagnostic examination should be:

A

Endometrial biopsy

90
Q

What is presenting in the pelvis transverse presentation?

A

Acromion

91
Q

At 28 weeks of pregnancy, labor contractions set in but were controlled by tocolysis. What
medication must be given to the mother to assist in fetal lung maturation?

A

Glucocorticoids

92
Q

A 32 year old G3P3 presents for routine gynecologic check-up. Pap smear showed LSIL.
What is the preferred next step?

A

Colposcopy or colposcopy with biopsy

93
Q

A 30 year old G6P6 comes for a recurrent vulvar mass first noted 2 years ago for which
antibiotics were given. Inspection revealed a 3 x 2 cm erythematous fluctuant and tender mass
lateral to the vaginal opening at the 4 o clock position. What is the diagnosis?

A

Bartholin’s Gland abscess

94
Q

A 25 year old G1 at 37 weeks presents to LR/DR with gross rupture of membranes. The fluid
is noted to be clear and the patient is noted to have regular contractions every 2 to 3 minutes
lasting for 60 seconds each. The fetal heart tracing is reactive. On cervical examination she is
noted to be 4 cm dilated, 90% effaced with the presenting part at -3 station. The presenting part is
soft and felt to be the fetal buttock. A quick bedside ultrasound reveals a breech presentation with
both hips flexed and knees extended. What type of breech presentation is described?

A

Frank

95
Q

Active management of third stage of labor for ALL women (name 2)

A

Oxytocin administration
Controlled cord traction
Uterine massage after delivery of the
placenta to keep the uterus contracted

96
Q

97) No menses during 7 days following 21 day cycle of correct use
98) Pill forgotten for 1 day
99) Pill forgotten for 3 continuous days
100) Light bleeding at midcycle during first month on pill

A

97) Continue pills as usual
98) Take an additional pill
99) Continue pills and use an additional form of contraception
100) Continue pills as usual

LU5 COMPRE (5 decks)

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