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Obstetrics & Gynecology Reviewer > OB Gyne Final Exam > Flashcards

OB Gyne Final Exam Flashcards

1
Q

Which of the following is the correct flow of blood from the uterine wall to the endometrium?

A

A. Uterine artery àarcuate artery àradial arteryà straight & coiled spiral artery

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2
Q

What is the functional life span of the corpus luteum?

A

B. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 daysB. 14 + 2 days

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3
Q

What hormone is secreted by the dominant ovarian follicle?

A

C. estradiol

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4
Q

During the embryonic period, where is the formation of blood first demonstrable?

A

B. yolk sac

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5
Q

During the secretory phase, what is the uppermost layer from the uterine cavity ?

A

A. Zona compacta

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6
Q

What stage of human development is implanted in the uterine cavity?

A

C. blastocyst

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7
Q

How many new primary oocytes are there during puberty?

A

A. 0

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8
Q

What is the important event that occurs prior to implantation?

A

D. Disappearance of the zona pellucida

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9
Q

At what phase does regresson of the corpus luteum occur?

A

C. During menstruation

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10
Q

A 34 year old G4P4 delivered vaginally an 8 lb baby at home assisted by a hilot. The placenta was delivered without difficulty. However, a few minutes later, there was profuse vaginal bleeding and the patient wa rushed to the hospital. In the ER, the patient was hypotensive, tachycardic and pale. On abdominal examination, the uterine fundus was soft and above the umbilicus. There were no vaginal or cervical lacerations. What is the most probable diagnosis?

A

D. uterine atony

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11
Q

A 33 year old G3P2 PU 18 weeks consulted at the ER because of watery vaginal discharge accompanied by hypogastric pain. Vital signs were normal. Speculum exam revealed pooling of watery discharge. I.E. revealed an open cervix, palpable fetal parts at the os, uterus enlarged to 18 weeks AOG. What is the most probable diagnosis?

A

C. Inevitable abortion

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12
Q

At what part of the fallopian tube does tubal rupture occur earliest?

A

C. Isthmic

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13
Q

What is the most commonly associated condition for abruption placenta?

A

B. Pregnancy- induced hypertension

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14
Q

Which of the following transvaginal utrasonographic cervical findings correlate positively with preterm delivery?

A

B. funneling

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15
Q

Preterm infant is an infant who is:

A

C. less than 37 weeks AOG

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16
Q

A 35 year old G1P0 had an infertility work-up fro which she was prescribed clomiphene citrate. She got pregnant and was diagnosed to have twin pregnancy. What is the most probable type of twinning?

A

B. Dizygotic

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17
Q

Which of the following is the most important parameter in the assessment of patient in true labor?

A

B. cervical dilatation and effacement

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18
Q

The level of the presenting part in the birth canal described in relationship to the ischial spines, which is halfway between the pelvic inlet and the pelvic outlet is called

A

D. station

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19
Q

The characteristic curve pattern of cervical dilatation in a normal labor is described as:

A

B. sigmoidal

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20
Q

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

A

B. Protracted cervical dilatation

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21
Q

What phase of the active labor reflects the feto-pelvic relationship?

A

D. deceleration phase

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22
Q

A 19 year old G1P0 PU 40 weeks, not in labor, was seen at the OPD for decreased fetal movement. She was hooked to an electronic fetal monitor and tracing showed: Baseline FHT- 140’s, good variability, with more than 2 accelerations of 20 bpm lasting for 20 secs. The tracing is interpreted as:

A

A. reactive

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23
Q

Fetal tachycardia is defined as a baseline heart rate greater than:

A

C. 160 bpm

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24
Q

What is the presentation type when the fetal head is artially flexed with the anterior fontanel or bregma is presenting?

A

D. sinciput

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25
Q

You were the intern on duty in the ER and you did an abdominal exam on a 22 year old G2P1 PU 37 weeks who consulted because of hypogastic pain. You found out that the fundus is occupied by a hard ballotable mass. What Leopold’s maneuver did you perform?

A

A. LM 1

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26
Q

There is an increase in the size of cardiac silhouette in X-ray during pregnancy because the heart is displaced to the:

A

A. left and upward

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27
Q

During pregnancy, the diaphragm rises by

A

B. 4 cm

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28
Q

Impaired gall bladder contraction during pregnancy is due to

A

C. progesterone

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29
Q

Naegele’s rule is use to estimate the expected date of delivery by ____.

A

D. adding 7 days to the first day of LMP and count back 3 months

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30
Q

Which of the following is proven teratogen?

A

A. Vitamin A derivatives

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31
Q

Which of the following vaccines is contraindicated during pregnancy?

A

D. Mumps, measles, rubella

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32
Q

The preferred method for the delivery of the aftercoming head is

A

B. Mauriceau-Smellie-Veit Manuever

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33
Q

You were assigned to deliver the baby of a 25 year old G1P0 PU 38 weeks. You applied the forceps on the fetal head with the following findings: head was at station +2 with the sagittal suture at left occiput anterior position. This is classified as

A

B. low forceps delivery

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34
Q

A 22 year old G1P0 patient at 39 weeks AOG was admitted for elective Cesarean Section for breech presentation. She requested to her obstetrician that a transverse suprapubic abdominal incision be done to her. This type of incision is called

A

C. Pfannensteil

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35
Q

Which of the following is one of the requirements that must be present before obstetric forceps must be used?

A

D. The cervix must be fully dilated and retracted

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36
Q

The single most significant risk factor in the development of post-partum pelvic infection is

A

C. Cesarean delivery

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37
Q

The process by which the uterus returns to its normal size, tone and position after delivery is called

A

A. involution

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38
Q

What is the mechanism behind the increase in cardiac output right after delivery?

A

D. autotransfusion

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39
Q

Congenital rubella syndrome is more likely common during which AOG?

A

A. 8-10 weeks

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40
Q

What is the diagnostic procedure of choice for identifying gallstones in pregnancy?

A

C. Ultrasound

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41
Q

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

D. combined oral contraceptives

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42
Q

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

C. Perform an transvaginal ultrasound

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43
Q

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

C. cervical stenosis

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44
Q

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

C. High dose estrogen

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45
Q

The most common cause of DUB in the premenarcheal and postmenopausal woman is _____.

A

B. Anovulartory

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46
Q

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

B. Sheehan’s syndrome

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47
Q

Menometrorrhagia is defined as:

A

B. Prolonged uterine bleeding at irregular intervals

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48
Q

Which of the following statements is true of DUB?

A

B. There is continuous estrogen production without corpus luteum formation

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49
Q

The most common histologic type of vaginal cancer is:

A

A. Squamous carcinoma

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50
Q

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

C. Excision biopsy of the mass

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51
Q

The area of the cervix that is most prone to precancerous and cancerous neoplasms is the:

A

B. Transformation zone

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52
Q

Which of the following HPV Types is associated with high oncogenic potential?

