General Review

Question 1

A 35-year old female came in for prenatal check-up. This is her fourth pregnancy. Her first pregnancy was allegedly a twin gestation for which she had an abortion at around 16 weeks. She had one vaginal delivery at 39 weeks with no fetomaternal complications, and one preterm delivery of a stillborn child at around 28 weeks. What is her obstetric score?

A. Gravida 4 Para 3 (1-1-1-1)
B. Gravida 4 Para 2 (1-1-1-1)
C. Gravida 4 Para 3 (1-1-2-1)
D. Gravida 4 Para 2 (1-1-2-1)

Answer 1

B. Gravida 4 Para 2 (1-1-1-1)

Question 2

During her follow up visit, a 33-year old primigravid in her first trimester showed you an FBS result of 99 mg/dL. How would you manage this case? *

A. Treat the patient as a case of overt diabetes mellitus.
B. Do 75-gram OGTT at 24-28 weeks to confirm your diagnosis.
C. Advise patient that her result is within normal parameters.
D. Treat the patient as a case of gestational diabetes mellitus.

Answer 2

D. Treat the patient as a case of gestational diabetes mellitus.

Question 3

A 23 year old female consulted at the emergency room for spotting with associated hypogastric pain. Her urine pregnancy test was positive. On bimanual examination, you noted her cervix to be closed with a corpus that was enlarged to 8-10 weeks’ size. Transvaginal ultrasound showed a singleton live intrauterine pregnancy. What is your diagnosis? *

A. Threatened abortion
B. Missed abortion
C. Incomplete abortion
D. Hydatidiform mole

Answer 3

A. Threatened abortion

Question 4

A 20-year old female consulted for spotting and mild hypogastric pain. She came with a positive urine pregnancy test. Bimanual examination revealed left adnexal tenderness. On ultrasound, there was no intrauterine pregnancy, and adjacent to the left ovary was complex mass. The following findings could allow for medical management in this case EXCEPT: *

A. Complex mass measuring 3.0 cm in the left adnexal region
B. Serum beta-hCG 4,000 IU/L
C. BP 100/60, HR 99, RR 20, afebrile
D. Presence of fetal cardiac activity

Answer 4

D. Presence of fetal cardiac activity

Question 5

A 34-year old G4P3 who previously underwent cesarean section with bilateral tubal ligation presented at the ER with loss of consciousness. She was noted to be hypotensive and tachycardic. A few hours prior to admission, she complained of severe abdominal pain and dizziness. Upon probing, her husband reported that patient had amenorrhea for 13 weeks. Abdomen was noted to be tense and tender. Pregnancy test was positive. What is the most likely diagnosis? *

A. Ovarian pregnancy
B. Cervical pregnancy
C. Interstitial pregnancy
D. Cesarean scar pregnancy

Answer 5

C. Interstitial pregnancy

Question 6

A patient was admitted for induction of labor. Internal examination findings were as follows: cervix dilated to 3 cm, 50% effaced, medium in consistency, posterior, head at station -2. What is her Bishop score? *

A. 4
B. 5
C. 6
D. 7

Answer 6

B. 5

Question 7

Which among the following conditions will allow for a safe vaginal delivery of a term normal-sized fetus? *

A. Mentum posterior position
B. Mentum anterior position
C. Prominent ischial spines with a diagonal conjugate measuring 10.5 cm
D. Transverse lie

Answer 7

B. Mentum anterior position

Question 8

For a fetus in vertex presentation, which among the following lists the cardinal movements of labor in its correct sequential order? *

A. Engagement, internal rotation, flexion, descent, external rotation, extension, expulsion
B. Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion
C. Engagement, descent, flexion, extension, internal rotation, external rotation, expulsion
D. Engagement, flexion, descent, internal rotation, external rotation, extension, expulsion

Answer 8

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

Question 9

Abdominal examination findings of a multigravida patient on her 31st week AOG are as follows: occupying the fundus is a nodular mass with a hard, convex structure on the maternal right; on suprapubic palpation, there is a round ballotable mass. In which quadrant will you most likely find the fetal heart tones? *

A. Right upper quadrant
B. Left upper quadrant
C. Right lower quadrant
D. Left lower quadrant

Answer 9

C. Right lower quadrant

Question 10

The following are criteria for outlet forceps extraction EXCEPT: *

A. Sagittal suture is in AP diameter.
B. Fetal skull has reached the pelvic floor.
C. Rotation does not exceed 45 degrees.
D. Scalp is visible at the introitus when you separate the labia.

