OBSTETRICS & GYNECOLOGY
1. Which of the following is the correct flow of blood from the uterine wall to the endometrium?
A. Uterine artery àarcuate artery àradial arteryà straight & coiled spiral artery
B. Uterine artery àradial artery àarcuate arteryà straight & coiled spiral artery
C. Uterine artery àarcuate artery àstraight arteryà radial & coiled spiral artery
D. Uterine artery àstraight artery àarcuate arteryà radial & coiled spiral artery
2. What is the functional life span of the corpus luteum?
A. 7 + 2 days
B. 14 + 2 days
C. 21 + 2 days
D. 28 + 2 days
3. What hormone is secreted by the dominant ovarian follicle?
A. estriol
B. estrone
C. estradiol
D. progesterone
4. During the embryonic period, where is the formation of blood first demonstrable?
A. bone marrow
B. yolk sac
C. liver
D. spllen
5. During the secretory phase, what is the uppermost layer from the uterine cavity ?
A. Zona compacta
B. Zona basalis
C. Zona spongiosa
D. Decidua basalis
6. What stage of human development is implanted in the uterine cavity?
A. blastomeres
B. embryo
C. blastocyst
D. morula
7. How many new primary oocytes are there during puberty?
A. 0
B. 1,000
C. 10,000
D. 100,000
8. What is the important event that occurs prior to implantation?
A. Formation of daughter cells
B. Extrusion of the polar body
C. Accumulation of fluid between blastomeres
D. Disappearance of the zona pellucida
9. At what phase does regresson of the corpus luteum occur?
A. At the end of the proliferative phase
B. At the end of the secretory phase
C. During menstruation
D. After ovulation
10. 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. uterine inversion
B. retained placental fragments
C. uterine rupture
D. uterine atony
11. 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. Recurrent abortion
B. Incomplete abortion
C. Inevitable abortion
D. Threatened abortion
12. At what part of the fallopian tube does tubal rupture occur earliest?
A. Interstitial
B. B. Ampullary
C. Isthmic
D. Fimbria
13. What is the most commonly associated condition for abruption placenta?
A. External trauma
B. Pregnancy- induced hypertension
C. alcohol consumption
D. Short cord
14. Which of the following transvaginal utrasonographic cervical findings correlate positively with preterm delivery?
A. negative transfundal pressure
B. funneling
C. 2.7 cm cervical length
D. T- shaped cervix
15. Preterm infant is an infant who is:
A. less than 2000 grams at birth
B. less than 2500 grams at birth
C. less than 37 weeks AOG
D. less than 38 weeks AOG
16. 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. Monozygotic
B. Dizygotic
C. Conjoined
D. Locked
17. Which of the following is the most important parameter in the assessment of patient in true labor?
A. intactness of the amniotic membrane
B. cervical dilatation and effacement
C. presenting part
D. bony pelvis
18. 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. position
B. B. effacement
C. Dilatation
D. station
19. The characteristic curve pattern of cervical dilatation in a normal labor is described as:
A. A. hyperbolic
B. sigmoidal
C. diagonal straight
D. horizontal
20. 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. Normally progressing
B. Protracted cervical dilatation
C. Protracted descent
D. Arrest in descent
21. What phase of the active labor reflects the feto-pelvic relationship?
A. latent phase
B. B. acceleration phase
C. phase of maximum slope
D. deceleration phase
22. 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. reactive
B. non-reactive
C. positive
D. negative
23. Fetal tachycardia is defined as a baseline heart rate greater than:
A. 140 bpm
B. 150 bpm
C. 160 bpm
D. 170 bpm
24. What is the presentation type when the fetal head is artially flexed with the anterior fontanel or bregma is presenting?
A. face
B. vertex
C. brow
D. sinciput
25. 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. LM 1
B. LM 2
C. LM 3
D. LM 4
26. There is an increase in the size of cardiac silhouette in X-ray during pregnancy because the heart is displaced to the:
A. left and upward
B. left and downward
C. right and dowmward
D. right and upward
27. During pregnancy, the diaphragm rises by
A. 2 cm
B. 4 cm
C. 6 cm
D. 8 cm
28. Impaired gall bladder contraction during pregnancy is due to
A. estrogen
B. estrogen and progesterone
C. progesterone
D. anatomical change in gall bladder
29. Naegele’s rule is use to estimate the expected date of delivery by ____.
A. adding 3 days to the first day of PMP and count back 7 months
B. adding 7 days to the first day of PMP and count back 3 months
C. adding 7 days to the first day of bleeding and count back 3 months
D. adding 7 days to the first day of LMP and count back 3 months
30. Which of the following is proven teratogen?
A. Vitamin A derivatives
B. Metronidazole
C. Cephalosporins
D. Ampicillin
31. Which of the following vaccines is contraindicated during pregnancy?
A. Pneumococus
B. Hepatitis B
C. Influenza
D. Mumps, measles, rubella
32. The preferred method for the delivery of the aftercoming head is
A. Piper’s forceps extraction
B. Mauriceau-Smellie-Veit Manuever
C. Bracht maneuver
D. Prague maneuver
33. 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. outlet forceps delivery