A

D. HPV Type 18

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53
Q

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

C. submucous myoma

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54
Q

A 68 year old woman has a biopsy result of atypical complex hyperplasia. What is the most appropriate treatment for her?

A

D. Perform TAHBSO

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55
Q

This granulose-theca cell tumor has this characteristic inclusion body.

A

B. Call-Exner bodies

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56
Q

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

C. Do transcervical resection of the myoma

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57
Q

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. How will you manage the patient?

A

C. Reevaluate the patient at 6-month interval to determine the rate of growth

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58
Q

This is the diagnostic procedure of choice for endometrial cancer.

A

D. Fractional D&C

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59
Q

This is the drug of choice for syphilis.

A

D. Parenteral Penicillin G

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60
Q

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

D. Genital herpes

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61
Q

What are the most important goals of the medical therapy of acute PID?

A

D. resolution of symptoms and preservation of tubal function

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62
Q

This occurs when increased intraabdominal pressure is not transmitted equally to the bladder and the functional urethra.

A

C. genuine stress incontinence

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63
Q

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

A

B. overflow incontinence

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64
Q

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

C. secondary infertility

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65
Q

The first drug to offer in women with anovulation is

A

D. clomiphene citrate

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66
Q

The most common cause of tubal/peritoneal factors of infertility is

A

C. PID

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67
Q

Among the factors causing female infertility, the easiest to diagnose and manage is

A

C. ovulatory factors

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68
Q

An absolute contraindication to hormone replacement therapy is:

A

A. Thromboembolic disease

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69
Q

Over the counter pregnancy test kits will test for which placental hormone? ((Baja-Panlilio Chapter 6, p. 64)

A

D. human chorionic gonadotropin

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70
Q

Mefenamic acid taken by pregnant women may result in the closure of what structure? (Baja-Panlilio, Vol I pp. 82-83)

A

C. ductus arteriosus

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71
Q

Hydroureter during pregnancy is more marked on the right than on the left because of: (Baja panlilio Chapter 8 Page 107)

A

B. dextrorotation of the uterus

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72
Q

In which of the following are relatively low levels of hCG detected in maternal blood? (Baja Panlilio Chapter 6 page 64)

A

D. Impending abortion

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73
Q

The majority of spontaneous abortions are due to: (Baja-Panlilio, Chapter 27, p. 317)

A

C. chromosomal defects

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74
Q

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

D. salpingitis

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75
Q

The best basis for the diagnosis of Preterm Labor in this patient is the presence of: (Baja Panlilio Chapter 37 , page 355)

A

D. cervical dilatation and effacement

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76
Q

A blood pressure of 160/110 mmhg. Proteinuria of 4 gm/day, with elevated liver enzymes is classified as: (Baja-Panlilio, Chapter 35 p 231)

A

B. preeclampsia severe

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77
Q

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

B. doppler velocimetry

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78
Q

A 35 year old, G6P5 (5005) on her 12th week of pregnancy was diagnosed on ultrasound to have an h-mole. What will be the management for this case? ((Baja-Panlilio, Chapter 30, p. 350)

A

D. hysterectomy, followed by prophylactic chemotherapy

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79
Q

When the long axis of the fetus parallels the longitudinal axis of the uterus, the lie of the fetus is called: (Panlilio, Textbook of Obstetrics (Pathologic and Physiologic) 2nd ed, Page 210)

A

B. longitudinal

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80
Q

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

A

B. has a late deceleration

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81
Q

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

C. immediate termination of pregnancy

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82
Q

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: (Baja-Panlilio, . 421-422)

A

A. Shoulder dystocia

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83
Q

A well-nourished patient on her third trimester of pregnancy has a Hemoglobin value of 10.5 gms/dl. This low value could be explained by: (Baja Panlilio 2nd Ed Chapter 8 page 112)

A

B. increase in blood volume

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84
Q

Iron supplementation during pregnancy is mandatory because of: (Baja Panlilio 2nd Ed Chapter 8 page 112)

A

C. increased demand by the increased production of RBCs

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85
Q

Pregnancy is said to be a diabetogenic state because of: (Baja Panlilio 2nd Ed Chapter 8 page 114)

A

D. increased insulin resistance

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86
Q

An increase in the following hormone is an indication of Thyrotoxicosis during pregnancy: (Baja Panlilio 2nd Ed Chapter 54 page 595

A

A. free Thyroxine hormone

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87
Q

A puerpera came for her postnatal follow up 2 weeks after an uncomplicated vaginal delivery. The following are expected findings on her physical examination: (Panlilio, Textbook of Obstetrics (Pathologic and Physiologic) 2nd ed, Pages 295-298)

A

B. lochia alba

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88
Q

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

B. foul smelling lochia and tender uterus

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89
Q

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

C. fundoscopy

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90
Q

The monitoring done to detect increased severity of preeclampsia is: (Baja-Panlilio, Chapter 35, p. 336)

A

C. serum uric acid

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91
Q

The most common pathophysiologic mechanism in perimenopausal bleeding is: (Compre Gyne, 1082)

A

C. anovulation

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92
Q

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

C. dysfunctional uterine bleeding

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93
Q

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

D. Transvaginal Ultrasound

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94
Q

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

A. follicular cyst

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95
Q

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

C. foreign body in the vagina

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96
Q

A mother is concerned with the appearance of whitish, non puritic vaginal discharge on her 11 year old child noted since 8 month preceding menarche. It is best to; (Comprehensive Gynecology, 4th ed, page 276)

A

D. reassure the mother and the child that the discharge is normal

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97
Q

The most frequent symptoms of endometrial hyperplasia is: (Compre Gyne, p. 870)

A

B. abnormal vaginal bleeding

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98
Q

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

B. Submucous myoma

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99
Q

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

B. Endometrium

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100
Q

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

C. III

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101
Q

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

C. Fractional curettage

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102
Q

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

C. direct punch biopsy

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103
Q

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

A. Herpes simplex infection

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104
Q

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

B. Candidiasis

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105
Q

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

B. Clue cells

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106
Q

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

A. Granuloma inguinale

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107
Q

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

A. RPR

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108
Q

According to CDC, treatment of patients diagnosed with HIV includes the following except: (Compre Gyne Chapter 22, page 686)

A

C. emotional

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109
Q

A patient diagnosed with gonorrhea should: (Compre Gyne, Chapter 22, page 692)

A

B. also be treated for Chlamydia infection

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110
Q

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

C. estrogen

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111
Q

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

B. Sheehan’s syndrome

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112
Q

Factors promoting puerpueral infection include:

A

A. prolonged rupture of membranes

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113
Q

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

A. right lower quadrant

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114
Q

The patient with abnormal uterine bleeding is a:

A

B. 41 y.o. whose menses last 8 to 10 days

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115
Q

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

C. IIIB

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116
Q

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

C. IC

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117
Q

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

B. trichomoniasis

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118
Q

The main arterial blood supply of the uterus is a branch of :

A

D. hypogastric artery

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119
Q

The uterus is derived from the:

A

C. Mullerian duct

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120
Q

The violaceous discoloration of the vagina during pregnancy is called:

A

C. Chadwick’s sign

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121
Q

Which of the following is markedly increased by about 28 weeks gestation?

