Bexam.

1.The antidote for Magnesium sulfate toxicity is

a.Calcium gluconate* c.Diazepam
b.Ca Channel blocker d.Midazolam

MPL 0.5
Williams Obstetrics
Recall
2.Which of the following is utilized for medical treatment of ectopic pregnancy?
a.dexamethasone c.methotrexate*
b.vincristine d.adriamycin

MPL 0.5
Williams Obstetrics
Recall

3.Of the following, which is most consistently associated with low birthweight
infants?
a.placenta previa c.diabetes mellitus
b.maternal ht.of <5 ft d.smoking in pregnancy*

MPL 0.25
Williams Obstetrics
Recall

4.A 23 year old G1 at 35 weeks age of gestation comes in for severe headache
and visual blurring. On prenatal check-up 1 week prior, her BP was noted to be
130/85 mmHg from her usual 110/70. On examination, BP was now at 160/110
mmHg, FHT 140/min, no contractions after ten minutes of observation. Cervix
was 1cm, 30% effaced,intact membranes, station-2. Most likely diagnosis is-
a.chronic hypertension c.mild preeclampsia
b.severe preeclampsia* d.chronic hypertension with
superimposed preeclampsia
MPL 0.5
Williams Obstetrics
Application

5.One of the maternal hazards of prolonged fetal death in utero is-

a.hemorrhege form placental abruption
b.disseminated intravascular coagulation*
c.hypertensive disorders
d.placental retention from calcification

MPL 0.5
Williams Obstetrics
Recall
6.Cervicovaginal fibronectin is used as a predictor of which condition?
a.preclampsia c.preterm labor*
b.fetal growth restriction d.PROM

MPL 0.33
Williams Obstetrics
Recall

7.A G2P1 with 4 weeks missed period presents with one week duration of vaginal
bleeding and hypogastric pains. She also has watery vaginal discharge before
consultation. IE findings- 1 to 2 cm dilated with ruptured BOW. What is the
diagnosis?
a.inevitable abortion* c.incomplete abortion
b.imminent abortion d.missed abortion

MPL 0.5
Williams Obstetrics
Application

8. The initial maternal immunologic response to a primary rubella infection is the

elaboration of:
a.IgG c.IgM*
b.IgA d.IgD

MPL 0.25
Williams Obstetrics
Recall

9.The vein which is most commonly involved in pelvic thrombophlebitis is:

a.femoral c.pelvic
b.saphenous d.ovarian*

MPL 0.25
Williams Obstetrics
Recall

10.In diamnionic monochorionic monozygotic twinning, the division occurs at this

time after fertilization-
a.within 72 hours c.8 days
b.4-8 hour* d.after formation of embryonic
disc
MPL 0.33
Williams Obstetrics p767
Recall

11.Which is a cause of polyhydramnios?

a.esophageal atresia* c.prematurity
b.renal agenesis d.abruption

MPL 0.5
Williams Obstetrics p.1128
Recall

12. Which of the following is an example of Buttram and Gibbons Class III
abnormality of the reproductive tract?
a.vaginal hypoplasia c.bicornuate uterus
b.unicornuate uterus d.uterine didelphys*

MPL 0.33
Williams Obstetrics p.916
Recall

13. A patient was diagnosed to have high risk gestational trophoblastic tumor.
This means that the patient has which of the following?
a.disease duration of 10 weeks
b.pretherapy hCG of 89,000 IU/ml*
 c.antecedent pregnancy terminated at 20 weeks
d.no previous chemotherapy

MPL 0.33
Williams Obstetrics p.836
Comprehension

14.On examining a pregnant patient with the ultrasound, the clinician noted that
the lower pole of the placenta was at the edge of the internal os. This type of
placenta previa is-
a.low lying c.marginalis*
b.partialis d.totalis

