What causes dextrorotation of the gravid uterus?
a. colorectal area
b. rectosigmoid
c. appendix
d. Underlying vessels
B
Mineral which requires supplementation:
a. Calcium
b. Potassium
c. Sodium
d. Magnesium
A
Staining of cells in the pap smear of a pregnant woman may be less than optimal due to:
a. prominence of basal cells
b. proliferation of cervical glands
c. copious amounts of cervical mucus
d. hypervascularity of the cervix
A
Which of the following does not influence uterine hypertrophy?
a. Position placental implantation
b. increase in estrogen
c. mechanical distention of the fetus
d. increased vasculature
D
A 25 years old primigravid patient undergoes c-section for twin gestation of malpresented twins. On exploration, you noted that both ovaries have been converted into large thin walled multicystic masses measuring 8x6 cm. The best method to take is:
a. Remove both ovaries
b. Remove one ovary and send to frozen section
c. Aspirate to decompress
d. Leave alone
D
This much Iron is required during pregnancy
a. 1000 mg
b. 1500 mg
c. 2000 mg
d. 2500 mg
A
Pregnancy is associated with a decrease in which of the following?
a. IL 2
b. IL 4
c. IL 6
d. IL 13
A
Fat deposition occurs primarily during
a. early pregnancy
b. midpregnancy
c. 3rd trimester
d. puerpuerium
B
Magnesium levels in pregnancy can be described as:
a. decrease in total serum and ionized forms
b. decrease total and increased ionized forms
c. normal total and decreased ionized forms
d. increased total and ionized
A
Total serum calcium is decreased in pregnancy due to:
a. decreased intestinal absorption
b. increased excretion
c. decrease in amount of bound calcium
d. increased metabolism of calcium
D
During pregnancy, there is prolonged hyperglycemia in the postprandial state. This is due primarily to:
a. dec insulin secretion
b. inc glycogen production
c. peripheral resistance to insulin
d. secretion of defective insulin molecules
C
What is the weight of the uterus upon full term?
a. 1000 g
b. 1100 g
c. 1200 g
d. 1300 g
B
Changes in the cervix during pregnancy EXCEPT:
a. hypertrophy of connective tissues
b. increased vascularity
c. hyperplasia of cervical glands
d. softening and cyanosis
A
The minimum amount of water that an average woman retains during pregnancy (in L)
a. 5.5
b. 6
c. 6.5
d. 7
C
This is the so-called mask of pregnancy
a. striae gravidarum
b. linea alba
c. melasma gravidarum
d. linea nigra
C
Which of the following is NOT true about nevi in pregnancy?
a. they undergo malignant transformation during pregnancy
b. about 6% increase in diameterduring pregnancy
c. they have enlarged melanocytes
d. there is increased deposition during pregnancy
C
Prolongation of the anagen phase of hair growth is caused by
a. Estrogen
b. Progesterone
c. Androgen
d. aldosterone
A
Characteristic feature of normal pregnancy
a. Scoliosis
b. lumbar lordosis
c. kyphosis
d. cervical lordosis
B
Which of the following statements is true?
a. pelvic joint relaxation due to relaxin
b. joint laxity during early pregnancy
c. wider permanent pelvis for multigravid
d. back pain treatment through bed rest and paracetamol
D
The most common neurologic complaint in pregnancy
a. headache
b. seizure
c. loss of consciousness
d. numbness
A
This condition is caused by growth of capillaries
a. granuloma gravidarum
b. spider angioma
c. epulis of pregnancy
d. palmar erythema
C
Treatment for leg edema:
a. diuretics
b. elastic stockings
c. decreased fluid intake
d. prolonged bed rest
B
The following changes in the CVS are considered to be normal or physiologic during pregnancy except
a. minimal pericardial effusion
b. inc heart rate by 10 to 15 beats per minute
c. displacement of the apex beat to the right and upwards
d. inc in cardiac silhouette on x-ray
C
Which of the following would be suggestive of pathology in a pregnant woman?