Answer 10

D. Scalp is visible at the introitus when you separate the labia.

Question 11

Which among the following patients is a good candidate for vaginal birth after cesarean section? *

A. A 25-year old G2P1, term, cephalic who delivered via LTCS 10 months ago for breech presentation
B. A 35-year old with 2 previous cesarean section
C. A 23-year old, term, cephalic, who delivered via LTCS for placenta previa
D. A 29-year old G3P2, with one term vaginal delivery, and one preterm classical CS

Answer 11

C. A 23-year old, term, cephalic, who delivered via LTCS for placenta previa

Question 12

Low transverse cesarean section may be done in the following cases EXCEPT: *

A. Cervical cancer in pregnancy
B. Preterm CS with formed lower uterine segment
C. Footling breech presentation
D. Back-up transverse lie position

Answer 12

A. Cervical cancer in pregnancy

Question 13

A 28-year old G1P0 Pregnancy uterine 31 weeks AOG presented at the ER for labor pains. Internal examination findings are as follows: cervix was 2 cm dilated, 50% effaced, intact membranes, cephalic presentation. The following are included in the management of this case EXCEPT: *

A. Antenatal steroid therapy
B. Initiation of IV antibiotics
C. Magnesium sulfate administration for neuroprotection
D. Tocolysis with oral Nifedipine

Answer 13

B. Initiation of IV antibiotics

Question 14

The patient in the previous number was eventually discharged. She came back after 3 weeks and is now complaining of watery discharge. On speculum examination, you noted pooling of clear amniotic fluid. How would you manage this case? *

A. Do expectant management.
B. Re-administer magnesium sulfate and steroids, then induce after 24-48 hours.
C. Give IV antibiotics and prepare for abdominal delivery.
D. Admit for labor induction.

Answer 14

D. Admit for labor induction.

Question 15

A 16-year old primigravid with no known co-morbidities in her 3rd trimester was referred by a primary hospital for elevated BP of 150/100. She was asymptomatic and all her laboratory tests were unremarkable except for a 24-hour urine collection result which showed 500 mg of total protein. What is her diagnosis? *

A. Gestational hypertension
B. Preeclampsia without severe features
C. Preeclampsia with severe features
D. Chronic hypertension

Answer 15

B. Preeclampsia without severe features

Question 16

A 16-year old primigravid with no known co-morbidities in her 3rd trimester was referred by a primary hospital for elevated BP of 150/100. She was asymptomatic and all her laboratory tests were unremarkable except for a 24-hour urine collection result which showed 500 mg of total protein. At 35 weeks AOG, she presented at the ER for severe headache and blurring of vision. Her BP was 170/100 with note of good fetal heart tones. Which among the following is NOT included in the management of this patient? *

A. Administer magnesium sulfate.
B. Give Hydralazine 5mg slow IV push.
C. Give anti-hypertensives and induce at 37 weeks.
D. Admit for delivery.

Answer 16

C. Give anti-hypertensives and induce at 37 weeks.

Question 17

A 16-year old primigravid with no known co-morbidities in her 3rd trimester was referred by a primary hospital for elevated BP of 150/100. She was asymptomatic and all her laboratory tests were unremarkable except for a 24-hour urine collection result which showed 500 mg of total protein. At 35 weeks AOG, she presented at the ER for severe headache and blurring of vision. Her BP was 170/100 with note of good fetal heart tones. Within a few minutes, patient developed generalized tonic-clonic seizures. Magnesium sulfate loading dose was given. For the succeeding doses, which among the following should be monitored to prevent toxicity? *

A. Respiratory rate
B. Blood pressure
C. Motor strength
D. Urine creatinine

Answer 17

A. Respiratory rate

Question 18

A 34-year old primigravid with chronic hypertension on her 38th week of gestation was brought to the ER for profuse vaginal bleeding and abdominal pain. Vital signs were as follows: BP 80/60, HR 115, RR 22, afebrile. On PE, she had pale conjunctivae, good FHTs and with note of tetanic contractions on abdominal palpation. On IE, the cervix was 2 cm dilated and uneffaced. How would you manage the case? *

A. Admit, hydrate then do cervical ripening once stable.
B. Admit for abdominal delivery.
C. Admit, give magnesium sulfate, and deliver after 24 hours.
D. Admit and do expectant management.

