Obstetrics - 2F

Question 1

Which of the following is true regarding the role of
chest imaging in patient management during COVID10 pandemic according to consensus of Fleischner
Society?

a. Imaging is indicated in patients belonging to
Scenario 1.
b. In a resource-constrained environment where
access to CT is limited, Chest X-ray may be
preferred for patients with COVID-19 unless
features of respiratory worsening warrant the use
of CT in Scenario 1, 2, 3.
c. Imaging is indicated for patients with COVID-19
and evidence of worsening respiratory status in
Scenario 2 and 3 except Scenario 1.
d. Imaging is indicated for patients with
moderate to severe features of COVID-19
regardless of COVID-19 test results in
Scenarios 2 and 3.

Answer 1

d. Imaging is indicated for patients with
moderate to severe features of COVID-19
regardless of COVID-19 test results in
Scenarios 2 and 3.

Question 2

In patients diagnosed with COVID-19, crazy-paving
and consolidation of air spaces by chest CT is seen
how many days after the onset of symptoms?
a. 0-4 days
b. 5-8 days
c. 9-13 days
d. More than 14 days

Answer 2

b. 5-8 days

Question 3

A 26-year-old at 36 weeks AOG presented with fever.
She’s tachypneic (>30 breaths per minute), with a
SpO2 of <92%. How will you classify this patient based
on disease severity?
a. Pregnant patient with mild symptoms
b. Pregnant patient with CAP, low-risk
c. Pregnant patient with Severe Acute
Respiratory Infection (SARI)
d. Pregnant patient with acute respiratory distress
syndrome (ARDS

Answer 3

c. Pregnant patient with Severe Acute 
Respiratory Infection (SARI)

Question 4

A 26-year-old at 36 weeks AOG presented with fever.
She’s tachypneic (>30 breaths per minute), with a
SpO2 of <92%.

Same patient (No. 3): How will this patient be
managed?
a. Patient may be managed at home or admitted as
CAP, low-risk
b. Patient must be admitted and managed as
CAP, moderate-risk
c. Patient must be admitted and managed as CAP,
high-risk
d. Patient must be admitted and managed based on
classification of ARDS

Answer 4

b. Patient must be admitted and managed as

CAP, moderate-risk

Question 5

A 28-year-old primigravid at 34 weeks and 5 days
came in at the respiratory unit due to fever and cough.
She was managed as having upper respiratory tract
infection. However, after 5 days from her first
consultation, her symptoms progressed. She’s
tachypneic (RR of >30 breaths/min), febrile, O2
saturation at 89%, chest x-ray result without
progressing infiltrates. Her RT-PCR revealed a
positive result. What is your diagnosis?
a. G1P0 Pregnancy uterine, 34 weeks and 5 days,
COVID-19 positive with mild pneumonia
b. G1P0 Pregnancy uterine, 34 weeks and 5 days,
COVID-19 positive with severe acute respiratory
infection (SARI)
c. G1P0 Pregnancy uterine, 34 weeks and 5 days,
COVID-19 positive with sepsis
d. G1P0 Pregnancy uterine, 34 weeks and 5
days, COVID-19 positive with acute
respiratory distress syndrome (ARDS

Answer 5

d. G1P0 Pregnancy uterine, 34 weeks and 5
days, COVID-19 positive with acute
respiratory distress syndrome (ARDS)

Question 6

Regarding antithrombotic therapy during pregnancy
and lactation diagnosed with COVID-19, which of the
following has a moderate-level of recommendation
and evidences based on expert opinion?
a. Antithrombotic therapy should be continued if the
therapy is prescribed during pregnancy prior to a
diagnosis of COVID-19
b. Venous thromboembolism prophylaxis after
hospital discharge is not recommended for
pregnant patients
c. For pregnant patients hospitalized for severe
COVID-19, prophylactic dose anticoagulation
is recommended unless contraindicated
d. Anticoagulation therapy should be managed in
pregnant patients with COVID-19 in a similar way
as in pregnant patients with other conditions that
require anticoagulation in pregnancy

Answer 6

c. For pregnant patients hospitalized for severe
COVID-19, prophylactic dose anticoagulation
is recommended unless contraindicated

Question 7

A 30-year-old G3P2 is on prophylactic low molecular
weight heparin due to history of VTE and Factor V
Leiden Mutation. She inquires as to why she has to
switch to a medication that requires injection twice
daily at 36 weeks gestation. What will be your
response to the patient?
a. Fetal exposure to low molecular weight heparin
close to delivery increases the risk of
intraventricular hemorrhage
b. Heparin has a shorter half-life and is more
easily reversible
c. Heparin has a lower rate of heparin-induced
thrombocytopenia
d. Heparin does not cross the placenta as low
molecular weight type does.

Answer 7

b. Heparin has a shorter half-life and is more

easily reversible

Question 8

A 28-year-old G2P1 (0110) presents for
preconception counselling because her last
pregnancy ended in delivery at 27 weeks gestation
due to preeclampsia with severe features. Her first
pregnancy was a miscarriage at 8 weeks. She brings
documentation of lab results showing that she is
positive for anti-beta-2-glycoprotein IgM. A minimum
of how many weeks after initial labs are the
confirmatory labs done?
a. 16 weeks2
b. 12 weeks
c. 10 weeks
d. 8 weeks

Answer 8

b. 12 weeks

Question 9

Regarding the pharmacologic difference between
unfractionated heparin and low molecular weight
heparin, which of the following is true?
a. Unfractionated Heparin binds simultaneously to
both Factor IIa and Factor Xa.
b. Unfractionated Heparin does not significantly
bind to proteins
c. Low Molecular Weight Heparin forms complex
with antithrombin
d. Low Molecular Weight Heparin have less
inhibitory activity against Factor IIa than to
Factor Xa.

Answer 9

d. Low Molecular Weight Heparin have less
inhibitory activity against Factor IIa than to
Factor Xa.

Question 10

10. Which of the following is in the clinical criteria for
    antiphospholipid syndrome?
    a. At least one unexplained fetal death beyond 20
    weeks gestation
    b. At least one spontaneous preterm birth
    c. At least one preterm birth before 34 weeks
    gestation due to preeclampsia with severe
    features
    d. All of the choices are correct

Answer 10

c. At least one preterm birth before 34 weeks
gestation due to preeclampsia with severe
features

Question 11

A 25-year-old primigravid diagnosed of severe iron
deficiency at 32 weeks was managed with ferrous
sulfate 3 times a day. After 1 week, you repeated her
CBC. What would you expect to see if she is
compliant with her iron therapy?
a. An elevated reticulocyte count
b. An increased in red cell distribution width
c. An increase in the mean corpuscular volume
d. A 20% rise in hematocrit

Answer 11

a. An elevated reticulocyte count

Question 12

A 19-year-old primigravid at 29 weeks gestation is
noted to have anemia with hemoglobin concentration
of 8 g/dL. The peripheral blood smear showed
presence of erythrocyte hypochromia and
microcytosis. Which of the following laboratory
findings are likely to accompany this condition?
a. Elevated mean corpuscular volume
b. Decreased serum ferritin level
c. Decreased total iron binding capacity
d. Positive sickle cell screen result