A

B. plasma volume

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122
Q

This maneuver is done to promote extension of the fetal head:

A

C. Ritgen’s maneuver

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123
Q

One of the following is a presumptive sign of pregnancy:

A

C. violaceous vaginal mucosa

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124
Q

The fundus of the uterus is at this level at 12 weeks gestation:

A

B. Above the symphysis

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125
Q

During the second and third trimester, daily caloric intake should be increased by:

A

B. 300

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126
Q

Lightening is the result of :

A

B. descent of the fetus

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127
Q

The relation of the point of direction to the right and left of the maternal birth canal is called:

A

C. position

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128
Q

Which ligament is considered as the strongest support of the uterus?

A

C. utero-sacral

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129
Q

Average duration of the first stage of labor in primigravidas:

A

C. 8 hours

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130
Q

Average duration of the third stage of labor among multiparous patients:

A

B. 20 minutes

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131
Q

Milk ejection is the result of the action of:

A

A. Oxytocin

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132
Q

Complete anesthesia for abdominal delivery necessitates a block from:

A

C. T8 to S1

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133
Q

The motor pathways to the uterus leaves the spinal cord at the level of:

A

B. T7T8

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134
Q

Phase 0 of parturition is characterized by:

A

A. uterine tranquility

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135
Q

Secondary arrest of cervical dilatation is cessation of cervical dilatation for:

A

B. two hours or more

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136
Q

TRUE of hypertonic uterine contractions EXCEPT:

A

A. absence of basal hypertonus

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137
Q

Method of delivery in a 19 year old primigravid patient, 39 weeks pregnant, transverse lie in labor:

A

C. emergency classical cesarian section

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138
Q

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

A

D. 5

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139
Q

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

A

C. outlet forceps extraction under epidural anesthesia

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140
Q

Which antihypertensive is NOT recommended during pregnancy?

A

B. ace inhibitors

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141
Q

The following are beta agonist tocolytic agents EXCEPT:

A

C. indomethacin

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142
Q

Which of the following is NOT true in the use of corticosteroids in premature labor?

A

C. it produces induction of fat cells that regulate fetal lunf maturity

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143
Q

Complete expulsion of sperm stored in the reproductive tracr beyond the interrupted vas deferens takes about _____ ejaculations:

A

C. 20

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144
Q

A form of gestational trophoblastic disease characterized by excessive trophoblastic proliferation and edema of the villous stroma without excessive local invasion is:

A

A. H. mole

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145
Q

Internal examination in cases of abruption placenta maybe done to determine:

A

C. cervical dilatation

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146
Q

In uterine atony, the source of bleeding is the:

A

B. placental implantation site

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147
Q

What maneuver in shoulder dystocia involves flexing the maternal thighs on the abdomen?

A

D. McRoberts

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148
Q

A woman using the oral contraceptive pills for the first time should be advised to start taking it :

A

A. on day 1 of menses

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149
Q

Management of choice for procidentia uteri in a 60 year old multiparous patient with marked cystorectocoele:

A

C. vaginal hysterectomy with anterior-posterior repair

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150
Q

The following are characteristics of Rokitansky syndrome EXCEPT:

A

C. normal uterus

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151
Q

The following are congenital anomalies of the mullerian duct EXCEPT:

A

A. imperforate hymen

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152
Q

The so called psammoma bodies are found in:

A

A. serous cystadenoma

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153
Q

Abnormal uterine bleeding during the pubertal and perimenarcheal period is due to:

A

C. delayed,aynchronous hypothalamic maturation

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154
Q

Most common cause of vaginal bleeding among postmenopausal women:

A

D. atrophic endometrium

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155
Q

A woman with postmenopausal bleeding warrants:

A

A. an endometrial biopsy

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156
Q

In Meig’s syndrome, the ovarian newgrowth is a:

A

A. Fibroma

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157
Q

Drug of choice for pregnant patients with Chlamydia infection:

A

C. erythromycin

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158
Q

The so called tobacco pouch appearance of the fallopian tube is seen in:

A

C. Pelvic tuberculos

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159
Q

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

A

D. complex hyperplasia with atypia

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160
Q

A post coital test is best done:

A

C. periovulatory period

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161
Q

Hysterosalpingography is best done:

A

C. after menses

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162
Q

Which of the following Pap’s smear will definitely require colposcopic examination of the cervix:

A

D. HSIL

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163
Q

Which of the following is considered a precursor of cervical carcinoma:

A

B. dysplasia

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164
Q

Endometrial carcinoma is LEAST likely if endometrial thickness is:

A

B. <5mm

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165
Q

Cystocele and rectocele occur because of weakness of the (ANS: C page 44)

A

C. endopelvic fascia

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166
Q

The sequence of events leading to menstruation (ANS: C page 106)

A

C. decrease in endometrial thickness, coiling of the arteries, vasoconstriction, vasodilatation, menses

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167
Q

Thromboxane differs from prostacyclin in that it (ANS: A page 89-90)

A

A. causes vasoconstriction

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168
Q

A main action prostaglandin 2a (PGF2a) is ( ANS: C page 89-90)

A

C. bronchoconstriction

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169
Q

A Pap smear is likely to identify all the following except (ANS: B page 150-151)

A

B. gonorrhea

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170
Q

Examination of a 3-year-old reveals labial adhesion. The child is able to void without difficulty. One should initially recommend (ANS: A page 278)

A

A. topical estrogen

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171
Q

The major mechanism of DMPA, which accounts for its contraceptive effect, is the (ANS: A page 327)

A

A. inhibition of the midcycle gonadotropin surge

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172
Q

The most commonly encountered cancer of the breast (ANS: D page 383)

A

D. ductal infiltrating carcinoma

173
Q

Fibrocystic breast change is characterized by (ANS: B page 364)

A

B. diffuse bilateral findings

174
Q

A 52-year-old woman has persistent, unilateral, spontaneous bloody nipple discharge and a cluster of microcalcifications identified by xeroradiography to be 3 cm deep under the nipple of the left breast. The next step in her management should be (ANS: B page 429-430)

A

B. repeat mammography in 3 months

175
Q

The greatest lifetime risk of breast cancer is associated with a(an) (ANS: C page 430)

A

C. history of oral contraceptive use longer than 10 years

176
Q

Anitiphospholipid antibodies have been found in the circulation of women with (ANS: A page 425-426)

A

A. recurrent abortions

177
Q

The most consistent symptom of ectopic pregnancy is (ANS: D page 456)

A

D. abdominal pain

178
Q

A morbidly obese woman undergoes preoperative evaluation for adenocarcinoma of the endometrium. Because of the high risk associated with an abdominal procedure, vaginal surgery is being considered. What tumor marker may be of help in her condition? (ANS D page 934-935)