Answer 18

B. Admit for abdominal delivery.

Question 19

An elderly primigravid at 24 weeks AOG consulted your clinic for spotting. On transvaginal ultrasound, the placental edge was noted to be within a 1.0-centimeter perimeter from the internal os. How would you advise this patient? *

A. Schedule cesarean section at 37-38 weeks.
B. Advise patient that she may undergo trial of labor under double set-up once in labor.
C. Advise patient for possibility of classical CS if she bleeds profusely.
D. Request for final placental localization at 32-36 weeks.

Answer 19

D. Request for final placental localization at 32-36 weeks.

Question 20

Which among the following is the most important intervention to prevent uterine atony? *

A. Uterine massage immediately postpartum
B. Manual evacuation of placenta and products of conception
C. Administration of oxytocin either IM or IV
D. Early latching of neonate

Answer 20

C. Administration of oxytocin either IM or IV

Question 21

A 35-year old primigravid patient was admitted for preterm labor. On ultrasound, you noted her AFI to be 27 cm. Which among the following will LEAST likely cause her condition? *

A. Maternal diabetes mellitus
B. Fetal esophageal atresia
C. Fetal CNS pathology
D. Fetal renal agenesis

Answer 21

D. Fetal renal agenesis

Question 22

A 30-year old primigravid who underwent IVF treatment showed you a second-trimester ultrasound picture showing two live embryos, a single placenta, and a thin intervening membrane (<2 mm) between two amniotic sacs. Which is true regarding this pregnancy?

A. The conceptus divided between 4-8 days after fertilization.
B. This type of twinning has the least chances of having twin-specific complications.
C. This chorionicity warrants automatic cesarean delivery.
D. Twin-to-twin transfusion is not possible in this case.

Answer 22

A. The conceptus divided between 4-8 days after fertilization.

Question 23

A pregnant patient who was diagnosed with Hepatitis B infection 2 years ago showed you her hepatitis profile: HBsAg, Anti-HBc are reactive; HBeAg, Anti-HBs are nonreactive. Which is true regarding her case? *

A. She has chronic hepatitis B infection with high infectivity.
B. Breastfeeding is contraindicated.
C. The neonate should be given hepatitis B vaccine and immunoglobulin within the first 12 hours of life.
D. Tenofovir must be initiated right away.

Answer 23

C. The neonate should be given hepatitis B vaccine and immunoglobulin within the first 12 hours of life.

Question 24

Which is TRUE regarding the management of UTI in pregnancy? *

A. Urine culture showing >100,000 colonies/mL of E. coli may be left untreated if the patient is asymptomatic.
B. As in non-pregnant patients, acute pyelonephritis may be managed on an outpatient basis.
C. Urinalysis is the preferred diagnostic examination to diagnose UTI.
D. IV hydration should be done for cases of acute pyelonephritis.

Answer 24

D. IV hydration should be done for cases of acute pyelonephritis.

Question 25

A 19-year old primigravid in her second trimester complains of vaginal discharge during her first prenatal visit. Upon speculum examination, there was note of copious milky-white, thin, foul-smelling discharge. How would you advise this patient? *

A. Give oral metronidazole.
B. Only topical azoles may be given.
C. Advise patient that this is a sexually transmitted infection.
D. Leukorrhea in pregnancy is a normal finding

Answer 25

A. Give oral metronidazole.

Question 26

30. A 33-year old G6P6 (6006) consulted regarding family planning. She is 12 weeks postpartum who is giving her infant a combination of formula and breast milk. She has no desire for future pregnancy. What is the most appropriate family planning method? *

A. Combined oral contraceptive pills
B. Progestin-only pills
C. Lactation amenorrhea method
D. Interval tubal ligation

Answer 26

D. Interval tubal ligation

Question 27

A 32-year old Gravida 3 Para 3 (3003) presented with a 6-month history of intermenstrual bleeding soaking one pantyliner a day for 5-7 days. She has unremarkable past medical history and systemic PE. Bimanual examination was likewise unremarkable except for blood-tinged examining fingers. Transvaginal ultrasound showed a thickened endometrium with cystic spaces and no myometrial invasion. Saline infusion sonography (SIS) was done revealing the following result. What is the most likely cause of the bleeding?