MPL 0.5
Williams Obstetrics p 630
Comprehension

15.A nullipara was admitted on active labor at 5 cms and ruptured bag of waters.
IE after 2 hours despite good contractions was 6 cms. This means that she has
this disorder-
a.prolonged latent phase c.prolonged deceleration phase
b.arrest of dilatation d.protracted active phase of
dilatation
MPL 0.33
Williams Obstetrics p.441 Comprehension
16. A patient diagnosed to have asymptomatic bacteriuria is one who has
A. persistently multiplying bacteria in the urine but no symptoms *
B. 100,000 organisms/ml in culture specimen with pyuria
C. a sterile urine culture with frequency and urgency
D. microscopic hematuria and colony count of 50,000/ml

MPL 0.25
Williams p1253
Comprehension

17. Pigmentation of the face during pregnancy is considered as

A. an indication of increased androgen from a male fetus
B. an temporary state rapidly regressing postpartum
C. a benign but persistent condition *
D. an indication for immediate hydroxyquinone application

MPL 0.33
Williams Obstetrics p.1430
Comprehension

18. A 25 year old consulted for vaginal spotting and sharp pelvic pain. History
revealed 6 weeks amenorrhea. Pregnancy test was positive. Physical exam
elicited cervical wriggling tenderness with a vague mass and tenderness in the
left adnexal. Posterior vaginal fornix was full and bulging. BP was 100/60mmHg,
PR 96/min. What should be done next to this patient?
A. culdocentesis
B. immediate exploration *
C. emergency TVS
D. blood transfusion
MPL 0.25
Williams Obstetrics p890-91
Application

19.A 6 year old had difficulty in voiding and was brought for consult.Inspection
revealed agglutination of the labia minora with the translucent vertical line
pathognomonic for adhesive vulvitis. What should be done?
A.observation
B.testosterone
C.scalpel incision
D.topical estrogen*

MPL 0.5
Comprehensive Gynecology p.277
Application

20. A preeclamptic patient at 34 weeks was rushed to the ER because of severe

abdominal pain. The best evidence to support the clinicians suspicion of
abruption can be obtained from -
A. physical examination *
B. ultrasonography
C. culdocentesis
D. abdominal tap

MPL 0.5
Williams Obstetrics p. 591
Application

21. A 33 year old parturient had postpartum atony and as a consequence

developed symptomatic anemia. Which can benefit her best?
A. fresh whole blood
B. whole blood
C. packed RBC*
D. fresh frozen plasma

MPL 0.33
Williams Obstetrics p.1310
Application

22. A woman on her 32nd week of gestation was admitted for threatened preterm
labor. Tocolytic management was initiated with magnesium sulfate. Which of the
following needs to be monitored closely while on tocolysis?
A. SGOT
B. Glucose
C. Blood pressure *
D. Potassium

MPL 1.0
Williams Obstetrics p714
Application

23.Despite multiple oxytocic administration, continuous bleeding was still noted in

a woman on the 4th stage of labor. Which should be done first?
a.begin transfusion
b.manual exploration of uterine cavity
c.inspect vagina and cervix
d.bimanual compression*
MPL 0.33
Williams Obstetrics p639
Application

24. A 20 yo primigravid at 39 weeks came in due to labor pains. This patient was
a diagnosed case of rheumatic heart disease. When should she receive the initial
dose of ampicillin-gentamicin?
A. about 2-3 hours after admission
B. prior to amniotomy
C. after the first internal examination
D. 30 minutes prior to anticipated delivery *

MPL 0.25
Williams Obstetrics p 1189-91
Application

25. A puerperal woman was rushed to the ER because of profuse bleeding. On

examination, a sac-like structure was seen out of the introitus with the
placenta still attached. A crater-like depression was noted on abdominal
palpation. Which of the following is part of good management?
A. immediate removal of the placenta before replacement
B. give oxytocin to facilitate replacement
C. administer fluids and magnesium sulfate for uterine relaxation *
D. do a vaginal hysterectomy