A

D. CA-125

179
Q

The cell origin of the most common type of ovarian neoplasm is (ANS B page 958)

A

B. epithelial cells

180
Q

The most common cause of direct maternal deaths in the Philippines: (ANS: A p.4)

A

A. Hemorrhage

181
Q

Most perinatal deaths are due to the following maternal factors: (ANS: A p.8)

A

A. Premature labor

182
Q

The placental circulation (feto-maternal) is established by this day after fertilization (ANS: D p.57)

A

D. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th dayD. 17th day

183
Q

The greatest concentration of hCG in human plasma/urine is found in this age of gestation: (ANS: A p.63)

A

A. 8-10 weeks

184
Q

This maneuver of Leopold is often called the umbilical grip and answers the question, “What side is the fetal back?” (ANS: B p.122)

A

B. second maneuver

185
Q

“Triple screen” as a diagnostic tool for the detection fof Down’s syndrome utilizes the following except: (ANS: D p.153)

A

D. human placental lactogen

186
Q

The earliest access to the prenatal diagnosis of heritable conditions is provided for by this technique: (ANS: B p.154)

A

B. chorion villus sampling

187
Q

Relation of the long axis of the fetus to the long axis of the mother; (ANS: C p.183)

A

C. lie

188
Q

A 28 y/o at 32 weeks age of gestation consults at a clinic. She had one set of twins both are alive and she had an abortion. Her OB code is:

A

B. G3P1(1012)

189
Q

The most common cause of arrest disorders in labor is:

A

A. CPD

190
Q

What is the maneuver were the index and middle fingers are applied over the maxilla in order to free the head?

A

D.Mauriceau

191
Q

The following anti-TB drugs can be given in pregnancy except:

A

B. pyrazinamide

192
Q

The most common cause of direct maternal deaths in the Philipppines is: (p. 4)

A

A. Hemorrhage

193
Q

Glucose transfer from the mother to the fetus is through: (p.110)

A

A. Facilitated diffusion

194
Q

The “fern” formation of dried cervical mucus is due to the effect of: (p.116)

A

B. Estrogen

195
Q

“Quickening” refers to: (p.114)

A

B. Perception of first movement by the mother

196
Q

When is the earliest time that can hCG be detected in maternal urine after implantation? (p.116)

A

C. 8- 9 days

197
Q

A woman who has had three consecutive abortions and no other pregnancies is called: (p.119)

A

A. Nullipara

198
Q

At what age of gestation should screening for glucose be done in a pregnant woman: (P. 125)

A

B. 24-28 wks

199
Q

The Biophysical Profile represents all of the following EXCEPT: (p.162)

A

B. Indirect measurement of fetal oxygenation

200
Q

The fetus is described as complete breech presentation as: (p 185)

A

A. Legs and thighs are flexed

201
Q

Cervical softening and ripening is brought about by: (p. 196)

A

A. Collagen breakdown and rearrangement

202
Q

The following characterize uterine changes during phase 2 of parturition: (p. 199)

A

A. The uterus is divided into an actively contracting upper part and a relatively passive lower segment

203
Q

The most ominous sign of fetal compromise: (p. 237)

A

B. Late deceleration

204
Q

Failure to maintain temperature regulation in the newborn may lead to one or all of the following: (p. 246)

A

A. Peripheral vasoconstriction / B. Hypoxia / C. Acidosis / D. All of the above

205
Q

Puerperium lasts for how many weeks: (p. 251)

A

C. 6 wks

206
Q

What is the average maternal weight loss immediately after delivery? (p. 254)

A

B. 5 kg

207
Q

The lochia consisting of servical mucus and debris from healing tissues and leucocytes, lighter yellow and creamy in color: (p. 254)

A

B. Alba

208
Q

The advantage/s of home delivery is/are: (p. 259)

A

A. Emotional support from family / B. Less expensive / C. Less tendency for nosocomial infections / D. All of the above

209
Q

This refers to 3 or more consecutive spontaneous abortions: (p. 274)

A

C. habitual abortion

210
Q

The implantation of a fertilized ovum outside the endometrium lining the uterine cavity is called: (p. 279)

A

A. Eccyesis

211
Q

Most ectopic pregnancies are found in the: (p. 279)

A

B. Tube

212
Q

The triad of symptoms of ectopic pregnancy are: (p. 282)

A

D. Amenorrhea, abdominal pain and vaginal bleeding

213
Q

The mechanism of preterm labor in chorioamnionitis is: (p. 294)

A

B. Increased prostaglandin synthesis

214
Q

HELLP Syndrome is the pnemonic for: (p. 332)

A

B. Hemolysis, elevated liver enzymes, low platelet count

215
Q

The anticonvulsant of choice control of convulsion secondary to pregnancy-induced hypertension is: (p. 339)

A

C. Magnesium sulfate

216
Q

Toxicity of magnesium sulfate therapy may be monitored using: (p. 339)

A

D. All of the above

217
Q

The most common cause of maternal morbidity in hypertensive disease of pregnancy is: (p. 342)

A

A. Cerebrovascular accidents

218
Q

In case of discordant twins resulting from “twin to twin transfusion”, the smaller twin usually presents with: (p. 348)

A

A. Severe anemia / B. Growth retardation / C. Oligohydramnios / D. All of the above

219
Q

The fetal mortality rate in multifetal pregnancy is highest in: (p. 348)

A

C. Monozygotic, monochorionic, monoamnionic

220
Q

A pregnancy is considered portterm if it lasts longer than: (p. 363)

A

D. 294 days

221
Q

The most common cause of respiratory distress syndrome (RDS) in the preterm neonate is: (p. 395)

A

A. Hyaline Membrane Disease

222
Q

What antenatal procedure is used to detect fetal lung maturity? (p. 395-396)

A

B. Amniocentesis

223
Q

In breech presentation, engagement is considered to have occurred when this has passed the pelvic inlet: (p. 434)

A

B. Bitrochanteric diameter

224
Q

Which is considered an indication for internal podalic version: (p. 445)

A

B. Delivery of second of twins

225
Q

A carefully monitored trial of labor may be undertaken in normal term pregnancies with average infants following a previous Cesarean section performed for the following indications, EXCEPT: (p. 458-459)

A

C. Contracted pelvis

226
Q

Cesarean hysterectomy may be indicated as a lifesaving measure in cases of postpartum hemorrhage due to: (p.462)

A

D. Uterine atony

227
Q

Postpartum hemorrhage is blood loss during the first 24 hours after delivery in excess of : (p.465)

A

C. 500 cc

228
Q

The following are viral infections known to be related to congenital infection syndromes, EXCEPT: (p. 524-525, 533)

A

C. Toxoplasmosis

229
Q

What is the daily minimum requirement for elemental iron in pregnancy? (p. 561)

A

A. 4-6 mg

230
Q

The principal cause of thrombocytopenia in pregnancy is: (p. 564)

A

D. Pre-eclampsia, eclampsia

231
Q

A primigravid patient at 28 weeks AOG came in due to hypogastric and lumbosacral pain. On physical examination uterine contraction was noted occurring every 5 to 10 minutes. I.E.: cervix is noted to be 1 cm dilated, 50% effaced, intact bag of water. Which of the following is a β-adrenergic receptor stimulant that can be used to inhibit preterm labor in this patient?