A. Endometrial polyp
B. Adenomyosis
C. Leiomyoma uteri
D. Endometrial hyperplasia
E. Endometrial cancer

Answer 27

A. Endometrial polyp

Question 28

A 48-year old Gravida 0 came in at the ER due to profuse vaginal bleeding for 3 days, soaking 2 diapers per day and with note of passage of blood clots. She had no known co-morbidities. She was noted to be tachycardic but with normal BP. On PE, she was noted to have pallor with no abdominal tenderness. Internal examination findings are as follows: normal external genitalia, no vaginal masses, cervix was smooth, corpus was enlarged to 14 weeks’ size with note of irregular, knobby contour. Negative pregnancy test was noted. A previously done transvaginal ultrasound is as follows. *

A. Endometrial polyp
B. Adenomyosis
C. Leiomyoma uteri
D. Endometrial hyperplasia
E. Endometrial cancer

Answer 28

C. Leiomyoma uteri

Question 29

A 48-year old nulligravid who is a known diabetic came in at the clinic for prolonged vaginal bleeding, soaking one pad per day every day for the past 6 weeks. On physical examination, she was noted to be obese with unremarkable bimanual examination findings. Ultrasound showed a thickened endometrium with less than 50% invasion into the anterior myometrium. *

A. Endometrial polyp
B. Adenomyosis
C. Leiomyoma uteri
D. Endometrial hyperplasia
E. Endometrial cancer

Answer 29

E. Endometrial cancer

Question 30

A 23-year old nulligravid consulted for irregular menses. Her last menstrual period was 3 months ago. Her previous menstrual period was 7 months prior to consult. On physical examination, her weight was 140 kg and she was noted to have hirsutism and acne. Pregnancy test was negative. Which is NOT true regarding her case? *

A. Ultrasound would most likely show 12 or more follicles on one/two ovaries.
B. Oophorocystectomy may alleviate the symptoms of this patient.
C. Cyclic oral contraceptive pills may be given.
D. Increased LH secretion causes the symptoms of hyperandrogenism.

Answer 30

B. Oophorocystectomy may alleviate the symptoms of this patient.

Question 31

The same patient in the previous number came back after 3 years due to difficulty conceiving despite regular unprotected sexual contact for the past 24 months. Workup showed patent tubes on HSG and normal semen analysis. What will you advise her? *

A. She may undergo ovulation induction with letrozole.
B. Recommend in-vitro fertilization.
C. Do Day 2-3 FSH to check ovarian reserve.
D. Do serum AMH to check ovarian reserve.

Answer 31

A. She may undergo ovulation induction with letrozole.

Question 32

A 12-year old presented at the ER with pallor and dizziness. Her mother reported that she had her first menses four days prior. On PE, there was note of profuse vaginal bleeding with passage of blood clots and bruises in her extremities. She was given oral tranexamic acid two days prior when she consulted at the OPD. What is the most likely cause of abnormal bleeding in this case? *

A. Immature HPO axis
B. Coagulopathy
C. Primary endometrial disorder
D. Drug-induced

Answer 32

B. Coagulopathy

Question 33

A 26-year old nulligravid presented at the ER for severe abdominal pain. She had a 6-month history of severe dysmenorrhea with associated dyspareunia and occasional constipation. Transvaginal ultrasound showed a unilocular cystic mass in the left adnexal region. On exploratory laparotomy, a cystic mass containing chocolate-brown fluid was excised from the left ovary. What is your diagnosis? *