Answer 12

b. Decreased serum ferritin level

Question 13

A 30-year-old G4P3 3003 at 38 weeks age of
gestation was brought to the ER due to profuse
vaginal bleeding. She immediately underwent
cesarean section due to placenta previa. However,
intraop, she had postpartum hemorrhage secondary
to uterine atony. Estimated blood loss was 2 liters.
She was transfused with 3 liters of fresh whole blood.
Postop day 3, she reports well and denies dizziness
nor palpitations when ambulating. She is
normotensive with a pulse rate of 92 beats/min. Her
repeat hemoglobin is stable at 8 g/dL. Which of the
following would you advise based on her clinical
status?
a. 3 months of iron supplementation at
discharge
b. Transfusion of 2 units of blood
c. Repeat a complete blood count emergently
d. All of the choices are correct

Answer 13

a. 3 months of iron supplementation at

discharge

Question 14

A 36-year-old G3P2 at 18 weeks gestation reports
extreme fatigue and is found to have a hemoglobin
concentration of 7.5 g/dL. The erythrocyte mean
corpuscular volume is markedly elevated and
measures 124. A peripheral blood smear is obtained
with findings of hypersegmented neutrophils with
macrocytic erythrocytes. What is the diagnosis?
a. Folic deficiency anemia
b. Iron deficiency anemia
c. Vitamin B12 deficiency anemia
d. Vitamin B6 deficiency anemia

Answer 14

a. Folic deficiency anemia

Question 15

A 29-year-old G1P0 at 37 weeks age of gestation
came in at the ER due to mild fever and headache.
She was noted to be febrile at 38 degrees Celsius with
a BP of 150/90 mmHg, and a heart rate of 115
beats/min. Lab exams are as follows: hematocrit at
25%, platelet count of 15, 000/μl, creatinine of 1.4
mg/dL and a peripheral blood smear which
demonstrates schistocytes. What is the most likely
underlying cause of her clinical presentation?
a. Idiopathic thrombocytopenic purpura
b. Elevated levels of large Von Willebrand factor
multimers
c. Preeclampsia with severe features
d. Endothelial damage secondary to infection

Answer 15

b. Elevated levels of large Von Willebrand factor

multimers

Question 16

She was noted to be febrile at 38 degrees Celsius with
a BP of 150/90 mmHg, and a heart rate of 115
beats/min. Lab exams are as follows: hematocrit at
25%, platelet count of 15, 000/μl, creatinine of 1.4
mg/dL and a peripheral blood smear which
demonstrates schistocytes.

Same patient (No. 15): What is the most appropriate
management for this patient?
a. Magnesium sulfate infusion to control convulsion
b. Induction of labor to terminate pregnancy
c. Plasmapheresis
d. All of the choices are correct

Answer 16

c. Plasmapheresis

Question 17

A 37-year-old G3P2 (2002) at 24 weeks age of
gestation complains of easy fatigability. She was
evaluated with a lab result of hemoglobin of 7 g/dL,
platelet count of 105, 000 and a mean corpuscular
volume of 122. Peripheral blood smear revealed
morphological changes with neutrophils that are
hypersegmented and macrocytic newly formed
erythrocytes. Peripheral nucleated erythrocytes were
also noted. Based on the findings, what additional
symptoms is she most likely to complain of?
a. Excessive perspiration
b. Dry skin
c. Hair loss
d. Anorexia

Answer 17

d. Anorexia

Question 18

A 30-year-old pregnant patient at 26 weeks AOG
came in due to severe bone pains. Her peripheral
smear revealed red cells with sickling and membrane
damage. Which of the following conditions do red cells
assume the shape?
a. Low oxygen tension
b. Dietary protein deficiency
c. Administration of certain antibiotics3
d. Anorexia

Answer 18

a. Low oxygen tension

Question 19

A 30-year-old pregnant patient at 26 weeks AOG
came in due to severe bone pains. Her peripheral
smear revealed red cells with sickling and membrane
damage.

Same patient (No. 18): Which of the following
perinatal outcomes has the highest risk in this patient?
a. Preterm birth
b. Preeclampsia
c. Growth restriction
d. Stillbirth

Answer 19

c. Stillbirth (SG)

Question 20

A 30-year-old pregnant patient at 26 weeks AOG
came in due to severe bone pains. Her peripheral
smear revealed red cells with sickling and membrane
damage.

Same patient : She also complains of
pleuritic chest pain and shortness of breathing. Chest
radiograph revealed ventricular hypertrophy. Which of
the following medical complications can aggravate the
cardiac dysfunction of this patient?
a. Preeclampsia
b. Serious infections
c. Chronic hypertension
d. All of the choices are correct

Answer 20

c. Chronic hypertension

Question 21

25-year-old female, primigravid at 33 weeks, came in
for consultation due to very itchy rashes noted on the
abdomen, 2 weeks duration. There is no past history
of atopy or psoriasis, no fever cough or difficulty of
breathing. Obstetrical examination was normal.
Weight gain was within acceptable limits. Skin
examination showed the following findings: face and
upper back with acne vulgaris, mild to moderate;
hyperpigmented skin over the armpits, areola,
inguinal areas; linea nigra prominent; striae deep
extending to the whole abdomen; erythematous
papules seen on the striae of the abdomen sparing
the umbilical region; nails with signs of brittleness and
transverse grooving; mild gingivitis setting in. Which
of the skin findings is/are not considered physiologic
in this patient?
a. Abdominal striae
b. Gingivitis
c. Linea nigra
d. Erythematous papules on the striae

Answer 21

d. Erythematous papules on the striae

Question 22

25-year-old female, primigravid at 33 weeks, came in
for consultation due to very itchy rashes noted on the
abdomen, 2 weeks duration. There is no past history
of atopy or psoriasis, no fever cough or difficulty of
breathing. Obstetrical examination was normal.
Weight gain was within acceptable limits. Skin
examination showed the following findings: face and
upper back with acne vulgaris, mild to moderate;
hyperpigmented skin over the armpits, areola,
inguinal areas; linea nigra prominent; striae deep
extending to the whole abdomen; erythematous
papules seen on the striae of the abdomen sparing
the umbilical region; nails with signs of brittleness and
transverse grooving; mild gingivitis setting in.