A

A. Isoxsuprine HCL

232
Q

This is the most critical issue in the management of postterm pregnancies? (page 431)

A

B. Confirmation of gestational age

233
Q

In all growth-restricted fetuses, which of the following biometric parameters will be the first to show discrepancy in measurement? (page 438)

A

C. Abdominal circumference

234
Q

In a patient with monozygotic twinning, if cell division occurs about 8 days after fertilization, what type of twinning will develop?

A

A. Monoamnionic, monochorionic twin pregnancy

235
Q

A patient at 38 weeks AOG came in labor. I.E. cervix is 5 cm dilated, 50% effaced, intact BOW, cephalic, station -3. Clinical pelvimetry shows the ischial spine is bilaterally prominent, pelvic sidewalls are convergent and concavity of the sacrum is shallow. With these findings, you suspect the presence of:

A

B. Midpelvic contraction

236
Q

When the fetal head is fully flexed, the chin lies in front of the chest and the presenting anteroposterior diameter is suboccipitobregmamtic. What type of presentation is this?

A

A. Vertex (occiput) presentation

237
Q

Which Leopold’s maneuver will identify the location of the cephalic prominence?

A

D. Leopold’s maneuver 4

238
Q

The cardinal movements of labor were as follows:

A

A. Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

239
Q

A multigravid patient at 39 weeks AOG came in due to hypogastric and lumbosacral pain. Which of the following additional statements will characterize that the patient is in true labor?

A

A. The cervix is dilated and effaced

240
Q

This type of deceleration is characterized by symmetrical fall in FHR beginning at or after the peak of a uterine contraction and returning to baseline only after contraction has ended.

A

C. Late deceleration

241
Q

This is considered as the most crucial event for the further development of an antral follicle

A

A. activation of the aromatase system by FSH

242
Q

Rubin’s pathologic criteria for cervical pregnancy include the following, EXCEPT:

A

B. he attachment of the placenta to the cervix must be intimate

243
Q

A 28-year old primigravida comes to your clinic on her 30th week of gestation complaining of chest pain. Which of the following findings will strengthen the diagnosis of heart disease in pregnancy?

A

C. Cardiomegaly

244
Q

The increase in plasma volume during pregnancy by about 50 to 65% reaches its peak during the:

A

B. Midtrimester

245
Q

Nayda, an 18-year old primigravida comes to the clinic on her 12th week of gestation for her 1st check-up. She is curious as to when she can start to perceive fetal movements. You will reassure her that this will occur :

A

C. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th weekC. between the 18th and 20th week

246
Q

Which of the following immunizations is recommended for routine use during pregnancy?

A

B. Tetanus toxoid

247
Q

In vertex presentation, the posterior fontanel is lowermost and the presenting head diameter is the:

A

C. Suboccipitobregmatic

248
Q

This movement of the head refers to turning of the occiput from its original transverse oblique position towards the symphysis pubis or less commonly towards the hollow of the sacrum:

A

A. internal rotation

249
Q

Overt diabetes during pregnancy is diagnosed by:

A

D. fasting plasma glucose of 126 mg/dl or higher

250
Q

Among mothers with thyrotoxicosis. Their neonates are usually

A

A. euthyroid

251
Q

Subclinical hypothyroidism is diagnosed when there is:

A

B. high serum thyrotropin level and normal thyroxine

252
Q

A 38 year old G4P3 at 18 weeks age of gestation has BP of 150/100 mmHg with no other signs and symptoms. Her prepregnancy BP was 130-140 / 80-90 mmHg controlled by intake of a calcium channel blocker. Urinalysis is negative for proteinuria. The most probable diagnosis of this patient:

A

C. chronic hypertension

253
Q

A 28 year old G1P0 at 35 weeks AOG consulted in the ER with chief complaint of severe abdominal pain. Accompanied by moderate vaginal bleeding. Her BP is 180/120 mmHg, PR-88/min, RR: 22/min. On palpation of the abdomen the uterus was tetanically contracted and the FHT was faint. The most probable diagnosis is:

A

B. abruptio placenta

254
Q

Pneumococcal vaccine recommended for

A

B. immunocompromised patients

255
Q

A G3P2 PU at 12 weeks is complaining of cough, weight loss and hemoptysis. The most important screening test at this time is

A

B. tuberculin test

256
Q

Among the anti-TB regimen, the drug which is contraindicated during pregnancy is

A

D. Streptomycin

257
Q

A 30 year old G3P2 at 24 weeks AOG complained of urinary frequency, dysuria, urgency, fever, chills and costovertebral angle tenderness. Urinalysis showed pyuria and bacteriuria. The most probable diagnosis is

A

D. acute pyelonephritis

258
Q

This type of forceps has a double pelvic curve to facilitate application to the after coming head in breech presentation

A

C. Piper forceps

259
Q

The following are contraindications for vacuum extraction EXCEPT

A

A. fetal postmaturity

260
Q

This is known as the low longitudinal incision of the uterus, used to delivery babies abdominally

A

C. Kronig incision

261
Q

A 25 y/o G2P2, three weeks postpartum came in because of profuse vaginal bleeding. She was afebrile with a BP of 100/70 mmHg and pulse rate of 105/min. What is the most likely diagnosis?

A

A. subinvolution

262
Q

What is the first histologic indication of the effect of progesterone on the endometrium?

A

C. subnuclear vacuolization

263
Q

At this gestational age, gross examination of the external genitalia identifies the sex of the fetus:

A

D. 16 weeks

264
Q

The most specific test for HIV is

A

B. Polymerase Chain Reaction

265
Q

A 26 y/o patient was seen in the OPD complaining of a vaginal discharge. The vaginal pH was 4.5. What is the most likely cause of the vaginitis

A

D. Moniliasis

266
Q

Infections with this virus is strongly linked to CIN:

A

C. HPV

267
Q

The least of the nodal involvement for distant metastasis of cervical cancer is via the:

A

D. Presacral nodes

268
Q

A 45 year old G2P2 female came in due to postcoital bleeding. Pelvic exam revealed a nodular cervix which bleeds to touch, sidewalls are free of lesion. What is the stage of the disease?

A

B. Stage IB

269
Q

Operative treatment for cervical cancer that guarantees the removal of the entire cervix and uterus with the ureters undisturbed.

A

A. Class I

270
Q

A 54 year old G5P5 woman came in due to metrorrhagia. She’s of heavy build, and a smoker of the following risk factors, what would have the least risk for developing endometrial carcinoma?