MPL 0.25
Williams Obstetrics p.643
Aplication

26. A 17 yo primigravid on her 28 th week consulted for the first time at the OPD.
PE revealed pale palpebral conjunctivae. Hgb was 9.2g/dl. How much elemental
iron (mg/dl) does this patient require?
A. 100
B. 200 *
C. 300
D. 400
MPL 0.25
Williams Obstetrics p.1310
Application

27. A 32 yo G1P0 sought her first prenatal check up at 9 weeks AOG. Family
history is positive for DM (father). When should she have her GCT?
A. at term
B. 32-36 weeks
C. 28-32 weeks
D. 24-28 weeks *

MPL 0.5
Williams Obstetrics p.1362
Application

28. A pregnant woman consulted because of itchy reddish wheal-like rashes. The
lesions were first seen in the abdomen eventually spreading to the rest of the
body. She denied having any allergies to food or drugs. What treatment is
appropriate?
A. antibiotics
 B. estrogen cream
C. corticosteroids *
D. lindane

MPL 0.33
Williams Obstetrics p.1025
Application

29. A pregnant woman on her 1st trimester of pregnancy was exposed to a

neighbor with german measles. What is the initial step in the management?
A. active immunization
B. immunoglobulins
C. antiviral therapy
D. ask history of past infection *

MPL 0.5
Williams Obstetrics p.1469
Application

30. A G1P0 PU 32 weeks was brought to the ER because of severe headache

and blurring of vision. BP was 170/110 mm Hg. Fundic height was 30 cms, FB on
the left, FHT 157/min . There was also grade II bipedal edema, edema of hands
and face. What should be done first?
A. Load MgSO4 *
B. Give Hydralazine
C. Do immediate CS
D. Administer Diazepam IV
MPL 0.33
Williams Obstetrics p.599
Application

31. A G5P4 PU 39 weeks was in active labor for 3 hours. IE showed cervix 7 cm
dilated, fetal head at station -1 to 0. Suddenly, fetal head rate decelerated and
maternal blood pressure dropped from 120/80 mmHg to 90/60 mmHg. On doing
IE, the presenting part appeared to retract. What is the most probable diagnosis?
A. Abruptio placenta
B. Spontaneous uterine rupture *
C C. Acute cord torsion
D D.Uterine atony

MPL 0.5
Williams Obstetrics p.650
Analysis

32. Immediately after an apparently normal labor and delivery, the mother
suddenly manifested with dyspnea and went into convulsions. Blood pressure
likewise dropped sharply from 120/80 mmHg. Cardiopulmonary arrest rapidly
ensued. What is the probable cause?
A. Cerebrovascular accident
B. Eclampsia
C. Amniotic fluid embolism *
D. Postpartum cardiomyopathy

MPL 0.33
Williams Obstetrics p.660
Analysis
33. A G2P1 PU 31 weeks came to the clinic with complaints of watery vaginal
discharge. After noting some fluid pooling at the culdesac, the clinician requested
for an ultrasonographic examination. What information can be derived from an
UTZ pertinent to management?
A. Demonstration of site of bag rupture
B. Confirmation of fetal maturity
C. Assessment of AFV *
D. Detection of fetal meconium staining

MPL 0.33
Williams Obstetrics
Analysis

34. As part of management during observation period, the clinician advised a

patient with a growth restricted infant to obtain adequate bed rest. Which position
can best benefit or augment fetal growth?
A. Supine
B. Half reclining
C. Prone
D. Lateral recumbent *

MPL 0.5
Williams Obstetrics
Analysis

35. During clinical pelvimetry, the ischial spines were noted to be prominent, the
sidewalls convergent and the sacrosciatic notch is narrow. Of the following,
what is the most common consequence of these findings?
A. This promotes cord prolapse
B. There is increase likelihood for transverse arrest of fetal head *
C. Extreme posterior asynclitism is favored
D. Production of abnormal presentation is facilitated
MPL 0.25
Williams Obstetrics p.756
Analysis