Same patient (No. 21): Given the nature of the skin
lesion and considering the history and physical
examination, what is the closest diagnosis for this
patient?
a. Contact dermatitis
b. Polymorphic eruption of pregnancy
c. Atopic eruption of pregnancy
d. Scabie

Answer 22

b. Polymorphic eruption of pregnancy

Question 23

30-year-old multigravid at 35 weeks age of gestation
(AOG), carrying twins by ultrasound, consulted to
your clinic due to presence of multiple painful and
itchy blisters on the periumbilical region that has
spread to the arms, thighs, palms, and soles in a span
of 1 month. Patient claimed that everything started as
reddish papules, plaques only on the abdomen
concentrating around the umbilical region, similar to
what she experienced during her [previous]
pregnancy. Low-grade fever was noted a week ago,
nonremitting and relieved by the intake of
paracetamol. According to the patient, the severe
itching made her feel weak. There was no history of
any medication intake prior to appearance of lesions.
What is your working diagnosis as you deal with this
patient?
a. Polymorphic eruption of pregnancy
b. Erythema multiforme
c. Dermatitis herpetiformis
d. Pemphigoid gestationi

Answer 23

d. Pemphigoid gestationis

Question 24

27-year-old multigravid at 36 weeks age of gestation
(AOG) complained of generalized itchy skin. Upon
examination, there are no particular prominent skin
lesion but areas of excoriation from scratching are
evident all over the skin. General lab results done
during the second trimester appeared to be all within
normal limits. Patient is afebrile and initial general
examinations are quite within normal expectations.
Results came back with elevated liver function test
and serum bile acid, low hemoglobin level, mild
pyuria, and with positive gallstones seen in
ultrasound. What is your working diagnosis?
a. Pruritus secondary to anemia
b. Pruritus secondary to UTI
c. Intrahepatic cholestasis of pregnancy
d. All of the above

Answer 24

c. Intrahepatic cholestasis of pregnancy

Question 25

27-year-old multigravid at 36 weeks age of gestation
(AOG) complained of generalized itchy skin. Upon
examination, there are no particular prominent skin
lesion but areas of excoriation from scratching are
evident all over the skin. General lab results done
during the second trimester appeared to be all within
normal limits. Patient is afebrile and initial general
examinations are quite within normal expectations.
Results came back with elevated liver function test
and serum bile acid, low hemoglobin level, mild
pyuria, and with positive gallstones seen in
ultrasound.

Same patient (No. 24): How will you approach
management of this patient?
a. Give antipruritic emollients to apply on the
itchy skin areas
b. Give oral antihistamine to somehow relieve the
skin.
c. Give oral corticosteroid to stop the itch.
d. All of the above

Answer 25

a. Give antipruritic emollients to apply on the

itchy skin areas

Question 26

27-year-old multigravid at 36 weeks age of gestation
(AOG) complained of generalized itchy skin. Upon
examination, there are no particular prominent skin
lesion but areas of excoriation from scratching are
evident all over the skin. General lab results done
during the second trimester appeared to be all within
normal limits. Patient is afebrile and initial general
examinations are quite within normal expectations.
Results came back with elevated liver function test
and serum bile acid, low hemoglobin level, mild
pyuria, and with positive gallstones seen in
ultrasound.

Same patient (No. 24): Which among the information
below is true?
a. Baby is safe, nothing to worry
b. Mother will not have any liver or biliary disorder
after giving birth
c. Condition is not contagious
d. Condition will only last for this pregnancy and
will not recur

Answer 26

d. Condition will only last for this pregnancy and

will not recur

Question 27

What dermatological disorder is characterized by
facial pustules and coalescing draining sinuses?
a. Eczema of pregnancy
b. Rosacea fulminans
c. Pruritic folliculitis of pregnancy
d. Pruritic urticarial papules and plaques of
pregnancy

Answer 27

b. Rosacea fulminans

Question 28

What is the characteristic rash seen with erythema
nodosum?
a. Erythematosus papules and bullae of the
abdomen
b. Nontender hypopigmented plaques of flexor
surfaces of the arms and legs
c. Tender, red, warm nodules and plaques of
extensor surfaces of the arms and legs4
d. Senile pustules of the trunk

Answer 28

c. Tender, red, warm nodules and plaques of

extensor surfaces of the arms and legs

Question 29

A 23-year-old G2P1 (1001) came to your clinic at 32
weeks complaining of pruritic plaques and pustules
on her abdomen. Which of the following lab values
would you not expect to see?
a. Hypercalcemia
b. Hypoalbuminemia
c. Leukocytosis
d. Elevated erythrocyte sedimentation rate (ESR

Answer 29

a. Hypercalcemia

Question 30

A 23-year-old G2P1 (1001) came to your clinic at 32
weeks complaining of pruritic plaques and pustules
on her abdomen.

Same patient (No. 29): What is the best initial choice 
of treatment for the patient?
a. Oral steroids
b. Emollients
c. Antibiotics
d. All of the choices are correct

Answer 30

a. Oral steroids

Question 31

Which of the following infections appear to occur
more frequently in pregnant patients than in
nonpregnant?
a. Hepatitis B
b. Syphilis
c. Trichomonas
d. Urinary Tract Infection (UTI)

Answer 31

d. Urinary Tract Infection (UTI)

Question 32

Which of the following infections can cause severe
problems for the fetus but minimal symptoms in the
mother?
a. Chicken pox
b. Bartholin gland abscess
c. Rubella
d. Rubeola

Answer 32

c. Rubella

Question 33

Two weeks after the birth of her infant, the mother
brings the child in to see you. The child’s eyes is
edematous with conjunctival erythema and a
mucopurulent discharge. Your evaluation and
treatment should include which of the following.
a. Pelvic exam of the infant
b. Culture maternal genital tract for GC
(Gonorrhea) and Chlamydia
c. Anaerobic cultures of the infant’s and the
mother’s eyes
d. Immunoglobulin M (IgM) titers of the infant

Answer 33

b. Culture maternal genital tract for GC

(Gonorrhea) and Chlamydia

Question 34

38-year-old 12 weeks pregnant woman presents with
painful vesicular pustular lesions with ulceration of the
vulvar area. She also has painful elevated inguinal
nodes. What is the most likely diagnosis?
a. Lymphogranuloma venereum
b. Genital herpes
c. Neisseria gonorrhea
d. Syphilis

Answer 34

a. Lymphogranuloma venereum

Question 35

Patient came in at 12 weeks gestation and was found
to be non-immune to rubella. Which of the following
information will you give her?
a. Rubella infection increases maternal mortality.
b. Significant percentage of fetuses of women
who develops rubella infection during
pregnancy will develop congenital rubella
syndrome.
c. Treatment with anti-viral medication is effective.
d. [Unclear audio] …rubella immunization during
this pregnancy

Answer 35

b. Significant percentage of fetuses of women
who develops rubella infection during
pregnancy will develop congenital rubella
syndrome

Question 36

23-year-old woman in her first trimester presents with
painless raised lesion in her vulva. RPR tests with
elevated titer is positive along with the fluorescent
treponemal antibody-absorption (FTA-ABS). Patient
should be offered which of the following counseling or
treatment option?
a. Causative agent for syphilis, Treponema
pallidum, does not cause the placenta therefore
there is no risk for congenital syphilis.
b. If the fetus is affected, the anatomic ultrasound
will always be abnormal.
c. Immediately treat her with parenteral
Penicillin G.
d. Penicillin-allergic women should be treated with
erythromycin.

Answer 36

c. Immediately treat her with parenteral

Penicillin G.