a. split s1
b. continuous murmur
c. presence of s3
d. loud diastole
D
An increase in cardiac output is accounted for by an increase in:
a. Peripheral vascular resistance
b. Heart rate
c. Maternal weight
d. NOTA
B
Highest peaks in cardiac output EXCEPT:
a. 28-32 weeks
b. 36-40 weeks
c. Late 2nd stage of labor
d. Immediately postpartum
B
Diminished blood flow from the lower extremities causes the following EXCEPT
a. Varicose veins
b. Dependent edema
c. Deep vein thrombosis
d. Hemorrhoids
D
The RA system, mediated both the maternal uteroplacental unit and maternal kidney, act to control blood pressure via their pressor effects. In woman, destined to become hypertensive, what change occurs?
a. They maintain this refractoriness to the pressor effects
b. They lose this refractoriness to the pressor effects
c. Their refractoriness is heightened/increased
d. NOTA
B
Which mode of anaesthesia makes hemodynamic changes during pregnancy, labor and delivery less labile?
a. General anaesthesia
b. Local anaesthesia
c. Conduction anaesthesia
d. Pudendal block
C
Which of the following respiratory changes occur in pregnancy?
a. Increase in inspiratory reserve volume
b. Increase in functional residual capacity
c. Increase in tidal volume
d. Increase in lung capacity
C
Increase in respiratory rate:
a. Decrease in maternal blood pCO2
b. Increase in maternal blood pH
c. AOTA
d. NOTA
C
Which of the following pulmonary functions is not affected by pregnancy?
a. Lung compliance
b. Tidal volume
c. Functional residual capacity
d. Expiratory reserve volume
A
Responsible for increase in GFR and renal blood flow
a. Estrogen
b. Progesterone
c. Relaxin
d. NOTA
C
A normal finding during pregnancy is:
a. Proteinuria
b. Hematuria
c. Glucosuria
d. Pyuria
C
The most probable explanation for very poor maternal and child health indicator:
a. Deficiency in surgical expertise
b. Lack of high technology equipments
c. Paucity of primary health care
d. AOTA
C
Affects mothers not to seek maternal health care:
a. Age
b. Education
c. Finance
d. AOTA
D
True of maternal mortality in the country
a. can be improved by new technology
b. it is still part of the top ten causes of mortality
c. improved by government reforms
d. all of the above
B
Equity in maternal health services are commonly based on the idea that
a. Optimum sexual and reproductive health is the right of every woman.
b. Services should only be given to the people who can afford
c. Equal prioritization of rich and poor
d. NOTA
A
Addressing the issue of availability is necessary to correct the problem associated with
a. Difference in health system of patients in urban areas
b. Similar utilization of services according to population
c. Imbalance of health system
d. AOTA
C
Optimal utilization of maternal health service is the concept of:
a. Efficiency
b. Equity
c. Accesibility
d. AOTA
A
Accessibility of maternal health care service will mean
a. Facility is in a place favorable to the provider
b. Providing maternal health service in a favorable place to the recipient
c. Developing of health service in urban areas because of dense population
d. AOTA
B
Problems associated with increased maternal and child health morbidity are:
a. High cost of care and services
b. Low accessibility to these care and services
c. Poor quality of care
d. AOTA
D
A 32 year old gravid consults at the outpatient clinic for her 4th pregnancy.
Her first pregnancy was a spontaneous abortion.
The 2nd was a live term pregnancy.
Her 3rd child was born at 30 weeks age of gestation (AOG), but died after a month due to membrane disease.
What’s her obstetric score?
a. G4P2 (1111)
b. G4P3 (1111)
c. G4P2 (1021)
d. G4P2 (2011)
A
A 26 year old primigravid is scheduled at the OPD for follow-up prenatal check up on Feb. 25, 2010. Her LNMP was last Sept. 17, 2009. What will be her AOG at the time of her next consult?
a. 21 3/7 weeks
b. 22 weeks
c. 22 2/7 weeks
d. 23 weeks
D
Compute first by DAYS. List down the months because 31/30/28 day months are counted individually (you cannot generalize that all months are 30 days). You want to be as close as possible in predicting something as important as childbirth.
