1.

A 22-year-old female comes to a general practitioner because her menstruation period has
been late for 3 weeks. She also complaints of nausea in the morning. Urinalysis shows β-
HCG is positive. Due to her condition, what physiologic changes will happen to her?
a. Decreasing cardiac output
b. Decreasing total blood volume
c. Decreasing glomerulus filtration rate
d. Decreasing oxygen consumption
e. Decreasing systemic vascular resistance

2. A 27-year-old G2P1 woman at 40 weeks gestation is admitted in labor. Her cervix is 9

cm dilated and she has broad pelvic. Uterine contraction occurs every 7-8 min lasting 10-
20 sec. The fetus is predicted 2700 gram from USG. She has history of giving birth to
3300 gram infant through spontaneous delivery. What is the next management in this
case?
a. Cesarean delivery
b. Intranasal gonadotropin therapy
c. Careful observation
d. Intravenous oxytocin
e. Ephysiotomi

3. A 33-year-old nulliparous woman has had difficulty becoming pregnant for the past 2
years. She was recommended by her gynecologist to chart her daily body temperature and
cervical mucus secretions to determine when ovulation is occurring. Which of the
following combination of events would indicate ovulation?
a. Thick cervical mucus; increased body temperature
b. Thin cervical mucus; no change body temperature
c. Thin cervical mucus; increased body temperature
d. Thick cervical mucus; no change in body temperature
e. No change in cervical mucus; decreased body temperature

4. A 40-year-old G5P2A2 woman at 32 weeks gestation complains of bright red vaginal

bleeding. She denies painful uterine contraction and leakage of fluid. She has history of
previous cesarean delivery and curettage. The abdomen is soft and non-tender. Fetal heart
sounds are normal. What is the pathological mechanism in this condition?
a. Increased blood pressure of fetomaternal circulation
b. Separation of placenta from the uterus
c. Implanted placenta at lower segment of uterus
d. Direct trauma to the uterus
e. Premature rupture of amniotic membrane
5. A 19-year-old primigravida is expecting her first child; she is 12 weeks pregnant by
dates. She has vaginal bleeding and an enlarged-for-dates uterus. No fetal heart sounds
are heard. The ultrasound exam reveals a "snow storm" pattern and no fetus. What is the
most likely diagnosis of this woman?
a. Sarcoma botryoides
b. TB endodermitis
c. Adenoca uterus
d. Hydatidiform mole
e. Ectopic pregnancy

6. A 50-year-old female with history of G6P5A1 complains of post-coital bleeding over the
past 6 months. Most recently, she complains of malodorous vaginal discharge. She used
to have multiple sexual partners and she still smokes 1 pack a day for over 20 years.
Speceulum examination reveals a 3 cm exophytic lesion on the cervix. What is the
confirmation examination needed?
a. Gram preparation of vaginal discharge
b. Biopsy of the lesion
c. KOH preparation of skin scraping
d. Histerosalpingografi
e. Culture of the vaginal discharge

7. A 22-year-old woman is noted to have hemorrhage due to ectopic pregnancy of the

isthmus of the left tube. Which of the following artery is ruptured?
a. Branch of Uterine artery
b. Pudendal artery
c. Vaginal artery
d. Vesical artery
e. Internal iliac artery

8. A 26 years old G1P0A0 woman at 10 weeks gestation comes to local clinic for antenatal
care. Her blood pressure is 150/90 mmHg, there was no proteinuria and no edema. She
had history of hypertension before she got pregnant. What is the most likely diagnosis?
a. Gestational hypertension
b. Preeclampsia
c. Eclampsia
d. Superimposed preeclamsia
e. Chronic hypertension
9. A 27-year-old G1 woman at 32 weeks gestation presents with a blood pressure of
160/100 mmHg, 3+ proteinuria and edema. Which medication would be indicated in the
treatment of this patient?
a. Indomethacin
b. Magnesium sulfate
c. Ritodrine
d. Terbutaline
e. Furosemide

10. A 30 years old G1P0A0 woman, 18 weeks pregnancy, comes to emergency room with a
large amount of vaginal bleeding since 2 hours ago after she felt down at bath room. She
also complains abdominal cramp. She is still alert, BP is 100/70 mmHg, pulse 100 x/min.
Speculum exam shows open ostium cervix with moderate bleeding comes out of it. What
is the most likely diagnosis?
a. Abruptio placenta
b. Placenta previa
c. Bladder rupture
d. Abortus insipiens
e. Intrauterine fetal death

11. A 15-year-old boy comes to your office for a health supervision visit. He expresses
concern that he is only 125 cm tall and is not competitive in track. On physical
examination, he appears healthy, has a height of 62 in, and weighs 96 lb. His testes are 8
mL in volume bilaterally, there is slight pubertal phallic enlargement, and he has Sexual
Maturity Rating 3 pubic hair. He has a small amount of subareolar breast tissue. His last
health supervision visit was 2 years ago. He did not have pubic hair at the last visit, and
his testes were described as "prepubertal" in size. Which of the following is the most
likely cause of his short stature?
a. constitutional delayed puberty
b. exercise-induced growth delay
c. Klinefelter syndrome
d. Prolactinoma
e. Undernutrition

12. A 29-year-old mother gave birth to a baby at 32 weeks gestation. She was never given
antenatal steroid before baby was born spontaneously. The baby boy was 1.750 gram,
Apgar Score 6/9. After 30 minutes later he becomes tachypneic, grunting and having
intercostals indrawing. The oxygen saturation is 70%. What is the most possible
pathophysiology mechanism at this condition?
a. Congenital heart disease
b. Hospital acquired pneumonia
 c. Hyaline Membrane Disease
d. Meconium Aspiration syndrome
e. Transient Tacyphneu of the Newborn

13. A 8-month-old baby was brought to pediatrician with history of vomiting and diarrhea.
On examination the baby looked lethargic and pale. His respiratory rate was 57 x/min, no
retraction and good breath sounds. His heart rate was 150 x/min and weak pulse, capillary
filling was 5 seconds. Which is the following diagnosis is most consistent in this case?
a. Cardiorespiratory failure
b. SVT with poor perfusion
c. Hypovolemic shock
d. Acute Gastroenteritis without dehydration
e. Early septic shock

14. A 29-week-old, 1000-g boy is admitted to the neonatal intensive care unit, where he
receives routine care. He does well until day 5 of life, when he develops an increased
respiratory rate, mild subcostal retractions, and a widened pulse pressure, but no cyanosis
or increased oxygen requirement. A continuous murmur is heard along the left sternal
border. Chest radiography shows pulmonary vascular congestion. Which of the following
medications may best relieve his symptoms?
a. Albuterol
b. Epinephrine
c. Indomethacin
d. Digoxin
e. Furosemide

15. A 3-day-old infant with a single second heart sound has had progressively deepening
cyanosis since birth but no respiratory distress. Chest radiography demonstrates no
cardiomegaly and normal pulmonary vasculature. An electrocardiogram shows an axis of
120° and right ventricular prominence. What is the most likely congenital cardiac
malformation happened in this child?
a. Tetralogy of Fallot
b. Transposition of the great vessels
c. Tricuspid atresia
d. Pulmonary atresia with intact ventricular septum
e. Total anomalous pulmonary venous return below the diaphragm