Question 37

A 25-year-old gravida, who have been following up
throughout her pregnancy, presents at 28 weeks’
gestation and complains of fever, runny nose,
conjunctivitis, tender anterolateral neck nodes
generalized maculopapular rash, and arthralgia.
What is the most likely cause of this patient’s
condition?
a. Hepatitis B
b. Rubella
c. Rubeola
d. H. influenza (Haemophilus influenzae Infection)

Answer 37

b. Rubella

Question 38

Patient reports having had intercourse with a new
sexual partner approximately 8 days ago. She now
complains of generalized malaise and fever, vulvar
pain, pruritus, and vaginal discharge. Genital
examination showed tender inguinal
lymphadenopathy, and vesicles and ulcer on the labia
majora bilaterally. What is the most likely diagnosis?
a. Chlamydia trachomatis
b. Neisseria
c. Syphilis
d. Genital herpes

Answer 38

d. Genital herpes

Question 39

30-year-old at 34 weeks ruptures her bag of water
(BOW). Three days later, she sought admission for
high-grade fever. White blood cell (WBC) count was
25,000 WBCs per microliter (μL), there is fetal 5
tachycardia, and mild tenderness of her lower
abdomen. Which of the following is the most likely
diagnosis for this patient?
a. Intraamnionic infection
b. Lower genital tract infection
c. Pyelonephritis
d. Genital herpes

Answer 39

a. Intraamnionic infection

Question 40

30-year-old at 34 weeks ruptures her bag of water
(BOW). Three days later, she sought admission for
high-grade fever. White blood cell (WBC) count was
25,000 WBCs per microliter (μL), there is fetal 5
tachycardia, and mild tenderness of her lower
abdomen. Which of the following is the most likely
diagnosis for this patient?
a. Intraamnionic infection
b. Lower genital tract infection
c. Pyelonephritis
d. Genital herpes

Answer 40

a. Intraamnionic infection

Question 41

What causes increased renal blood flow during 
pregnancy?
a. Increased glomerular filtration rate
b. Increases peripheral resistance
c. Increased plasma volume
d. Ureteral dilatation

Answer 41

c. Increased plasma volume

Question 42

A 34-year-old G4P3 on her 12th week of pregnancy
was referred for hypertension. Her vital signs were:
BP of 180/90, pulse rate of 80/min, RR of 20/min,
afebrile. Her urine protein was +2. Platelet count was
250,000/ul. ALT 24 U/L, creatinine 1.6 mg/dl, LDH
126 U/L. What is the most likely diagnosis?
a. Severe preeclampsia
b. Urinary tract infection
c. Primary renal disease
d. Nephrotic syndrome

Answer 42

c. Primary renal disease

Question 43

Same patient (No. 44): A 34-year-old G4P3 on her
12th week of pregnancy was referred for
hypertension. Her vital signs were: BP of 180/90,
pulse rate of 80/min, RR of 20/min, afebrile. Her urine
protein was +2. Platelet count was 250,000/ul. ALT
24 U/L, creatinine 1.6 mg/dl, LDH 126 U/L. 24-hr urine
collection was done which revealed creatinine
clearance of 58 ml/min. Protein excretion of
750mg/24 hours. What are the risks to the mother and
the baby?
a. Deterioration of renal function in the mother
b. Preeclampsia may occur
c. IUGR and preterm labor
d. All of the above

Answer 43

a. Deterioration of renal function in the mother
b. Preeclampsia may occur
c. IUGR and preterm labor
d. All of the above

Question 44

A 24-year-old G2P1 consulted for dysuria, frequency,
and urgency for 3 days. Associated symptoms were
copious mucopurulent discharge. Urinalysis showed
microscopic hematuria and pyuria. There are no
bacterial growth. What could be the offending
organism?
a. Candida
b. Chlamydia
c. Gonorrhea
d. Trichomonas

Answer 44

b. Chlamydia

Question 45

Routine urinalysis of a 24-year-old G2P1 on her 13th
week of pregnancy was found to have significant pus
cells and bacteria. Urine culture yielded more than
10,000 colony count of E. coli. She is symptomatic.
What is the best management approach for this
patient?
a. Militant watch
b. Normal prenatal check-up
c. Outpatient treatment and monitoring
d. Prompt hospitalization and aggressive treatment

Answer 45

c. Outpatient treatment and monitoring

Question 46

What could prevent recurrence of pyelonephritis
during pregnancy?
a. Immediate treatment of the acute episode
b. Antibiotic use for 3 days based on culture and
sensitivity
c. Daily use of prophylactic antibiotics for the
remainder of the pregnancy for those who had
an episode of pyelonephritis
d. All of the above

Answer 46

c. Daily use of prophylactic antibiotics for the
remainder of the pregnancy for those who had
an episode of pyelonephritis

Question 47

A 24-year-old G2P1 on her 37th week of gestation has
admitted for labor pain. She had hypertension,
proteinuria of +3 with edema. Blood pressure started
rising at 28 weeks AOG and on admission the BP was
200/100 mmHg. 2 hours of good labor, she delivered
spontaneously to a live baby boy. Postpartum BP
went down to 150 mmHg. She developed oliguria,
rising creatinine, increased plasma bicarbonate and
hyperkalemia. What complication might have
occurred in this patient?
a. Nephrotic syndrome
b. Acute glomerulonephritis
c. Acute renal failure
d. Acute cortical necrosis

Answer 47

c. Acute renal failure

Question 48

Which combination are predictive of the outcome of
pregnancy in patients with chronic disease?
a. Hypertension and underlying renal disorder
b. Hypertension and the degree of renal
insufficiency
c. Underlying disorder and the degree of renal
insufficiency
d. All of the above

Answer 48

b. Hypertension and the degree of renal

insufficiency

Question 49

Which of the physiologic changes in pregnancy 
increases the risk of pyrosis?
a. Prolonged gastric emptying time
b. Increase in pressure within the veins
c. Lower esophageal sphincter tone is 
decreased
d. Lower intraesophageal pressure and increased 
intragastric pressure

Answer 49

c. Lower esophageal sphincter tone is

decreased

Question 50

Hyperemesis gravidarum usually lasts until what age 
of gestation?
a. 12 weeks
b. 14 weeks
c. 16 weeks
d. 18 weeks

Answer 50

c. 16 weeks

Question 51

Which of the following is NOT part of the 
management of hyperemesis gravidarum?
a. Vitamin supplementation
b. Hydration
c. Anti-emetic
d. Steroids

Answer 51

d. Steroids

Question 52

This is the first line agent in the management of 
gastroesophageal reflux in pregnancy.
a. Antacids
b. H2 blockers
c. Proton pump inhibitors
d. Thiamine supplementation

Answer 52

a. Antacids

Question 53

This is the antibiotic of choice for diarrhea caused by 
enterotoxic E. coli.
a. Metronidazole
b. Tinidazole
c. Azithromycin
d. Ciprofloxacin

Answer 53

d. Ciprofloxacin

Question 54

Which of the following characteristics of acute
appendicitis is typically seen in pregnancy?
a. Appendix is moved upward and posteriorly
behind the gravid uterus
b. It may be confused with acute pyelonephritis
c. Most common finding in pregnant women with
acute appendicitis is leukocytosis that confirms
the diagnosis
d. Laparoscopy is safe for pregnant women at 30
weeks and below

Answer 54

b. It may be confused with acute pyelonephritis

Question 55

Pregnant women may have the following outcome if
they acquire viral Hepatitis A infection.
a. Effects of Hepatitis A teratogens may occur
b. Can be transmitted to the baby via breastmilk
c. Vertical transmission is negligible
d. None of the above