Sept 17, 2009 +30 Oct 17, 2009 +31 Nov 17, 2009 +30 Dec 17, 2009 +31 Jan 17, 2009 +31 Feb 17, 2009 +8 Feb 25, 2010 ---------- TOTAL: 161 days / 7 = 23 weeks
Recommended routine laboratory tests for the initial prenatal care visit include the following, EXCEPT:
a. CBC (complete blood count)
b. FBS
c. HbsAg
d. VDRL
B
High-risk pregnancies include the following, EXCEPT:
a. History of early neonatal death in a previous pregnancy
b. Preeclampsia
c. History of cervical cancer in a cousin
d. Maternal undernutrition
C
Screening for gestational diabetes is best done at ______ weeks AOG.
a. 20
b. 24
c. 30
d. 32
B
- Which of the following statements is TRUE?
a. Women with uncomplicated pregnancies can work until the onset of labor
b. Prolonged standing at work does not increase risk of preterm delivery
c. High-risk pregnancies, such as preeclampsia, do not benefit from a sedentary lifestyle
d. A maternity leave of 4 weeks prior to delivery is recommended.
A
Choose the correct statement regarding signs of early pregnancy
a. The absence of menses is a reliable indication of pregnancy as early as one day of missed menses.
b. Uterine bleeding in early conception may be physiologic, due to blastocyst implantation.
c. Increase pigmentation &changes in the appearance of abdominal striae is diagnostic of pregnancy
d. During early pregnancy, increase in uterine size is limited to its longitudinal diameter
B
Which of the following common complaints of pregnant women would have serious sequelae?
a. Nausea and vomiting
b. Heartburn
c. Backache
d. Watery vaginal discharge
D
Which of the following vaccines may be given during pregnancy?
a. Influenza
b. Measles
c. Rubella
d. Varicella
A
The recommended total weight gain endorsed by the American College of Obstetritians andGynecologists for pregnant women with normal prepregnant body mass index (BMI) is
a. 15 lbs.
b. 15-25 lbs.
c. 25-35 lbs.
d. 28-40 lbs.
C
Low BMI (29):
During prenatal visit, the following fetal parameters should always be assessed EXCEPT:
a. Fetal size
b. Fetal movement
c. Fetal heart rate
d. Fetal breathing
D
The following maternal parameters should always be assessed every pre-natal checkup, EXCEPT:
a. Blood pressure
b. Danger signs and symptoms
c. Vaginal examination
d. Weight
C
Choose the correct statement
a. Iron is the only nutrient for which requirements during pregnancy could not be met by diet alone.
b. A daily supplement of 60mg of elemental iron is recommended.
c. Iron should be taken on a full stomach for better absorption.
d. Iron is best taken at bedtime to minimize nausea and vomiting
D
The most accurate method of determining the age of gestation (AOG) is by:
a. Calculating from the last normal menstrual period (LNMP)
b. Dating AOG based on the first detection of a positive pregnancy test
c. Correlating it with the patient’s fundic height and estimated fetal weight
d. Basing it on early ultrasound measurement of crown to rump length (CRL)
D
Folic acid intake is best started:
a. Prior to conception
b. During the first trimester
c. During the second trimester
d. During the third trimester
A
The main endocrine organ during pregnancy:
a. Ovary
b. Pituitary gland
c. Thyroid gland
d. Placenta
D
Which of the following is not essential in maintaining pregnancy?
a. Adrenal gland
b. Thyroid gland
c. Pituitary gland
d. Parathyroid gland
C
Principal function of maternal serum prolactin
a. Ensure successful pregnancy outcome
b. Regulate fetal growth
c. Regulate calcium absorption
d. Ensure lactation
D
Which of the following is TRUE regarding thyroid physiology:
a. Thyroxine-binding globulin decreases during the first trimester
b. Moderate thyroid enlargement is due to glandular hyperplasia and increased vascularity
c. There is increased availability of iodide
d. Thyroxine (T4) is greatly decreased
B
The following have increased levels during pregnancy EXCEPT:
a. Dehyrdoepianrosterone sulfate (DHEAS)
b. Aldosterone
c. Cortisol
d. Testosterone
A
Which of the following pregnancy hormones have an immunosuppressive affect?
