INSTRUCTION: Select the correct answer for each of the following questions.

Mark only one answer for each item by shading the box corresponding to letter of your choice on the answer sheet provided. STRICTLY NO ERASURES ALLOWED. Use pencil no. 1 only. OBSTETRICS AND GYNECOLOGY MULTIPLE CHOICE 1. A woman who has been on estrogen- progestin contraceptive pills for 3 yrs. Stopped the intake 6 weeks ago. She is worried she has no menses yet. Pregnancy test was negative. You will a. ask patient to wait c. request for ultrasound b. resume pill intake d. repeat the pregnancy test

2. Myomas in pregnancy is/are associated with increase in all EXCEPT a. abortions c. preterm labor b. caesarean section d. fetal malpresentation 3. Complications of teenage pregnancy include the following EXCEPT a. uterine dysfunction c. low birth weight infant b. pre eclampsia d. breech presentation

4. The modified squatting position for the second stage of labor produces the following EXCEPT a. increase diameter outlet c. increase spinous diameter b. a shorter second stage d. decrease labial secretions

5. The highest number of neonatal deaths occur during the first____ of life a. month b. 24 hours c. week d. minute 6. Which of the following statement is NOT true a. severe anemia is a problem in malaria endemic areas b. pregnant women have a higher density of the parasite c. pregnant women are more predisposed to falcifarum d. antimalaria drugs are contraindicated during pregnancy

7. Long term control of glucose is verified by A, 2 hour post prandial glucose test b. all of these

c. glucose tolerate test d. glycosylated hemoglobin A determination

8. The purpose of the endometrial cycle is a. to provide lubrication during sexual activity

c. all of this

b. to produce eyelic menstruation

d. to prepare for implantation of fertilized ovum

9. The following are true regarding Billings method EXCEPT it is a. useful for women with irregular cycles c. approved by Catholic Church b. based on cervical mucus changes d. a natural family method

10. Most frequent cause of morbidity in infants of diabetic mother is a. hypoglycemia c. respiratory distress b. hypocaicemia d. severe malformation

11. Biophysical profile aside from fetal heart acceleration and movement include the following EXCEPT a. amniotic fluid volume c. fetal tone b. fetal size d. fetal breathing

12. If a woman was operated for breast cancer, the following relatives must be screened for breast cancer EXCEPT her. a. mother b. in laws c. daughter d. sisters 13. Precipitate labor is caused by which of the following a. absence of painful sensation c. low resistance of soft parts b. all of these d. abnormal strong concentration 14. Main advantage of vasectomy is a. reversal procedure can not fertility b. it causes impotence

c. the vas deferens can not connected d. wife can still get pregnant

15. The least possibility of trauma among procedures is in a. midforceps delivery c. delivery of very large infant b. vaginal delivery post caesarean section d. manual extraction of placenta

16. The most common bacteria causing puerperal infection is a. clostridium perlinges c. E. coli b. anaerobic staphylococcus d. anaerobic streptococcus

17. Candidates for postpartum tubal ligation should defer the procedure for these EXCEPT a. psychosis c. prolonged rupture of membrane b. mild hypertension d. puerperal fever 18. After external rotation of the head and spontaneous delivery do not occur, one should do the following EXCEPT a. hook the fingers in the axillae b. apply gentle downward traction on head until anterior shoulder is under symphisis c. follow with upward movement to deliver posterior shoulder d. apply moderate pressure on uterine fundus is acceptable 19. Which of the following factors increase perinatal mortality in breech deliveries a. prematurity c. congenital anomalies b. all of this d. prolapsed cord 20. The possibility of diabetes mellitus should be considered the following condition EXCEPT a. previous baby more than 4 kg. c. history of twins in family b. history of infant with congenital anomaly b. history of polyhydramious

21. In cephalic presentation it is ____ presentation is considered relatively safe to use a. brow b. face c. sinciput vertex

22. Which of the following conditions in the use of prostaglandin is considered relatively safe to use a. to hasten labor c. to ripen the cervix b. for induction of delayed menstruation d. to correct postpartum atony