Answer 55

c. Vertical transmission is negligible

Question 56

Which of the following parameters indicate the
marked infectivity of patients with Hepatitis B
infection?
a. Hepatitis B DNA
b. HBs antigen
c. HBe antigen
d. Anti-Hbe

Answer 56

c. HBe antigen

Question 57

This parameter indicates an acute or a chronic 
infection with Hepatitis B virus?
a. Hepatitis B DNA
b. HBs antigen
c. HBe antigen
d. Anti-HBe

Answer 57

b. HBs antigen

Question 58

The drug of choice for acetaminophen overdose is:

a. Thiamine
b. Acetylcysteine
c. Chelating agents
d. Activated charcoal

Answer 58

b. Acetylcysteine

Question 59

A 38-year-old came into your clinic. Regularly
menstruating until she became amenorrheic for 7
months. Positive pregnancy test. This is her 1st
prenatal checkup and she claims to have no co
morbidities. This is her third pregnancy. Previous
pregnancies were all spontaneous miscarriage < 10
weeks. No D and C was done. PE= normotensive,
Cardiac rate: 93, RR: 18, pre pregnancy weight: 75kg,
present weight: 90kg, height: 5 ft 1”, abdomen:
globular, fundic height: 32cm, good Fetal heart tone
best heard on the maternal left side. Pelvic exam:
soft, close, no motion tenderness, uterus enlarged
Lab= Hb 110, Hct: 40, WBC: 9, neutrophils: 68,
monocytes:4, lymphocytes: 23, eosinophils: 75g
OGTT= FBS: 7.15mmol, 1st hour: 10.45mmol, 2nd
hour: 8.4mmol. Blood type: O, HBsAg: non-reactive,
RPR: non-reactive. What is your impression?
a. Wrong dates
b. Multiple gestation
c. Gestational diabetes
d. Pre gestational diabetes

Answer 59

d. Pre gestational diabetes

Question 60

A 38-year-old came into your clinic. Regularly
menstruating until she became amenorrheic for 7
months. Positive pregnancy test. This is her 1st
prenatal checkup and she claims to have no co
morbidities. This is her third pregnancy. Previous
pregnancies were all spontaneous miscarriage < 10
weeks. No D and C was done. PE= normotensive,
Cardiac rate: 93, RR: 18, pre pregnancy weight: 75kg,
present weight: 90kg, height: 5 ft 1”, abdomen:
globular, fundic height: 32cm, good Fetal heart tone
best heard on the maternal left side. Pelvic exam:
soft, close, no motion tenderness, uterus enlarged
Lab= Hb 110, Hct: 40, WBC: 9, neutrophils: 68,
monocytes:4, lymphocytes: 23, eosinophils: 75g
OGTT= FBS: 7.15mmol, 1st hour: 10.45mmol, 2nd
hour: 8.4mmol. Blood type: O, HBsAg: non-reactive,
RPR: non-reactive.

Same patient (No. 61): 75g OGTT= FBS: 7.15mmol,
1st hour: 10.45mmol, 2nd hour: 8.4mmol. with a
diagnosis of pre gestational diabetes. How will you
manage?
a. Advise medical nutritional therapy at 1650
kcal per day
b. Advise medical nutritional therapy at 1425 kcal
per day
c. Advise medical nutritional therapy at 2100 kcal
d. Start insulin therapy

Answer 60

a. Advise medical nutritional therapy at 1650

kcal per day

Question 61

A 38-year-old came into your clinic. Regularly
menstruating until she became amenorrheic for 7
months. Positive pregnancy test. This is her 1st
prenatal checkup and she claims to have no co
morbidities. This is her third pregnancy. Previous
pregnancies were all spontaneous miscarriage < 10
weeks. No D and C was done. PE= normotensive,
Cardiac rate: 93, RR: 18, pre pregnancy weight: 75kg,
present weight: 90kg, height: 5 ft 1”, abdomen:
globular, fundic height: 32cm, good Fetal heart tone
best heard on the maternal left side. Pelvic exam:
soft, close, no motion tenderness, uterus enlarged
Lab= Hb 110, Hct: 40, WBC: 9, neutrophils: 68,
monocytes:4, lymphocytes: 23, eosinophils: 75g
OGTT= FBS: 7.15mmol, 1st hour: 10.45mmol, 2nd
hour: 8.4mmol. Blood type: O, HBsAg: non-reactive,
RPR: non-reactive.

Same patient (No. 61): Given the total nutritional
requirement for this patient, how will you advise the
dietician in making the food plan?
a. Carbs: 185g, protein: 82.5g, fats: 144g
b. Carbs: 200, protein: 9.5, fats: 150g
c. Carbs: 215g, protein: 100, fats: 115g
d. Carbs: 230g, protein:150g, fats: 130g

Answer 61

a. Carbs: 185g, protein: 82.5g, fats: 144g

Question 62

A 28-year-old G1P0 pregnancy uterine at 28 weeks is
diagnosed with GDM. Her CBG pre meals were 4.05-
5.7mmol/L and her CBG 2 hour post prandial was
6.05-6.55mmol/L. On ultrasound, the fetal abdominal
circumference is more than 90th percentile. Fetal
biometry is at 50th percentile for AOG. Pre pregnancy
weight: 65kg, present: 73kg, height: 5ft 3”. How will
you manage?
a. Advise medical nutritional therapy
b. Start insulin therapy 34 SQ in am 17 SQ in pm
c. Start insulin therapy 30 units SQ in am and 15
units SQ in pm
d. Start insulin therapy 32 units SQ in am and 16
units SQ in pm

Answer 62

b. Start insulin therapy 34 SQ in am 17 SQ in pm

Question 63

A 27-year-old G1P0 pregnant for the 1st time was
seen at the clinic for prenatal checkup. She is
amenorrheic for 8 weeks, positive pregnancy test. 7
TVS: compatible with AOG. She complains of
frequent urination and unexplained weight loss which
started 6 months PTC. Urinalysis showed glucosuria.
FBS: 5.2mmol/L. what is your diagnosis
a. G1P0, pregnancy uterine, 8 weeks AOG
b. G1P0, pregnancy uterine, 8 weeks, GDM
c. G1P0, pregnancy uterine, 8 weeks. Overt
diabetes
d. G1P0, pregnancy uterine, 8 weeks, UTI

Answer 63

b. G1P0, pregnancy uterine, 8 weeks, GDM

Question 64

A 27-year-old G1P0 pregnant for the 1st time was
seen at the clinic for prenatal checkup. She is
amenorrheic for 8 weeks, positive pregnancy test. 7
TVS: compatible with AOG. She complains of
frequent urination and unexplained weight loss which
started 6 months PTC. Urinalysis showed glucosuria.
FBS: 5.2mmol/L.