a. hPL
b. LHRH
c. hCG
d. TRH
C
The antigenically foreign fetus is protected from rejection by the maternal immune system by:
a. Mast cells
b. Trophoblastic tissues
c. Plasma cells
d. Intravenous immunoglobulins
B
The highest levels of leukocyte count during normal pregnancy occurs during
a. 1st trimester
b. 2nd trimester
c. 3rd trimester
d. Labor
D
The suppression of T-helper-1 and T-cytotoxic 1 cells decreases the following EXCEPT:
a. Interleukin- 2
b. Interleukin- 4
c. Interferon-g
d. Tumor necrosis factor-β
B
Which of the following tests can be used to reliably diagnose inflammation during pregnancy?
a. ESR
b. C-reactive protein
c. Complement factors C3 and C4
d. None of the above
D
Gastric emptying time may be prolonged at which stage of pregnancy
a. 1st trimester
b. 2nd trimester
c. 3rd trimester
d. Labor
D
Pyrosis is caused by
a. Decrease in lower esophageal sphincter tone
b. Increase in intraesophageal pressure
c. Decrease in intragastric pressure
d. Higher wave and amplitude of esophageal peristalsis
A
Which of the following increases during pregnancy?
a. Alkaline phosphatase
b. Bilirubin
c. Gamma-glutamate transferase
d. Alanine transferase
A
The increased predisposition of cholesterol stones in the gallbladder of multiparous women can be explained by the following EXCEPT:
a. Increased cholecytokinin- mediated smooth muscle contraction
b. Increased contractility of the gallbladder
c. Increased residual volume of gallbladder contents
d. Increased cholesterol saturation
B
Which is a presumptive sign of pregnancy?
a. Hegar’s sign
b. Goodel’s sign
c. Chadwick’s sign
d. Fetal cardiac activity
C
The presumptive sings of pregnancy are abdmonial striae, breast changes, violaceous vagine (Chadwick’s sign), no menses and increase in skin pigmentation.
Which of the following causes amenorrhea or cessation of menses?
a. Pregnancy
b. Anovulation
c. Severe chronic diseases
d. AOTA
D
Changes in breast during pregnancy
a. Breast enlargement
b. Breast engorgement
c. Darkening of the nipple and areola
d. AOTA
D
Quickening is usually felt within:
a. 6th- 10th week AOG
b. 10th-14th week AOG
c. 16th-20th week AOG
d. 20th-24th week AOG
C
Which of the following is a probable sign of pregnancy manifesting as softening of the isthmus?
a. Hegar’s sign
b. Chadwick’s sign
c. Goodel’s sign
d. NOTA
A
At approximate what age of singleton pregnancy will the uterus be an abdominal organ?
a. 6 weeks AOG
b. 12 weeks AOG
c. 16 weeks AOG
d. 20 weeks AOG
B
Which of the following is not a positive sign of pregnancy?
a. Fetal heart action identified
b. Perception of active fetal movement by examiner
c. Positive detection of B-HCG
d. Ultrasound or radiographic recognition of fetus
C
Detection of B-HCG is a probable sign
At what AOF can transvaginal ultrasound document fetal heart activity?
a. 5 weeks
b. 13 weeks
c. 17 weeks
d. 21 weeks
A
@ 5 weeks – transvaginal ultrasound can detect fetal heart action
@ 13 weeks – Doppler can detect fetal heart action
@ 17 weeks – Stethoscope can detect fetal heart action
What is the term that describes the longitudinal axis of the fetus in relation to the mother’s?
a. Fetal lie
b. Fetal station
c. Fetal attitude
d. Fetal presentation
A
What is the fetal lie when the fetal axis is perpendicular to maternal axis?
a. Breech presentation
b. Longitudinal lie
c. Transverse lie
d. Oblique lie
C
Which of the following position show extension of both legs?
a. double footing
b. single footing
c. Frank position
d. NOTA
C
Which of the following refers to the relation of a determining point of the fetal presenting part of the right and left side of the maternal canal?
a. Station
b. Lie
c. Position
d. Posture
C
What is the fetal position when the lower most portion of the presenting fetal part is at the level of the ischial spines?
a. Floating
b. Station 0
c. Station +3
d. Station -3
B