A

C. Multiparity

271
Q

A tumor metastatic to the ovary, usually bilateral, consisting of signet ring cells, that usually originate from GIT is

A

B. krukenberg tumor

272
Q

A 30 year-old G0P0 was found to have stage 1a grade 1 serous cystadenocarcinoma of the ovary. The best form of management is:

A

C. USO with follow up Ultrasound of the contralateral ovary

273
Q

A 13 year old who has not had menarche was brought in for consult with the following features: short stature, low breast development, with webbing of the neck. The diagnosis is:

A

B. Turner syndrome

274
Q

It is a malformation of a 46-XX individual with a normal ovarian function resulting in failure of the uterus and vagina to form

A

B. Rokitansky Kusterhaus syndrome

275
Q

A 35- year old female came in for infertility work-up. When is the best time to do hysterosalpingography (HSG)?

A

B. during the week following the end of menses

276
Q

What is the pathognomonic symptoms of menopause caused by estrogen depletion?

A

A. hot flushes

277
Q

Which of the following statements is true regarding LH?

A

A. LH acts on the theca cells to produce androgen.

278
Q

What event induces follicular rupture and subsequent ovulation?

A

B. LH surge

279
Q

Which of the following explains uterine enlargement during pregnancy?

A

A. It is due to increased number of muscle fibers.

280
Q

Which of the following are endometrial changes during pregnancy?

A

There is conversion of secretory endometrium into decidua.

281
Q

Which of the following are cervical changes during pregnancy?

A

The cervix is edematous.

282
Q

Which of the following are cardiovascular changes in pregnancy?

A

There is an increase in heart beat to 10 beats per minute.

283
Q

The following are respiratory changes in pregnancy except:

A

Tidal volume is decreased.

284
Q

What is the average increase in maternal blood volume during pregnancy?

A

C. 50 %

285
Q

Which of the following is a positive sign of pregnancy?

A

C. Recognition of the fetus by ultrasound

286
Q

A radiologic evidence of fetal death that shows significant overlapping of fetal skull bones

A

A. Spalding’s sign

287
Q

The mean duration of a normal pregnancy calculated from the first day of LMP averages close to

A

A. 40 weeks

288
Q

At what age of gestation can fetal cardiac activity be detected by ultrasound?

A

A. 4 weeks ovulation age

289
Q

At what age of gestation will the testes start to descend?

A

C. 32 weeks

290
Q

What is the term used to describe the encirclement of the largest fetal head diameter by the vulvar ring?

A

C. crowning

291
Q

What is the main disadvantage of median episiotomy?

A

C. rectal extension

292
Q

What is the purpose of the WHO partograph?

A

B. To identify patients needing timely intervention.

293
Q

A 31 year old, primigravid was admitted 5 cms. station -1 at 12 noon. In an hour she was 7cm, station 0. At 2 pm she was 9 cm Station +1 and was fully dialted at 3 pm. She delivered shortly thereafter. What is your assessment?

A

A. normal labor

294
Q

A 32 year old G6P5 patient comes in 7cm. dilated at 10 am. What time do you expect her to be fully dilated if labor progress is normal?

A

A. 11 am

295
Q

A G3P2 patient had a cesarean delivery because of a previous myomectomy. In the ER she was 3-4 cms, breech presentation, with contractions every 4-7 minutes. What is the best management for this patient?

A

C. Have her prepared for an emergency cesarean delivery.

296
Q

A 21 y/o primigravid presents with severe abdominal pain associated with shoulder pain and dizziness. BP – 90/60, PR – 110/min. These is rebound tenderness on examination of the abdomen and exquisite tenderness on wiggling the cervix. The patient has history of completion of abortion by curettage at 6 weeks gestation 2 weeks prior to consult. Histopath findings reveal decidual reaction. Pregnancy test is (+). The most likely diagnosis is

A

B. Ruptured ectopic pregnancy

297
Q

A 39 y/o, G4P3, 33 weeks gestation presents with minimal bleeding. Physical examination is unremarkable. Ultrasound report is total placenta previa. The most appropriate treatment is

A

D. Expectant management

298
Q

A 22 year old G2P1 (1001) at 35 weeks AOG has a chief complaint of regular uterine contractions for 12 hours. She has stable vital signs. Fundic height is 27 cm, estimated fetal weight is 2,400 grams. Fetal heart tones are 148 bpm and presentation is cephalic. On internal examination, the cervix is 7 cm dilated, fetal head at station -1, intact bag of waters. What would be your management?

A

D. Admit her and allow labor to progress.

299
Q

What is the ACOG recommendation in managing a postterm pregnancy with a favorable cervix?

A

B. Induction of labor

300
Q

The following finding with postterm pregnancy mandates delivery.

A

B. oligohydramnios

301
Q

A 17 y/o. primigravid registers at 16 weeks’ gestation with a BP of 100/60. At 38 weeks’ gestation, she is seen in the clinic with a BP of 146/94 and negative proteinuria. She is admitted in the hospital for further evaluation, where, on overnight observation, she has persistent BP above 140/90. A 24-hour urine protein determination is 20mg. What is your diagnosis?

A

A. Gestational HPN

302
Q

What is the role of the hepatitis B surface antigen (+) patient in the genesis of hepatitis B infection?

A

A. Chronic carrier state

303
Q

What is the most common mode of transmission of Hepatitis B?

A

D. Mother-to-infant route

304
Q

A 21 y/o G1P0 12rh week AOG complained of sore throat, cough and fever and developed post-auricular lymphadenopathy. What is your main consideration?

A

B. Rubella

305
Q

A primigravid at 39 weeks delivered by low forceps extraction. On the first post-partum day, the patient complained of excruciating vulvar pain. On examination, there was a fluctuant, violaceous gray, 8x6 cm mass on the postero-lateral aspect of the vulva, tense and tender on palpation. What is your diagnosis?

A

D. Vulvar hematoma

306
Q

R.C., 28 y/o, G2P2, delivered spontaneously to a live fetus 8 days ago at home assisted by a nurse. She developed high-grade fever on the 5th post-partum day associated with body malaise, lower abdominal pain & moderate vaginal bleeding. On admission, the patient was febrile and on IE, the cervix was open, the uterus was enlarged to 18 week-size & both adnexae were tender and foul-smelling lochia was noted. Your impression is

A

A. Puerperal infection

307
Q

You are attending to a 25 y/o, G3P3 who just delivered vaginally to a live term fetus. Five minutes later, signs of placental separation appeared followed by profuse vaginal bleeding. Bleeding before placental delivery is called

A

C. Third-stage bleeding

308
Q

The definitive treatment in a 40 y/o, G8P5 (5,0,3,5) who developed septic shock due to endomyometritis is

A

A. Surgical removal of the nidus of infection

309
Q

A 16 y/o girl is complaining of irregular menstruation.What would be the ideal treatment to restore her menstrual cycle?

A

D. Cyclic progesterone

310
Q

When is it recommended to start doing Pap smear for screening of cervical cancer?