23. A woman who had four previous term deliveries with one neonatal death is pregnant again. She is __ a. grand multipara c. these means the same b. grand multigravida d. multipara 24. A painful bluish red ischiorectal mass is due to a. varicosities b. hematoma

c. hermorrhoid

d. edema

25. Which of the following are aggregation of veins which are pushed beneath the pubic are during delivery injury of which may cause bleeding a. Bartholins gland c. labia minora b. clitoris d. vestibular bulbs

26. For high risk patients FHT should be checked every _____ minutes during first stage a. 60 b. 15 c. 10 d. 30 27. Post oral glucose screening for gestational diabetes is recommended for all of the following EXCEPT a. patients over 30 years old c. family history of diabetes b. history of antiasthma drugs d. history of still births 28. Methods of estimating blood loss in pregnant women are the following EXCEPT a. urinary output c. BP & PR values b. furosimide test d. visual

29. Which of the following immunizations is contraindicated during pregnancy a. typhoid b. mumps c. influenza d. poliomyelitis

30. The first day of the last menses of a woman with a regular 28 days cycle was March 1. Her ovulation date will be March 14

31. Which of the following antenatal factors is/are proven to predispose to postpartum pelvic infections a. premature rupture of membrance c. anemia b. malnutrition d. all of these

32. If these are doubt as to presence to tubal pregnancy which single procedure is done A. culdoscopy c. laparotomy b. culdocenthesis d. culpotomy

33.Which of these favour growth of anerobic bacteria a. all of these b. devitalized tissue

c. blood and serum collection d. foreign body

34. Which is NOT an indication for repeat internal exam. When______ a. malpresentation is suspected c. prior to transport to referral center b. membranes rupture d. contractions are weak and irregular 35. The most common gynecologie complaints is/are A. vaginal discharge b. pain c. all of these

d. bleeding

36. Adherent placenta may result in which of these a. infection c. perforation b. all of these d. severe hemorrhage

37. The reproductive function of women is directed towards which of the following a. delivery of the fetus c. achievement of pregnancy b. nourishment of fetus d. all of these

38. The following contain 23 autosomes and 1 sex chromosomes EXCEPT a. mature oocyte c. primary spermatocyte b. spermatids d. secondary spermatocyte 39. Which is used for medical management of selected tubal pregnancy a. ampicillin c. progesterone b. methyl ergonavine d. methotrexate

40. A 30 week pregnant multigravida called you because she had painless vaginal bleeding and about 3 glassfuls. You will do all these EXCEPT a. bring a blood donor c. insert in IV fluid b. do an internal exam d. bring to a hospital 41. Higher levels of HCG are found in all the following EXCEPT a. multifetal pregnancy c. hydaitidiform mole b. hydrochaphalic pregnancy d. erythroblastosis

42. Natural childbirth is all EXCEPT a. elimination of fear b. antepartum training

c. relaxation exercises d. elimination pain

43. The benefit of having a woman with fetus in breech deliver in a hospital is a. there are more assistance c. immediate if cord prolapsed b. the midwife does not know breech delivery d. to avoid malpractice suit 44. If HbsAg of a pregnant mother is positive the following are done EXCEPT a. breastfeeding not allowed c. baby is given recombinant vaccine b. baby is given hepatitis B immune globulin d. mother is given immune globulin

45. Ultrasonography during first trimester is useful for all EXCEPT a. embryo identification c. fetal number b. congenital anomalies d. location gestation sac

46. Which antibacterial is avoided in pregnancy a. penicillins b. tetracycline

c. nitrofurantoin d. clindamycin

47. Which of the following cause failure of bilateral tubal ligation a. spontaneous c. surgical error b. luteal phase pregnancy d. all of these

48. The reasons a pregnant woman with significant bleeding in late pregnancy should NOT be subjected to internal exam by midwife is/are a. need for immediate caesarean section c. danger of profuse bleeding b. medico legal problem d. all of these

49. A breech presentation must be differentiated from which of the following a. shoulder presentation c. anencephalic presentation b. all of these d. face presentation