36. Anticipating a large baby, the patients legs were removed from the stirrups
and sharply flexed upon her abdomen. What will be the effect of this maneuver?
A. Increase pelvic dimension
B. Facilitate bearing down effort
C. Rotates symphysis pubis toward maternal head *
D. Dislodges the posterior shoulder
MPL 0.25
Williams Obstetrics p.461
Analysis

37. A primigravid was brought to the ER by the attending midwife after 10 hours
of labor. Apparently she has been bearing down for 2 hours already. Exam
showed that the fetal scalp is visible at the introitus without separating the labia.
The sagittal suture was at AP diameter. The mother appeared weakened by her
efforts to bear down. What is the best management?
A. Strong fundal pressure
B. Outlet forceps extraction *
C. Cesarean section
D. Await vaginal delivery
MPL 0.25
Williams Obstetrics p.487
Analysis

38. To deliver a foot in the vagina in cases of frank breech presentation, why is it
important for the clinician to push a fetal knee away from the midline?
A. This facilitates spontaneous flexion so that foot can be grasped *
B. The maneuver will facilitate descent of fetal breech
C. This will push the umbilical cord out of the way
D. This will initiate rotation to occiput anterior
MPL 0.5
Williams Obstetrics p.520
Analysis

39. A woman consulted due to increased vaginal discharge with musty odor most
pronounced after coitus with her husband.She appeared distressed as this is the
first time she experienced this. Her pap smear 1 month prior was normal. She
denied pruritus, dyspareunia, or any missed priod. Howevere, she recently had a
bout of AURI which was treated with an antibiotic regimen. Exam showed a thin
homogenous, grayish, white discharge with a pH of 5.5. Which of the following
most likely predisposed her to this type of vaginitis?
A.autoinoculation from her AURI
B.coital activity with the husband
C.intake of antibiotics*
D.alkaline pH of 5.5

MPL 0.33
Comprehensive Gynecology p.670-72
Analysis

40. A 20 year old, primigravid , PU 39 weeks, presented at the ER in labor for 3

hours.PE revealed multiple vesicular lesions in the vulva and perineal area. IE
showed 3 cm cervical dilatation, 50% effaced, (+) BOW, cephalic , station -1.
Clinical pelvimetry was adequate. What is the best route of delivery?
A. Cesarean section *
B. vacuum extraction
C. Outlet forceps extraction
D. Spontaneous vaginal delivery

MPL 0.5
Williams Obstetrics p.1496-97
Analysis

41.Damage to these muscles during vaginal delivery may cause rectal

incontinence-
A.Coccygeus
B.Deep transverse perineal
C.External and internal sphincter ani*
D.Bulbocavernosus

MPL 0.5
Williams Obstetrics
Recall

42. The most accurate ultrasonic parameter for fetal aging in the first trimester
is-
a.biparietal diameter
 b.crown-rump length*
c.head circumference
d.femur length

MPL 0.5
Williams Obstetrics
Recall

43.A woman who had three pregnancies, all of which were aborted is a-
A.nulligravid
B.nullipara
C.multipara*
D.primipara

MPL 0.5
Williams Obstetrics
Comprehension

44.A second degree perineal laceration involves up to the-

A.skin and mucosa
B.fascia and muscles*
C.anal sphincter
D.rectal mucosa

MPL 0.5
Williams Obstetrics
Comprehension

45.One of the followinbg becomes the new source of endometrium after delivery-
A. placental implantation site
B. decidua vera
C. decidua basalis*
D. decidua serosa

MPL 0.33
Williams Obstetrics
Recall

46.The earliest age of gestation when fetal sex can be identified by gross
examination of the external genitalia is at-
A.10 weeks
B.12 weeks
C.14 weeks*
d.16 weeks