A

D. At age 18 or earlier when sexually active

311
Q

Which of the following increases the risk of developing endometrial cancer?

A

C. Polycystic ovarian symdrome

312
Q

What is the most appropriate treatment for a 20 year nulligravid diagnosed with simple hyperplasia without atypia by curettage?

A

B. Continous or cyclic progestin

313
Q

Which of the following is classified as homologous type of sarcoma?

A

A. High grade endometrial stromal sarcoma

314
Q

What type of ovarian tumor is Brenner tumor classified?

A

A. Epithelial tumor

315
Q

A patient underwent THBSO omentectomy and lymph node dissection for an ovarian cancer. Histopathological report showed the tumor in the right ovary measured 10x8x8 cm ruptured with extension to the fallopian tube and omentum. One para aortic node showed malignant cells. What is the stage?

A

D. Stage III-C

316
Q

What is the primary treatment of malignant epithelial ovarian tumor?

A

B. Surgical removal of the tumor

317
Q

Definitive diagnosis of vulvar carcinoma is established by

A

D. Biopsy

318
Q

The major symptom of most vulvar atypias is

A

C. Pruritus

319
Q

A 3 y/o girl was brought to the Emergency Room because of vaginal bleeding. On inspection of the external genitalia, there was a mass protruding through the vaginal introitus. It measured 4x3 cm and resembled a cluster of grapes forming multiple polypoid masses. The most likely diagnosis is

A

B. Sarcoma botryoides

320
Q

The most common symptom of vaginal cancer is

A

B. abnormal bleeding

321
Q

Which of the following patients with PID must be hospitalized?

A

B. A 21 y/o G1P0 at 10 weeks AOG

322
Q

What is the most common route of spread of the organisms in PID?

A

D. Ascending route

323
Q

What is the route of spread of abdomino-pelvic Koch’s?

A

C. Hematogenous spread

324
Q

On histologic sections, what are the findings highly suggestive of AP Kock’s?

A

C. Langhan’s glant cell

325
Q

Which of the following is an indicator of ovulation?

A

A. Progesterone level of 10 mg/ml during luteal phase

326
Q

Which of the following is required in semen analysis?

A

A. 2-3 days abstinence before collection

327
Q

WHO standard for normal semen analysis include

A

A. 40 M sperm count

328
Q

Which of the following is required for hysterosalpingogram?

A

A. Done post menstrual, pre-ovulatory

329
Q

Which of the following organisms are hostile to sperm in the vagina?

A

A. Ureaplsma urealyticum

330
Q

A 12 y/o girl was noted to have breast budding. What is the average age you would expect her to experience menarche?

A

C. 14 year old

331
Q

A 45 y/o patient consulted at your clinic because of amenorrhea of 10 months duration. She would want to know if indeed she is menopausal already. What laboratory test will you request?

A

B. FSH assay

332
Q

What will be the first index of declining ovarian function?

A

B. Declining inhibin levels

333
Q

Which of the following events is associated with menstrual flow?

A

A. withdrawal of progesterone

334
Q

A 47 year old woman has poorly differentiated endometrial carcinoma and a uterine cavity that measures 10 cm in depth. The endocervix has stromal invasion of endometrial carcinoma but no other structure is involved. What is the stage of her disease?

A

D. II B

335
Q

What endoscopic procedure is utilized to evaluate tubal disease?

A

B. laparoscopy

336
Q

Tuberculosis of the genital tract invariably involves the

A

A. fallopian tubes

337
Q

A 26 year old G1P1 had cervical intraepithelial neoplasia involving the entire thickness of the cervical epithelium. What is the best management?

A

C. conization

338
Q

A 25 year old woman and her husband use natural family planning as their method of contraception. Her menstrual cycle length range from 26 to 32 days. She does not measure her basal body temperature. The time of her maximum or peak fertility with the first day of her menses defined as day 1 would be between

A

C. day 8 – 21

339
Q

What is the drug of choice for bacterial vaginosis?

A

D. metronidazole

340
Q

What type of myoma insinuates itself between the leaves of the broad ligament?

A

D. intraligamentary

341
Q

What tumor will be positive for the tumor marker HCG?

A

B. choriocarcinoma

342
Q

What type of abnormal uterine bleeding is excessive in amount and duration of flow occurring at regular interval?

A

A. Menorrhagia

343
Q

A 67 year old had episodes of vaginal bleeding 15 years after menopause. Biopsy revealed endometrial hyperplasia. Transvaginal sonogram reveals a solid adnexal mass of 4 cm diameter. She is not on hormonal replacement therapy. What is the most likely cause of the bleeding?

A

B. granulose cell tumor

344
Q

A 40 year old housewife complains of foul smelling vaginal discharge. On examination, discharge was greenish-gray in color, fishy odor, and frothy. What is the primary consideration?

A

B. Trichomoniasis

345
Q

A 36 year old G2P2 has amenorrhea of 11 months with hot flushes. Examination reveals a small uterus. If this is a case of premature ovarian failure, which finding is applicable?

A

C. elevated FSH > 40 IU/ml

346
Q

What is a contraindication to hormonal replacement therapy?

A

A. history of pulmonary thromboembolism

347
Q

Which of these is the most likely site for implantation of endometriosis?

A

D. peritoneum of culdesac

348
Q

Which disease of the vulva is best treated with wide excision?

A

A. hidradenitis suppuritiva

349
Q

What ovarian tumor will most commonly cause precocious puberty ?

A

C. granulosa cell tumor

350
Q

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

C. gynecoid

351
Q

Stage III vaginal cancer means extension of lesion up to

A

C. pelvic wall

352
Q

On endometrial biopsy, glycogen-rich subnuclear vacuoles were seen in the base of the cells lining the glands. What does this mean?

A

B. ovulation has occurred

353
Q

Which theory of endometriosis best explains remote sites of the disease such as in the spinal cord, nasal septum or lungs?

A

D. lymphovascular metastasis

354
Q

Which is an abnormal semen parameter?

A

B. sperm morphology 30 %

355
Q

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

B. repeat smear in 4 months

356
Q

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

C. ruptured corpus luteum

357
Q

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

B. GnRH agonist

358
Q

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

B. acyclovir

359
Q

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

A. Neisseria gonorrheae and Chlamydia trachomatis

360
Q

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

D. TSH determination

361
Q

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

B. chemoradiation

362
Q

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

C. Karyotyping

363
Q

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

C. Chronic hypertension with superimposed hypertension

364
Q

Which of the following conditions can be predicted by cervicovaginal fibronectin?

A

C. preterm labor

365
Q

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

B. Imminent abortion

366
Q

Which is a cause of polyhydramnios?

A

D. esophageal atresia

367
Q

A 26 year old G3P2, Previous CS I, on her 29th week age of gestation went to the hospital because of episodes of bright red vaginal bleeding upon waking up without other symptoms. Vital signs were normal with no uterine contraction noted. Leopolds maneuver showed a baby in cephalic presentation, floating, FHT was 150/min. What is the diagnosis?