50. The term applied to external organs from mons to perineum is a. vulva b. fouchette c. labia majora 51. Fetal complication/s or severe anemia of the mother is/are a. low birth weight b. all of these c. stillbirth

d. perineal body

d. perineal body

52. Factors which improve success of external version for breech presentation include the following EXCEPT a. engage breech c. anteriorly loated fetal spine b. frank breech d. adequately amniotic fluid

53. The most useful index of the quality of obstestrics care is the _____ rate a. maternal mortality c. neonatal mortality b. stillbirth d. perinatal mortality

54. A 5 week pregnant student from UST wants to know what protection she needs since many of her friends had Hepatitis A a. do not eat with her friends c. her hepatitis B immunization protects her from A b. have hepatitis A immune globulin injection d. drink only bottled water

55. Which of the following is delivered from the mesoderm a. pancreas b. liver c. kidney d. brain 56. General anaesthesia together with the following drugs EXCEPT ____ are used for uterine relaxation and repositioning postpartum uterine inversion a. ritodrine b. MgSO4 c. terbutaline d. oxytocin 57. The following are effects of severe asthma in pregnancy EXCEPT a. preterm labor c. low birth weight b. abortions d. congenital anomalies

58. The type of pelvis with an almost circular inlet with wide pubic are and curved sacrum is a. plantypelliod b. gynecoid c. android d. anthropoid

59. A patients tells you that she had a total hysterectomy. This means she has no more risk for cancer of the ____ a. ovaries c. cervix and corpus b. fallopian tubes d. all of these

60. Which among the following is/are contraindication/s for the use of injectable contraceptives a. obsessed patient c. irregular menstrual date b. history of jaundice d. all of these

61. The following are true regarding transformation zone of the cervix EXCEPT a. it is important to get samples from this area in paps smear b. in older women this goes within the endocervix c. this is not involved in malignancy d. it is the junction of columnar epithelium

62. Which portion of the blastocyst will give rise to the embryo a. outer cell mass b. trophoblast c. inner cell

blasttomere

63. If the posterior fontanelle is lower than the anterior fontanelle the head is ____ a. flexed c. military attitude b. sincipital d. deflexed 64. Prior to oxytocin augmentation which of the following should be assured a. all patient is in true labor c. these is no fetopelvic disproportion b. all of these d. there is hypnotonic uterine dysfunction

65. Which is the principal area involved in puerperal sepsis a. placental site c. myometrium b. endometrium d. deciduas

66. Which is the principal area involved in puerperal sepsis a. placental site c. myometrium b. endometrium d. deciduas

67. After a normal spontaneous vaginal delivery the patient has respiratory distress,cyanosis vaginal bleding and coagulation defect. Diagnosis is a.Sepsis c.aspiration pneumonia b.hoart failure d.amniotic fluid embolism 68.Which of the following is derived from the endoderm a. brain b. skin c. uterus

d. pancreas

69. Complete expulsion or extraction of a fetus from the mother is considered birth, EXCEPT a. gestational age of 20 weeks or more c. crown to heel length of 20 cms. b.umbilical cord has been cut d. fetus is 500 grams or more

70. Abnormal adherence of the placenta is often fund in the following conditions EXCEPT a. pre-eclampsia severe c. previous curettage b. previous caesarean section d. fetus is 500 grams or more

71. When the cephalic prominent and back of baby are on the same side, the head is___ a. engaged b. flexed c. extended d. military attitude 72. The fetal tones heard should be observed a. 1 minute after uterine contraction b. during uterine contraction

c. during uterine relaxation d. immediate after uterine contractions

73. The most common sexually transmitted bacterial disease in women is a. syphilis c. tricomonas vaginalis b. Chlamydia trachomatis d. gonococcus

74. A higher incidence of uterine dysfunction is found in the following condition EXCEPT a. pelvic contraction c. breech presentation b. big baby d. multifetal pregnancy

75. This is not yet engage when the most dependent portion of the skull is at ischial spines, when a. head markedly molded c. all of these extensive caput formation d. shallow pelvis