MPL 0.33
Williams Obstetrics
Recall

47.This is the midline brownish black pigment that is observed in pregnant

patients-
A.striae gravidarum
B.linea nigra
C.melasma
D.chloasma gravidarum

MPL 1.0
Williams Obstetrics
Recall

48.How many weeks does it take for the entire endometrium to regenerate after
delivery?
A.1
B.2
C.3*
D.4

MPL 0.5
Williams Obstetrics
Recall

49.The female pelvis has an inlet that is commonly-

A.android
B.platypelloid
C.gynecoid*
D.anthropoid

MPL 1.0
Williams Obstetrics
Recall

50.A 24 year old patient on her 35th week of gestation has a hemoglobin level of
11.8 g/dl. What should be done for her?
A. request for blood transfusion
B. double daily dose of iron supplement*
C. continue daily iron supplementation until puerperium
D. order for a peripheral smear
MPL 0.5
Williams Obstetrics
Application

51.The third stage of labor commences

A. when cervix is fully dilated
B. after epissiorraphy
C. after delivery of the fetus*
D. after expulsion of placenta
MPL 0.5
Williams Obstetrics
Recall

52.This division /phase of labor is most sensitive toanalgesia and maternal

sedation-
A.preparatory division*
B.dilatational division
C.pelvic division
D.deceleration phase

MPL 1.0
Williams Obstetrics
Recall

53.The relation of the fetal parts to one another determines the-

A.presentation
 B.lie
C.attitude*
D.station
MPL 0.5
Williams Obstetrics
Recall

54.Rina, a ramp model, pergnant for the first time on her 6 th week AOG needs to
gain how much weight in pounds for the whole duration of her pregnancy?
A.10
B.14
C.18
D.20*
MPL 0.5
Williams Obstetrics
Application

55. On histopath, a placenta is found to have dense stroma containing round

cells with granular and vacuolated cytoplasm with vascular and eccentric nuclei.
In terms of age, this placenta is most probably-
A.8 weeks
B.14 weeks
C.24 weeks
D.40 weeks
MPL 0.33
Williams Obstetrics p.97
Comprehension

56.If a neonate has increased IgM antibodies, it means that-

A.this was passively transferred from the mother
B.the neonate has congenital infection*
C.this is a healthy normal newborn
D.the baby was born post term

MPL 0.33
Williams Obstetrics p.148
Comprehension

57.Amniotic fluid pocket of <1 cm vertical dimension is suggestive of-

A.oligohydramnios*
B.normohydramnios
C.borderline oligohydramnios
D.polyhydramnios

MPL 0.5
Williams Obstetrics p.821
Comprehension

58.What CTG finding can be anticipated if the mother develops chorioamnionitis

during labor?
A.sinusoidal pattern
B.bradycardia
C.tachycardia*
D.variable decelerations

MPL 0.5
Williams Obstetrics
Comprehension

59.A pregnant mother developed UTI. Which of the following antibiotics is safest
to give?
A.erythromycin*
B.tetracycline
C.chloramphenicol
D.sulfonamides

MPL 1.0
Williams Obstetrics p.1254
Application

60.A woman on her 41st week of pregnancy had a BPS with the following findings
during the 30 minutes test-sustained breathing movement of 45 secs, five
simultaneous limb and trunk movements, 2 episodes of arm flexion and
extension, 3 episodes of fetal heart rate accelerations each for 15 secs with fetal
movement, amniotic fluid pocket of 3 cms in 2 perpendicular planes. What should
be done for this patient based on the BBS score?
A.induce labor immediately
B.repeat BPS after a week*
C.Do CS
D.Repeat test on same day

MPL 0.5
Williams Obstetrics p/1104
Analysis

61.Shortly before hospital discharge, a puerperal patient asked when she should
start protecting herself from subsequent pregnancy. If she has no intention to
fully breast feed, protection should be advised ____ weeks after delivery.
A.1-2
B.2-4
C.6-8*
D.9-11