Same patient (No. 65): Diagnosed with GDM, how will
you manage?
a. Since she is still in 1st trimester, no further
workups needed. Advise to follow up after 4
weeks
b. Request for 75g OGTT at 24-28 weeks. If normal,
repeat at 32-34 weeks
c. Request for 75g OGTT now since she is high risk
d. Do nutritional counseling and advise selfglucose monitoring pre and 2 hours post
prandial to ensure glycemic control. Start
folic acid. Follow up after 2 weeks

Answer 64

d. Do nutritional counseling and advise selfglucose monitoring pre and 2 hours post
prandial to ensure glycemic control. Start
folic acid. Follow up after 2 weeks

Question 65

A healthy 23-year-old G1P0 at 36 weeks and 4 days.
She had no unusual medical or family history. She
had regular prenatal checkup, no obvious
abnormalities. She underwent C section due to fetal
distress under general anesthesia. After tracheal
extubation, the patient had upward rolling of eye balls,
tachycardic at >120bpm with sweating and
hyperpyrexia. What is your diagnosis?
a. Eclampisa
b. Malignant hyperthermia
c. Diabetic ketoacidosis
d. Thyroid storm

Answer 65

d. Thyroid storm

Question 66

Which of the following is included in Burch-Wartofsky
Point Scale for thyrotoxicosis?
a. Temp <35 degrees Celsius
b. Diarrhea
c. Incoherent
d. Disoriented as to time place and person

Answer 66

b. Diarrhea

Question 67

A 35-year-old woman complains of palpitation,
excessive sweating and heat intolerance at 16 weeks
AOG. Although she experienced these symptoms in
previous pregnancies, the current symptoms are
much worse. Serum free T4: 51.7 μmol/L, serum
thyrotropin: 0.1 mIU/L. How will you manage?
a. PTU 50 mg TID
b. Methimazole 10 mg PO
c. Levothyroxine 50 ug per tab BID
d. No medication needed. Patient is euthyroid.

Answer 67

b. Methimazole 10 mg PO

Question 68

A 35-year-old woman complains of palpitation,
excessive sweating and heat intolerance at 16 weeks
AOG. Although she experienced these symptoms in
previous pregnancies, the current symptoms are
much worse. Serum free T4: 51.7 μmol/L, serum
thyrotropin: 0.1 mIU/L.

Same patient (No. 69): After 4 weeks, patient came

back. Repeat serum free T4: 30 μmol/. Serum
thyrotropin: 0.15 mIU/L. How will you manage?
a. PTU 100 mg TID
b. Methimazole 20 mg PO
c. Levothyroxine 100 ug
d. No medication needed. Patient is euthyroid.

Answer 68

b. Methimazole 20 mg PO

Question 69

Which of the following causes dilatation of the urinary 
tract during pregnancy?
a. Mechanical obstructive factors
b. Human chorionic gonadotropin
c. Dilatation of the radial arteries
d. All of the above

Answer 69

a. Mechanical obstructive factors

Question 70

A 35-year-old G3P2 2002, 26 weeks AOG, sought
consult for dull ache in the right periumbilical area
radiating to the back. What diagnostic findings will
clinch your diagnosis?
a. Elevated WBC
b. Elevated ESR and CRP
c. Non compressible right blind-ended tuberous
structure with a maximum diameter of >6mm
d. Right pelvocaliectasia

Answer 70

c. Non compressible right blind-ended tuberous

structure with a maximum diameter of >6mm

Question 71

A patient previously treated with methotrexate for
rheumatoid arthritis got pregnant. She was worried
that her baby was exposed to methotrexate in the
pregnancy in the 1st trimester. What
complications/side effect will you expect in the baby?
a. Hearing loss
b. Neural tube defects
c. Neutropenia
d. Congenital glaucoma

Answer 71

b. Neural tube defects

Question 72

A pregnant patient on her 2nd trimester came in with
a pap smear result of ASCUS, HPV +. How will you
manage this patient?
a. Colposcopy
b. Cervical punch biopsy
c. LEEP
d. Cold knife conization

Answer 72

a. Colposcopy

Question 73

A 28-year-old G1P0, 16 weeks AOG was referred for
colposcopy. Colposcopic finding showed no
abnormal vessels, with thin aceto-whitening and
partial Lugol’s uptake. How will you manage this
patient?
a. Do cervical punch biopsy
b. LEEP
c. Cold knife conization
d. Observe

Answer 73

d. Observe

Question 74

Which is not true regarding ovarian cancer in
pregnancy?
a. Antenatal chemotherapy is relatively safe during
2nd and 3rd trimester
b. Surgery is safe in all trimesters
c. Early termination to be able to start adequate
treatment improves overall survival
d. Prognosis is poorer because of late initiation of
proper treatmen

Answer 74

c. Early termination to be able to start adequate

treatment improves overall survival

Question 75

A 36-year-old G5P4 4004 on her 28 weeks AOG
consulted for a cervical punch biopsy which revealed
squamous cell carcinoma large cell keratinizing.
Pelvic exam: normal external genitalia, smooth
vagina, cervix measuring 3x3cm at anterior cervical
lip with a mass measuring 1.5x1.5 cm. No adnexal
tenderness. Bilateral parametria was smooth. Patient
wants to keep the pregnancy. How will you manage
this patient?
a. Start antenatal chemotherapy to reduce tumor
burden during pregnancy8
b. Cervical trachelectomy to remove the tumor while
preserving her pregnancy
c. Delay treatment and give steroids
appropriately and perform C section at 34- 36
weeks
d. Give brachytherapy

Answer 75

c. Delay treatment and give steroids
appropriately and perform C section at 34- 36
weeks

Question 76

Ototoxicity secondary to antepartal administration of
cisplatin is due to:
a. Formation of superoxide damaging cochlea
a. Alkylation of cochlear cells
b. Supermethylation of organ of Corti
c. Prevention of microtubule formation of the
acoustic nerve cells

Answer 76

a. Formation of superoxide damaging cochlea

Question 77

Which is true regarding the use of MRI with
gadolinium contrast in pregnancy to adequately stage
cancer?
a. MRI with gadolinium contrast is safe during
pregnancy because it is non-ionizing and may be
used in any trimester
b. The use of gadolinium contrast in MRI should
be limited. It may be used as a contrast agent.
c. MRI with gadolinium contrast should be reserved
for suspected malignancy
d. MRI with gadolinium contrast is not safe during
the 1st trimester

Answer 77

The use of gadolinium contrast in MRI should

be limited. It may be used as a contrast agent.

Question 78

A pregnant woman at 28 weeks AOG was diagnosed
with squamous cell carcinoma after cone excision
biopsy. Biopsy showed the tumor invades the stroma
with a depth of 5mm. How will you manage if she
wants to keep the pregnancy?
a. Delay of treatment is acceptable
b. Start antenatal chemotherapy and possible CS
with radical hysterectomy at 34-36 weeks
c. Start vaginal brachytherapy with accurate uterine
shielding
d. Observe progression of the tumor by doing
colposcopy every 3 months and intervene with
progression

Answer 78

a. Delay of treatment is acceptable

Question 79

A 28-year-old G2P1 1001 on her 20th week AOG
diagnosed with 10 cm complex mass with solid areas
and papillary excrescences on TVS ultrasound. How
will you manage this patient?
a. Request for tumor markers to determine if the
mass is benign or malignant
b. Repeat TVS after 1 month to observe for rapid
growing or changes in the ultrasound findings
c. Immediately perform surgery to remove the
adnexal mass
d. Schedule the patient for elective CS at 37 weeks
with removal of the ovarian mass

Answer 79

c. Immediately perform surgery to remove the

adnexal mass

Question 80

. Which of the following is not contraindicated for the 
use of IUD?
a. Suspicion of pregnancy
b. Post-abortal women
c. Uterine Anomaly
d. AUB of unknown origin

Answer 80

b. Post-abortal women

Question 81

Which of the condition did OCP is advised with 
precaution?
a. Endometrial Cancer
b. Uncontrolled Hypertension
c. Smoker <35 yrs. old
d. History of DVP

Answer 81

c. Smoker <35 yrs. old

Question 82

Which of the following is not seen in patients with 
pregnancy IUD in utero?
a. Congenital Anomaly
b. Septic abortion
c. Ectopic pregnancy
d. Prematurity

Answer 82

a. Congenital Anomaly

Question 83

Which statement characterizes levonorgestrel
intrauterine system?
a. It is inserted during 1st day of menses.
b. Can be inserted anytime provided when there
is no pregnancy.
c. Increases the incidence of menorrhagia
d. Can be kept in place for 12 years.