A. Hemorrhagic corpus luteum cyst
B. Endometriotic cyst
C. Immature cystic teratoma
D. Mature cystic teratoma

Answer 33

B. Endometriotic cyst

Question 34

A 55-year old G1P1(1001) was referred for enlarging abdominal girth. She denies weight loss or anorexia. Transvaginal ultrasound result is as follows: massive ascites, occupying the abdominopelvic area is a 9 x 10 cm complex mass that is predominantly solid. CA-125 was noted to be 700 U/mL. What is the appropriate surgical management for this case? *

A. Oophorocystectomy
B. Unilateral salpingo-oophorectomy
C. Total hysterectomy with bilateral salpingo-oophorectomy
D. Total hysterectomy with bilateral salpingo-oophorectomy with staging

Answer 34

D. Total hysterectomy with bilateral salpingo-oophorectomy with staging

Question 35

A 19-year old nulligravid came in at the ER for severe abdominal pain. Emergency exploratory laparotomy with unilateral oophorocystectomy was done. On cut section, the mass had a thin capsule and contained sebum, hair and teeth-like structures. No solid or necrotic areas were noted. What is the most likely diagnosis? *

A. Ovarian fibroma
B. Mature cystic teratoma
C. Yolk sac tumor
D. Granulosa cell tumor

Answer 35

B. Mature cystic teratoma

Question 36

45-year old G7P7(7007) consulted for foul-smelling vaginal discharge and post-coital bleeding. Speculum examination showed a fungating, necrotic mass measuring 2 x 2 cm at the posterior lip of the cervix. What will you advise the patient? *

A. Pap smear must be done.
B. The standard treatment for this case is radical hysterectomy, regardless of stage.
C. The most likely cause is malignant degeneration of a cervical polyp.
D. A biopsy must be done to confirm the diagnosis.

Answer 36

D. A biopsy must be done to confirm the diagnosis.

Question 37

A 21-year old nulligravid presented at the ER with fever (39.2°C) and abdominal pain. Upon examination, she was noted to have foul-smelling mucopurulent vaginal discharge and pain upon manipulation of her cervix. Ultrasound showed a complex mass measuring 4 x 3 cm occupying the left adnexal area. The left ovary was no longer distinguishable from the said mass. How will you manage this case? *

A. Give one dose of IM Ceftriaxone and discharge on oral doxycycline for 14 days.
B. Give one dose of IM Ceftriaxone and discharge on oral doxycycline for 7 days.
C. Admit and give IV Clindamycin with Gentamicin.
D. Admit and prepare for exploratory laparotomy.

Answer 37

C. Admit and give IV Clindamycin with Gentamicin.

Question 38

The following are true regarding pelvic organ prolapse EXCEPT: *

A. In the POP-Q exam, there are 9 points measured at the vagina with respect to the hymen.
B. The points above the hymen are negative numbers; while the points below are positive numbers.
C. Vaginal childbirth is a known risk factor for pelvic organ prolapse.
D. Vaginal hysterectomy and pessaries are among the treatment options

Answer 38

A. In the POP-Q exam, there are 9 points measured at the vagina with respect to the hymen.

Question 39

A 20-year old college student consulted for painful vesicles in on her right labia minora. The vesicles eventually coalesced to form ulcers. What is the treatment? *

A. Doxycycline
B. Penicillin
C. Ceftriaxone
D. Acyclovir

Answer 39

D. Acyclovir

Question 40

Clotting factor that triggers the extrinsic pathway: A 15-year old nulligravid patient consulted for a left-sided labial mass. One week prior, she noted a pea-sized mass in the 5 o’clock position which gradually enlarged to a 5 x 6 cm mass which was fluctuant and tender on palpation. What is the appropriate management?

A. Treat on OPD basis with oral antibiotics.
B. Drain abscess with sterile syringe.
C. Perform excision of the cyst and send for biopsy
D. Perform marsupialization.

Answer 40

D. Perform marsupialization.

Question 41

A 60-year diabetic patient presented at your clinic for vaginal pruritus. Upon speculum examination, you noted white, curd-like discharge in her vaginal walls. Which is true regarding her case? *

A. “Clue cells” will be noted on wet mount.
B. She may be treated with intravaginal azoles.
C. Motile trichomonads may be observed on wet mount.
D. A fishy odor is produced when KOH is mixed with her discharge.