B. low forceps delivery
C. midforceps delivery
D. high forceps delivery
34. 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. Kerr
B. Kronig
C. Pfannensteil
D. Classical
35. Which of the following is one of the requirements that must be present before obstetric forceps must be used?
A. The membranes should be intact
B. Cephalic presentation
C. The fetal head must be floating
D. The cervix must be fully dilated and retracted
36. The single most significant risk factor in the development of post-partum pelvic infection is
A. early rupture of membranes
B. Prolonged labor
C. Cesarean delivery
D. Multiparity
37. The process by which the uterus returns to its normal size, tone and position after delivery is called
A. involution
B. puerperium
C. subinvolution
D. atony
38. What is the mechanism behind the increase in cardiac output right after delivery?
A. maternal exhaustion
B. increase caval compression
C. sympathetic stimulation
D. autotransfusion
39. Congenital rubella syndrome is more likely common during which AOG?
A. 8-10 weeks
B. 12-14 weeks
C. 16-18 weeks
D. 36-38 weeks
40. What is the diagnostic procedure of choice for identifying gallstones in pregnancy?
A. CT Scan
B. X-Ray
C. Ultrasound
D. MRI
41. A patient consulted because her husband is a seaman and will be coming home in 2 months for a 1-month vacation. She just had her menses 2 days ago. What is the most effective reversible form of contraception will you give?
A. combined oral contraceptive
B. calendar rhythm method
C. Depo-Provera
D. combined oral contraceptives
42. A 30 year old G1P1 consulted at the OPD for Pap smear. According to her, she had an IUD in-situ for 1 year. On PE, you can not visualize the tail of the IUD string. What is the best thing to do for this patient?
A. Assume that the device has been expelled
B. Assume that the patient is telling a lie
C. Perform an transvaginal ultrasound
D. Assume that the device has been expelled and perform the Pap smear
43. A 35 y.o., G3P3 (3-0-0-3) complained of scanty menstrual flow and continuous severe cramping throughout the menstrual period after undergoing cryotherapy due to chronic cervicitis. What is the most likely cause of her complaint?
A. pelvic inflammation
B. ectopic endometrial tissue
C. cervical stenosis
D. stress and tension
44. A 21 y.o. patient, nulligravid , single came in because of severe vaginal bleeding of 2 days duration. What is the management of choice in this case?
A. D & C
B. High dose progestins
C. High dose estrogen
D. Hysteroscopy
45. The most common cause of DUB in the premenarcheal and postmenopausal woman is _____.
A. Ovulatory
B. Anovulartory
C. Organic
D. Iatrogenic
46. A 32 y.o., G2P2 (2-0-0-2) consuted for amenorrhea since delivery up to almost 1 year after. Breastfeeding was not practiced.The last pregnancy was delivered via NSD with history of uterine atony and blood transfusion. What is the most likely cause of her amenorrhea?
A. Asherman’s syndrome
B. Sheehan’s syndrome
C. Simmond’s syndrome
D. Polycystic ovarian syndrome
47. Menometrorrhagia is defined as:
A. Abnormal uterine bleeding occurring at regular intervals
B. Prolonged uterine bleeding at irregular intervals
C. Normal amount of vaginal bleeding at frequent intervals
D. Decreased amount of vaginal bleeding at frequent intervals
48. Which of the following statements is true of DUB?
A. Anovulatory bleeding is the most common cause in the premenarcheal years
B. There is continuous estrogen production without corpus luteum formation
C. Halban’s syndrome is a common cause of DUB
D. It is usually associated with severe dysmenorrhea
49. The most common histologic type of vaginal cancer is:
A. Squamous carcinoma
B. Adenocarcinoma
C. Malignant melanoma
D. Sarcoma
50. A 69- year old G4P4 (4004) consulted for an ulcerated mass on the right labium majus. She had been to several physicians who have prescribed unrecalled topical creams and solutions without relief. Upon seeing the patient, your recommendation would be:
A. Observation
B. Steroid topical cream
C. Excision biopsy of the mass
D. Simple vulvectomy
51. The area of the cervix that is most prone to precancerous and cancerous neoplasms is the:
A. Histologic portio
B. Transformation zone
C. Histologic endocervix
D. Isthmus
52. Which of the following HPV Types is associated with high oncogenic potential?
A. HPV Type 1
B. HPV Type 5
C. HPV Type 6
D. HPV Type 18
53. A 37 year old, G3P3 was admitted because of vaginal bleeding. Pregnancy test is negative. She underwent diagnostic curettage. While doing the curettage humps and bumps were noted. What is the most likely diagnosis?
A. intramural myoma
B. subserous myoma
C. submucous myoma
D. broad ligament myoma
54. A 68 year old woman has a biopsy result of atypical complex hyperplasia. What is the most appropriate treatment for her?
A. Judicious observation
B. Repeat fractional D&C after 6 months
C. Give cyclic progestin therapy to promote monthly withdrawal bleeding
D. Perform TAHBSO
55. This granulose-theca cell tumor has this characteristic inclusion body.
A. Psamomma bodies
B. Call-Exner bodies
C. Schiller Duvall bodies
D. keratin pearls
56. A 33 year old nulligravid patient consulted in your clinic because of cervical mass. She was diagnosed as a case of prolapsed myoma . What is the best management for her case?
A. Do myomectomy by laparotomy
B. Do subtotal hysterectomy
C. Do transcervical resection of the myoma
D. Do total abdominal hysterectomy only
57. A 28 year old, single, nulligravid patient consulted in the OPD for the result of her pelvic ultrasound. It revealed a 18mm x 10mm x 14mm and a 13mm x 16mm x 10 mm intramural myomatas. She is asymptomatic.
58. How will you manage the patient?
A. Work up the patient , then schedule her for myomectomy
B. Give her GnRH agonists
C. Reevaluate the patient at 6-month interval to determine the rate of growth
D. Perform fractional D & C
59. This is the diagnostic procedure of choice for endometrial cancer.