Answer 83

b. Can be inserted anytime provided when there

is no pregnancy.

Question 84

Which of the following statement is true regarding the
calendar system of contraception?
a. Generally effective to all women.
b. Can be advised to women with regular interval
with past 3 cycles.
c. As part of the determination of fertile period the
shortest cycle is subtracted by 11 days.
d. The fertile period, couple can use the barrier
method

Answer 84

d. The fertile period, couple can use the barrier

method

Question 85

It maintains the endometrium

a. Estrogen effect of OCP
b. Progestin effect of OCP
c. Both

Answer 85

a. Estrogen effect of OCP

Question 86

It inhibits midcycle gonadotropin?

a. Estrogen effect of OCP
b. Progestin effect of OCP
c. Both

Answer 86

a. Estrogen effect of OCP

Question 87

8. Peeling of endometrium
   a. Estrogen effect of OCP
   b. Progestin effect of OCP
   c. Both

Answer 87

b. Progestin effect of OCP

Question 88

Irregular bleeding

a. Estrogen effect of OCP
b. Progestin effect of OCP
c. Both

Answer 88

c. Both

Question 89

Acne

a. Estrogen effect of OCP
b. Progestin effect of OCP
c. Both

Answer 89

b. Progestin effect of OCP

Question 90

Given the labor curve, at what hour did the patient
entered the deceleration phase? (Deceleration phase
is when patient enters 8 cm)
a. 4th hour9
b. 6th hour
c. 8th hour
d. 10th hour

Answer 90

c. 8th hour

Question 91

Given the labor curse, what is the abnormality? (From
8 cm, after 4 hours still full cervical dilatation)

(From 5 cm to 8 cm, it took her 5 hrs.)

a. Prolonged latent phase
b. Protracted labor
c. Arrest of cervical dilatation
d. Failure of descend

Answer 91

b. Protracted labor

Question 92

(Labor curve: From 5 cm to 8 cm, it took her 5 hrs.)

How will you manage patient in above question?
a. She should not wait for full cervical dilatation
since there is already dysfunctional labor.
b. Do forceps delivery
c. do immediate CS
d. Augment labor

Answer 92

d. Augment labor

Question 93

Another labor curve given, what is the abnormality in
this labor curve? (Fetal head reaches past station 0
and it is at station +1 for 3 hours)
a. Protracted disorder
b. Arrest of cervical dilatation
c. Arrest of descent
d. Failure of descent

Answer 93

c. Arrest of descent

Question 94

Another labor curve given, what is the abnormality in
this labor curve? (Fetal head reaches past station 0
and it is at station +1 for 3 hours)

Same patient (No. 94): What is the complete
diagnosis of labor of this patient?
a. Prolonged second stage of labor secondary
to arrest of descent
b. Prolonged second stage of labor secondary to
failure of descent
c. Prolonged active phase secondary to arrest of
cervical dilation
d. Prolonged latent phase secondary to protracted
cervical dilatation.

Answer 94

a. Prolonged second stage of labor secondary

to arrest of descent

Question 95

Another labor curve, what is the abnormality? (Fetal 
head is at station -1 for 3 hours)
a. Protracted disorder
b. Arrest of cervical dilatation
c. Arrest of descent
d. Failure of descent

Answer 95

d. Failure of descent

Question 96

Antibiotic prophylaxis in elective CS delivery is given 
within:
a. 30 min before start of surgery
b. An hour before the scheduled surgery
c. After cord clamping
d. After delivery of baby

Answer 96

a. 30 min before start of surgery

Question 97

These vessels are encountered in transverse
incisions such in Pfannenstiel incision:
a. Ilioinguinal vessels
b. Iliohypogastric vessels
c. Superior and inferior epigastric vessels
d. pudendal vessels

Answer 97

c. Superior and inferior epigastric vessels

Question 98

Which of the following item is not indication for 
classical CS?
a. Deeply engaged fetal head
b. Myoma of lower uterine segment
c. Anterior placenta previa
d. Anterior placenta accreta

Answer 98

a. Deeply engaged fetal head

Question 99

A patient in labor gives the history of mitral stenosis.
She is asymptomatic and currently taking a beta
blocker but she is not sure why her doctor
recommended it. What complication is the
prophylactic beta blocker trying to prevent in this
patient?
a. Irregular heart rhythm
b. Neural thrombus formation
c. Tachycardia leading to pulmonary edema
d. Left ventricular hypertrophy and dilatation

Answer 99

c. Tachycardia leading to pulmonary edema

Question 100

In a pregnant woman with a mechanical heart valve,
which of the following anticoagulant regimen would
be considered inadequate for prevention of
thromboembolism involving the prosthesis?
a. Warfarin
b. Low dose unfractionated heparin
c. Adjusted dose unfractionated heparin
d. Adjusted dose low unfractionated heparin

Answer 100

b. Low dose unfractionated heparin

Question 101

A 28-year-old primigravid at 28 weeks of gestation
came in due to dyspnea. She is gravida cardiac?
patient. On auscultation, you noted low pitched
crumbling? diastolic murmur at the apex when put on
a left lateral position. She also noted an occasional
increase in her heart rate. To improve her heart rate,
you want to reduce left atrial pressure by giving
which of the following medication?
a. Diuretics
b. Vasodilators (Nitroglycerin)
c. Beta blockers
d. Digitalis

Answer 101

c. Beta blockers

Question 102

Regarding fetal position, fetal heart sounds are best
heard as short distance from the umbilicus in which
of the following?
a. Occipitoanterior
b. Occipitoposterior
c. Occipitomental
d. Transverse position

Answer 102

a. Occipitoanterior

Question 103

In cephalic presentation, if the fixed point of
reference is the frontum. What will be the AP
diameter presenting into the pelvis?
a. Suboccipitobregmatic
b. Occipitofrontal
c. Occipitomental
d. Trachelobregmatic

Answer 103

c. Occipitomental

Question 104

A 28-year-old G1 presents in the clinic at 42 weeks.
She states that she is tired all the time and her feet
swell when she stands for too long. When her cervix
was checked by the consultant, it is noted that it is
posterior, close, and very firm. As discussion begins
for the possibility of induction, the patient asked what
can be done to improve her chances of care of
having her baby delivered vaginally. What do you tell
her as provider?
a. CS is the best option for the baby at this point.10
b. Induction with artificial ripening agent is an
option
c. Transvaginal ultrasound will tell us if your cervix
is ready to deliver
d. Cervix must ripen on its own.