A

A. placenta previa

368
Q

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

B. arrest of cervical dilatation

369
Q

A patient diagnosed to have asymptomatic bacteriuria is one who has?

A

A. persistently multiplying bacteria in the urine but no symptoms.

370
Q

Pigmentation of the face during pregnancy is considered as

A

C. a benign but persistent condition

371
Q

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

D. immediate exploration

372
Q

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

C. Blood pressure

373
Q

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

D. 30 minutes prior to anticipated delivery

374
Q

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

C. administer fluids and magnesium sulfate for uterine relaxation

375
Q

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

C. corticosteroids

376
Q

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

D. ask history of past infection

377
Q

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

C. amniotic fluid embolism

378
Q

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

B. spontaneous uterine rupture

379
Q

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

C. assessment of amniotic fluid volume

380
Q

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

B. there is increase likelihood for transverse arrest of fetal head

381
Q

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

C. rotates symphysis pubis toward maternal head

382
Q

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

B. oulet forceps extraction

383
Q

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

A. cesarean section

384
Q

A 53 A 29 year old, Gravida 5 Para 4 (4-0-0-4), Pregnancy uterine 37 weeks, complaining of hypogastric pain of 2 hours, came in the emergency room. Her vital signs were normal. Fundic height was 35 cms. Fundus is occupied by a hard, round, ballotable mass, fetal back palpated at the left, as well on the right, another hard, round mass on the hypogastric area, fetal heart tones of 143/min heard at the left periumbical area and 152/min heard at the right lower quadrant. On internal examination, the cervix was 5 cms. Dilated, 1 cm long, ruptured bag of waters, cephalic, station -2. All her previous pregnancies were delivered at home. What is the recommended mode of delivery?

A

A. an outright cesarean section

385
Q

Which of the histological presentation is a characteristic of complete molar pregnancy?

A

A. hydropic degeneration and swelling of the villous stroma

386
Q

When the fetal breech presents with both legs extended and the hips flexed, it is classified as

A

C. frank breech

387
Q

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

B. internal podalic version

388
Q

Which of the following is associated with Abruptio placenta?

A

B. Hypertension

389
Q

Which of the following conditions in NOT an indications for classical cesarean section?

A

A. Myoma occupying the fundus of the uterus

390
Q

What is considered as the major vestibular glands that lie under the constrictor muscles of the vagina

A

D. Bartholin’s glands

391
Q

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

B. 24 – 28 wks

392
Q

What is the most accurate ultrasonographic parameter for fetal aging in the first trimester ?

A

D. crown – rump length

393
Q

What do you call a woman who had 3 pregnancies, all of which were aborted?

A

B. nullipara

394
Q

What is the earliest age of gestation when fetal sex can be identified by gross examination of the external genitalia?

A

C. 14 weeks

395
Q

What is most common type of the female pelvis?

A

D. gynecoid

396
Q

When does the 2nd stage of labor end?

A

B. when the baby is fully delivered

397
Q

How much weight does a average weighted woman gain throughout her pregnancy?

A

C. 24 lbs

398
Q

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

D. 40 weeks

399
Q

What CTG finding is indicative of head compression?

A

C. early deceleration

400
Q

A woman on her 41st week of pregnancy had a BPS with the following findings during the 30 minutes test-sustained breathing movement of 45 secs, five simultaneous limb and trunk movements, 2 episodes of arm flexion and extension, 3 episodes of fetal heart rate accelerations each for 5 secs with fetal movement, amniotic fluid pocket of 3 cms in perpendicular planes. What should be done for this patients based on the BPS score?

A

D. Repeat the BPS after a week

401
Q

When can a puerperal patient start using a hormonal contraceptive method if does not intend to breast feed?

A

C. 6 – 8 weeks postpartum

402
Q

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

B. the vertex is presenting

403
Q

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

A. give analgesic and breast support

404
Q

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

C. No intervention needed

405
Q

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

A. pelvic inlet is adequate

406
Q

What maneuver will the fetal head undergo right after engagement?

A

D. descent

407
Q

What part of the uterus forms the lower uterine segment during labor?

A

D. isthmus

408
Q

What diameter of the pelvic inlet can be assessed clinically?

A

B. Diagonal conjugate

409
Q

What is the major source of progesterone in early pregnancy?

A

C. corpus luteum

410
Q

Which of the following antibiotics are contraindicated during pregnancy?

A

B. tetracycline

411
Q

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

B. wait for spontaneous labor *

412
Q

In which part of labor does the descent of the presenting part of the fetus is most marked?

A

C. pelvic division of labor

413
Q

Which of the following maternal changes are decreased during pregnancy?

A

A. gastric emptying time

414
Q

What conclusions can be made when meconium passage in-utero in a term parturient is observed after amniotomy?

A

B. Can be a sign of fetal hypoxia

415
Q

What is the earliest histological evidence of progesterone action in the endometrium

A

D. basal vacuolation

416
Q

Which is the most biologically potent estrogen in the normal menstrual cycle?

A

B. estradiol

417
Q

If her last menstrual period is last Jan 23, 2007, when is her expected date of confinement?

A

D. Oct 30, 2007

418
Q

Lochia serosa is expected to occur

A

B. after 3 or 4 days

419
Q

Through what nerve is pain of uterine contractions transmitted?

A

D. T10 - L1

420
Q

What is the antidote for magnesium toxicity?

A

A. Calcium gluconate

421
Q

Which of the following is utilized for medical treatment of ectopic pregnancy?

A

C. Methotrexate

422
Q

Of the following, which is most associated with low birthweight infants?

A

D. Smoking in pregnancy *

423
Q

A 5 year old was referred to you at the ER due to complaints of perineal pain. What is the best way to examine the vagina of this child?

A

B. knee-chest position

424
Q

Keanna, 32 y/o “sexy dancer” and ramp model complained of burning sensation over her vulva after a lingerie fashion show where she wore “thongs” and stringed nylon bikinis. There was pruritus so she used a newly-launched vaginal wash. Immediately, the burning sensation became worse but she thought it was normal. The next morning, she found her vulva to be erythematous and inflamed. The redness now reached the peri-anal area. What is the diagnosis?

A

C. Allergic dermatitis

425
Q

On cut-section of an ovarian mass in a 26 year old nulligravida, there were ufts of hair, sebum and bony cartilage. What type of ovarian mass is most likely in this case?

A

C. Cystic teratoma (dermoid)

426
Q

What ulcerative lesion of the genital tract is characterized by the presence of “groove sign”?

A

B. Lymphogranuloma venereum

427
Q

What surgical procedure will prevent a woman from experiencing vaginal coitus?

A

B. Colpocleisis

428
Q

Which is the most common predisposing factor to ectopic pregnancy?

A

A. previous genital infection

Obstetrics & Gynecology Reviewer (1 decks)

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