Answer 41

B. She may be treated with intravaginal azoles.

Question 42

A 49-year old G3P3(3003) consulted your clinic with a 18-month history of amenorrhea with associated hot flushes and dyspareunia. Which among the following is TRUE regarding the hormonal milieu in this patient? *

A. Increased FSH
B. Increased inhibin
C. Increased estrogen
D. Increased testosterone

Answer 42

A. Increased FSH

Question 43

A G4P3(3003) 36 1/2 weeks AOG pregnant patient wanted her son to be born in the US. She currently resides in Quezon City, Philippines. What is the best advice for the patient ? *
A. Encourage the patient so the baby becomes an American citizen
B. Allow the patient to travel but not beyond 37 weeks
C. Do not allow the patient to travel
D. The patient can travel after 37 weeks
E. Only travel through air is not advisable

Answer 43

C. Do not allow the patient to travel

Question 44

A 28 weeks AOG G2P1(1001) pregnant patient without complications came in the clinic for consult. She asked about the advised schedule for prenatal visits near term. What should you tell her? *
A. Monthly
B. Every 2 weeks
C. Weekly
D. Twice a week
E. Thrice a week

Answer 44

C. Weekly

Question 45

A patient came in for consult for dysuria and subsequently diagnosed with UTI. She was also prescribed with Cotrimoxazole which she completed. She was also amenorrheic at that time but forgot to tell her doctor. If the patient is pregnant, what side effect would be expected in the baby? *
A. ASD
B. VSD
C. Coarctation of Aorta
D. TGA
E. Anencephaly

Answer 45

E. Anencephaly

Question 46

A 35 yo postpartum patient presented at the ER with persistent bleeding after 2 weeks from delivery. An ultrasound showed a snowstorm appearance. She then undergone dilatation and curettage. Which of the following scenario would not increase the risk of the patient developing Gestational Trophoblastic Neoplasia ? *
A. BhCG plateaus for 3 weeks
B. increase in BhCG >10% for 2 weeks
C. BhCG still detectable after 6 months
D. BhCG shows no decrease after 3 months
E. Positive Histology

Answer 46

D. BhCG shows no decrease after 3 months

Question 47

The patient above was diagnosed with stage 3 GTN, low risk. What should be the management for the patient ? *
A. Single Methotrexate
B. Single Actinomycin
C. EMA
D. EMACO
E. Hysterectomy

Answer 47

A. Single Methotrexate

Question 48

. In relation to the question above, if a patient presented with postpartum bleeding right after delivery, what is the next line of medication to be given to a patient after oxytocin? *
A. Atosiban
B. Ritodrine
C. Methylergonovine
D. Methysergide
E. Carboprost

Answer 48

C. Methylergonovine

Question 49

Upon forceful pulling of the placenta by an intern, an ovoid bleeding mass was palpated by the resident at the introitus. Manual reduction was performed but with little to no avail, what should be the next thing to do? *
A. Repeat manual reduction
B. Use of relaxant or nitroglycerin
C. Laparotomy
D. Hysterectomy
E. It will resolve spontaneously

Answer 49

B. Use of relaxant or nitroglycerin

Question 50

What is the leading cause of death in pregnant patients? *
A. Infection
B. UTI
C. Heart disease
D. Seizure
E. COPD

Answer 50

C. Heart disease

Question 51

The most common illicit substance used during pregnancy is? *
A. Smoking
B. Alcohol
C. Marijuana
D. Cocaine
E. Heroin

Answer 51

C. Marijuana

Question 52

. A diabetic pregnant patient with positive GBS culture from a specimen collected in the ectocervix is scheduled for Cesarean section following cephalopelvic disproportion. Which of the statements below does not describe a correct management for the patient? *
A. Give Penicillin for (+) GBS culture
B. Give insulin
C. Do not give insulin
D. Do not give Pen G
E. Do not do Spontaneous vaginal delivery

Answer 52

D. Do not give Pen G

Question 53

A pregnant patient with Systemic Lupus Erythematosus presented at the ER because of 160 Systolic blood pressure and proteinuria. Which of the following does not support the diagnosis of the patient? *
A. High BP can be present in Lupus Flare
B. Preeclampsia can happen alongside Lupus but is hard to distinguish because both can present with proteinuria
C. Preeclampsia can be differentiated from SLE by low complement levels
D. Severe Preeclampsia is a probable diagnosis in the patient
E. There is improvement in the Glomerular Filtration rate of the patient following pregnancy