Answer 104

b. Induction with artificial ripening agent is an

option

Question 105

This is observed when lower uterine segment
contractions are stronger than the upper segment.
What is this called?
a. Fundal dominance of contraction
b. Asynchronous uterine contraction
c. Hypotonic uterine contraction
d. Hypertonic uterine contraction

Answer 105

b. Asynchronous uterine contraction

Question 106

This phenomenon results to the expulsion of fetus.

a. Fundal dominance of contraction
b. Asynchronous uterine contraction
c. Hypotonic uterine contraction
d. Hypertonic uterine contraction

Answer 106

a. Fundal dominance of contraction

Question 107

Which of the following patients would most likely
have a repeat caesarean section given that the
pregnancy is a term infant, average size and cephalic
in presentation?
a. 32-year-old G2P1 (1001) who underwent primary
CS due to arrest in cervical dilatation
b. 31-year-old G3P1 (1011) who underwent CS due
to breech presentation
c. 38-year-old G2P1 (1001) whose first
pregnancy was CS for failure of descent
d. 40-year-old G4P2 (2012) whose second
pregnancy was CS due to placenta previa

Answer 107

c. 38-year-old G2P1 (1001) whose first

pregnancy was CS for failure of descent

Question 108

A 32-year-old nulligravid referred to you after a preemployment clinic noted reactive RPR. What is the
next best step in the management of this patient?
a. Request for VDRL
b. Obtain specimen for vaginal discharge culture
and tissue culture
c. Request for fluorescent Treponemal antibody
absorption test
d. Treat immediately with penicillin

Answer 108

c. Request for fluorescent Treponemal antibody

absorption test

Question 109

A 27-year-old comes to your clinic. Patient follows a
strict vegetarian diet wants to know if her dietary
choices are optimal for her baby’s development.
Patient voices her willingness to change her diet if it
would benefit the baby. Compared with a less
stringent lacto-ovo-vegetarian diet, this patient’s diet
is most likely to be deficient in which of the following?
a. Vitamin A
b. Vitamin B12
c. Vitamin C
d. Calcium

Answer 109

b. Vitamin B12

Question 110

A 22-year-old G2P1, 13 weeks presents for prenatal
check-up. On review of her routine prenatal labs, a
positive urine culture of Staphylococcus
saprophyticus was noted. Urinalysis reveals (-)
nitrates. Upon review of system, she denies urinary
urgency, frequency or other symptoms. What is your
rationale for antibiotic treatment?
a. Prevent kidney stone
b. Prevent preterm labor
c. Decrease the risk of chorioamnionitis
d. Prevent secondary trimester bleeding

Answer 110

b. Prevent preterm labor

Question 111

A 36-year-old G5P0 at 37 weeks and 6 days present
at the OB admitting complaining of decrease fetal
movement. The patient denies any somatic
complaints and states that she has no other health
problems. Her blood pressure is 120/70 mmHg, HR
of 66 bpm, fetal heart tone 130. What is the next step
in the management?
a. Reassure the patient that it is normal
b. Schedule a 3 day recheck appointment
c. Perform a biophysical profile immediately
d. Schedule an ultrasound in a week

Answer 111

c. Perform a biophysical profile immediately

Question 112

A 35-year-old G3P2 at 38 weeks AOG came in due
to frank rupture of amniotic fluid. Patient was hook
to a fetal monitor. CTG strips revealed rapid drop of
fetal heart rate with good variability with
decelerations. You will immediately check for:
a. Uterine contraction
b. Cervical dilatation
c. Cord
d. Color of amniotic fluid

Answer 112

c. Cord

Question 113

A 35-year-old G3P2 at 38 weeks AOG came in due
to frank rupture of amniotic fluid. Patient was hook
to a fetal monitor. CTG strips revealed rapid drop of
fetal heart rate with good variability with
decelerations. What is your immediate potential
intervention in the above case?
a. Give tocolytics
b. Initial lateral decubitus position
c. Discontinue oxytocin
d. Manually elevate presenting part while
preparing for immediate delivery

Answer 113

d. Manually elevate presenting part while

preparing for immediate delivery

Question 114

A 29-year-old G2P1 at 30-week gestation comes to
see you with new onset gastric reflux not responsive
to antacids. The patient reports that she did not
experience this symptom during her first pregnancy
at age 20. What physiologic changes of pregnancy
explained this symptom?
a. Increase gastric emptying time
b. Increase large bowel motility
c. Decrease water absorption in the small bowel
d. Decrease gastroesophageal sphincter tone

Answer 114

d. Decrease gastroesophageal sphincter tone

Question 115

Which of the following cases is categorized as nonmaternal death?
a. Death due to congestive heart failure secondary
to Rheumatic heart disease
b. Death due to complications of cervical cancer
associated with pregnancy
c. Death from cerebrovascular accident secondary
to preeclampsia severe
d. Death from cardiac failure secondary to thyroid
storm in pregnanc

Answer 115

b. Death due to complications of cervical cancer

associated with pregnancy

Question 116

Which of the following is considered pregnancyassociated death?11
a. Death due to DIC secondary to severe health
secondary to preeclampsia
b. Death due to hypovolemic shock secondary
to ruptured ectopic pregnancy
c. Death due to cardiac failure secondary to mitral
stenosis
d. Death due to hemorrhage secondary to uterine
rupture

Answer 116

b. Death due to hypovolemic shock secondary

to ruptured ectopic pregnancy

Question 117

As a public health officer in Angeles City, your live
birth is 9500, your stillbirth is 59. Your data for death
of live birth born neonate before 7 days is 60. You
are asked to compute for the fetal death rate.
a. 5.5
b. 6.2
c. 7.3
d. 8.2

Answer 117

b. 6.2

Question 118

As a public health officer in Angeles City, your live
birth is 9500, your stillbirth is 59. Your data for death
of live birth born neonate before 7 days is 60. You
are asked to compute for perinatal mortality rate.
a. 10.5
b. 11.5
c. 12.5
d. 13.

Answer 118

c. 12.5

Question 119

Which of the following placental steroid hormone 
serve as a substrate for fetal adrenal gland 
production of glucocorticoids and 
mineralocorticoids?
a. Estrogen
b. Progesterone
c. hCG
d. HPL

Answer 119

b. Progesterone

Question 120

A diagnosis of syphilis was made on a pregnant
woman who came in for a painless vulvar ulcer.
Which of the following is true of the disease?
a. Transmission to the fetus occur slowly during the
secondary stage of the disease
b. Treponema can survive for years in the infant and
later cause disease
c. Usually transmitted to the fetus as ascending
infection
d. CNS manifestation on the mother appears as
tertiary disease

Answer 120

b. Treponema can survive for years in the infant and
later cause disease

Congenital syphilis is a chronic infectious disease caused by a spirochete (treponema pallidum) acquired by the fetus in the uterus before birth. Symptoms of this disease may not become apparent until several weeks or months after birth and, in some cases, may take years to appear. (rarediseases.org)