76. A woman has threatened abortion has increased of the following EXCEPT a. preterm delivery c. perinatal death b. low birth weight d. conginetal malformation

77. A pregnant patient with heart disease goes into failure AT a. 2nd trimester b. anytime c. 3rd trimester

d. puerperium

78. If a postpartum patient is brought to the health center in shoch due to blood loss. You will do the following EXCEPT a. insert fluids c. give oxygen b. give vasoconstrictor injection d. call the physician

79. Modified Ritgens maneuver gives which of the following advantages A. it allows controlled delivery of the head c. it helps prevents lacerations b. it favors extension d. all of these

80.If a patient is diagnosed as having twin pregnancy the following measure are acceptable EXCEPT a. limited physical activity c. preparation for transfusion b. caesarean section d, hospital delivery

81. During the first stage of risk pregnancy fetal heart tones should be checked every____ min. a. 10 b. 60 c. 30 d. 15

82. The greatest transverse diameter of the fetal head is the _____ diameter a. biparietal c. suboccipito bregmatic b. occipitofrontal d. bitemporal 83. A woman comes to the clinic in the 10th day of her cycle. She wants to use contraceptives pills for family planning. You will advise the following EXCEPT a. wait for her next cycle c. advise use of condoms for this month b. start her on contraceptive pills d. tell the couple to abstain until the next menses

84. The most common fixative for paps smear is a. ethyl alcohol b. spray cycle

c. rubbing alcohol d. spray net

85. Hyper immune globulin as post exposure prophylaxis maybe given against which a. hepatitis B b. all of these c. varicella d. rabies

86. A midwife who intends to practice in a remote must be good at which of the following a. risk assessment c. all of these b. community mobilization d. emergency management and referral

87. The functional life span of the corpus luteum is____ days a. 10 b. 20 c. 14 d. 7

88. Baseline mammography according to American Cancer Society should be done by age a. 45 50 b. 25 to 30 c. 35 40 d. 30 to 35 89. Diabetic pregnant patients are best delivered after 38th week, for which of the following a. all of these c. fetal growth retardation b. marked hydramnios d. preeclampsia

90. Which of the following is NOT a cause of persistent corpus luteum a. unruptured graafian follicle c. incomplete abortion b. early missed abortion d. normal intrauterine pregnancy

91. The endoderm gives rise to the following EXCEPT a. thyroid gland b. respiratory tract

c. gastrointestinal tract d. urinary tract

92. Low oxygenation of umbilical vein blood is compensated by the following EXCEPT a. increase fetal cardiac output b. increases oxygen carrying capacity of fetal haemoglobin c. higher fetal haemoglobin d. larger heart proportion body

93. A 32 weeks pregnant multigravida patient had profuse vaginal bleeding without pain. Themost likely diagnosis is a. abruption placenta c. placenta previa b. uterine rupture d. cervical carcinoma

94. The milk injecting hormone is a. oxytocin b. prolactin

c. progesterone d. estrogin

95. Which of the following organism causing infection is implicated as cause of abortion a. Trichomonas vaginalis c. Neisseria gonorrhea b. Chismydia trochemates d. Herpes simplex.

96. Application of 1% tetracycline ointment to eyes of newborn prevents_____ infection a. gonococcal b. all of these c. HIV d. enterococcal

97. Which hormone produces thick, scanty, cellular cervical mucus? a. FSH b. I.H c. estrogen

d. progestin

98. A pregnant woman whose height is less than ___ cius. And an average size baby is at risk for cephalopelvic disproportion a. 160 b. 130 c. 145 d. 175

99. A 12 year old girl was a victim of rape. The best method to prevent pregnancy is a. insert an intrauterinedivice c. give an acid douche b. perform menstrual regulation d. give 4 tabs high dose contraceptive pills

100. The most important reason why a grand multipara is advised hospital delivery is the risk for ____ a. abnormal presentation c. prolapsed of cord b. postpartum hemorrhage d. hypertensive complications