Answer 53

C. Preeclampsia can be differentiated from SLE by low complement levels

Question 54

What describes the sidewalls of an anthropoid pelvis? *
A. straight
B. convergent
C. narrow
D. wide
E. Divergent

Answer 54

C. narrow

Question 55

A 45 yo pregnant patient in her 1st trimester was advised to undergo screening because her age puts the baby at high risk for congenital and genetic disease. Which of the results below of her maternal blood tests and ultrasound will not support a diagnosis of Down syndrome? *
A. low PAPP-A
B. low estriol
C. low inhibin
D. high hCG
E. low AFP

Answer 55

C. low inhibin

Question 56

Which of the following incorrectly describes a molar pregnancy? *
A. Complete H. Mole is formed only from paternal chromosomes
B. Snowstorm appearance in UTZ correlate more with complete H. mole than with partial
C. Gestational Trophoblastic disease has a poorer prognosis following preterm delivery than with term pregnancy
D. Complete H. mole is diploid
E. Complete H. mole is often referred to as empty egg

Answer 56

C. Gestational Trophoblastic disease has a poorer prognosis following preterm delivery than with term pregnancy

Question 57

The most common cause of death from cancer in women arises from? *
A. Ovarian cancer
B. Endometrial cancer
C. Cervical cancer
D. Vaginal cancer
E. Metastasis to the GU tract

Answer 57

A. Ovarian cancer

Question 58

(Cont. of 195) The most common mechanism for the spread of the cancer above is through? *
A. Direct Exfoliation
B. Hematogenous
C. Lymphatic
D. Direct extension
E. Downward to the vaginal wall

Answer 58

A. Direct Exfoliation

Question 59

Which of the following is not a protective factor for the occurrence of the cancer in number 195? *
A. Smoking
B. OCP
C. Hysterectomy
D. Chronic Anovulation
E. Breastfeeding

Answer 59

A. Smoking

Question 60

Which of the following drugs should not be avoided in PCOS patients with hirsutism? *
A. SSRI
B. Minoxidil
C. Phenytoin
D. Diazoxide
E. Cyclosporin

Answer 60

A. SSRI

Question 61

In an elderly female following menopause, the most common cause of bleeding would be from? *
A. Genitourinary Syndrome
B. Ovarian Cancer
C. Endometrial Hyperplasia
D. Endometrial Cancer
E. Atrophic Vaginitis

Answer 61

A. Genitourinary Syndrome

Question 62

A painful leiomyoma would probably be located where? *
A. Subserosal
B. Intramural
C. Submucosal
D. Pedunculated
E. Endocervical

Answer 62

A. Subserosal

Question 63

Which of the ff. should be done in cases of episiotomy dehiscence?

1. sitz bath
2. adequate analgesia
3. debride necrotic tissue

Answer 63

1,2,3

Preoperative protocol for Early repair of Episiotomy dehiscence
1. open wound, remove suture, begin IV antibiotics
2. wound care
3.sitz bath several time daily of hydrotherapy
4. Adequate analgesia– regional or general
5.Scrub wound twice daily with povidone iodine
Debride necrotic tissue
Closure when afebrile and pink, healthy granulation tissue predominates
5.Bowel preparation for 4th degree repair

Question 64

Which of the following benign ovarian tumors is associated with Meigs syndrome?

• Fibroma
• Brenner tumor
• Thecoma
• Gynandroblastoma

Answer 64

• Fibroma

Meigs syndrome is defined as the triad of benign ovarian tumor with ascites and pleural effusion that resolves after resection of the tumor. Ovarian fibromas constitute the majority of the benign tumors seen in Meigs syndrome.

a diagnosis of exclusion, only after ovarian carcinoma is ruled out.

Question 65

Meigs syndrome is characterized by: 
I. Pericardial effusion
II. Ascites III. Benign ovarian tumor ]
- I, II
- II, III
- I, III
- I, II, III

Answer 65

• II, III

Pleural effusion
Ascites
Benign ovarian tumor