MPL 0.33
Williams Obstetrics p.412
Application

62.Two pregnant women were admitted at the same time both for induction of
labor with oxytocin. Patient A was at 27 weeks AOG IUFD while patient B was
postterm at 42 weeks, EFW 2,700 grams. Both cervices were closed. Which
patient will probably be delivered first?
A. Patient A because the baby is smaller
B. Patient B because the term uterus has more oxytocin receptors*
C. Both will deliver at about the same time since oxytocin dose is the
same
D. It is impossible to predict

MPL 0.5
Williams Obstetrics p.274
Application

63.In attending the a delivery, the clinician observed that with each contraction
the fetal head already distends the perineum and opens the introitus to a diametr
of 6 cms.What should the clinician do?
 A.hyperflex the mothers thighs
B.catheterize the bladder
C.administer anesthesia
D.perform Ritgen manuever*

MPL 0.25
Willaims Obstetrics p.217
Application

64.A pregnant 85 lbs woman sought her very first prenatal consult. Being
underweight, the physician formulated a good nutritional surveillance for her.
Which of the following constitute a sound part of the plan?
A.ensure she force feeds herself everyday
B.serially weigh her to achieve appropriate weight gain*
C.monthly hgb and hct determination
D.give 60 mg iron tablets 3x a day

MPL 0.33
Williams Obstetrics p.228
Analysis/Synthesis

65.During CTG intrapartum monitoring, minimal variability was noted with one
episode of deceleration (15 beats below the baseline) after a contraction in a 10
minute period of observation. Which of the following is an appropriate next step?
A.do amnioinfusion
B.place the patient on left lateral recumbent*
C.prepare for immediate
D.perform scalp bllod pH determination

MPL 0.33
Williams Obstetrics p.342
Analysis

66.If a pregnant woman on her 24 weeks of gestation was accidentally

administered oxytocin in her IVF instead of the antibiotic prescribed for her, what
will be the effect on her pregnancy?
A.she will have tetanic uterine contractions
B.her cervix will efface
C.no labor pains is likely tio set in *
D.there will be immediate lactation
MPL 0.33
Williams Obstetrics p.476
Analysis

67.On performing the third Leopolds manuever, the cephalic prominence is

palpated on the left lower quadrant and the fetal heart tones is maximally heard
at the right lower quadrant, which of the following can be concluded?
A.the head is already engaged
B.the vertex is presenting*
C.the head is extended
D.the presenting part is sinciput

MPL 0.33
Williams obstetrics p.299-300
Analysis
68.On physical examination of a pregnant woman, the clincian detected a 2/6
systolic murmur intensifying during inspiration. What should be done for this
patient with regards this finding?
A.cardiology referral
B.ECG
C.no intervention needed*
D.echocardiogram

MPL 0.5
Wiliams Obstetrics p.1184
Application

69.Which of the following is a component of a good plan for conducting labor and
delivery?
A.pain reliever every 3 hours
B.strict bed confinement from 2 cms on
C.hourly internal examination
D.IV hydration for lengthly labor*
MPL0.33
Williams Obstetrics p.314
Analysis/synthesis

70.On the second postpartum day, a parturient developed a temperature of

39.0C pertinent PE included breast that were edematous,tender,firm and
nodular.What must be done for this patient?
A.give analgesic and breast support*
B.stop breastfeeding immediately
C.give antistaphylococcal agents
D.give bromocriptine for 7 days

MPL 0.25
Williams Obstetrics p.413
Analysis

71. Which of the following events is associated with menstrual flow-

A.withdrawal of progesterone*
B.prolonged maintenance of estrogen
C.withdrawal of LH
D.prolonged maintenace of progesterone

MPL 0.25
Comprehensive Gynecology
Comprehension

72.A 47 year old woman has poorly differentiated endometrial carcinoma and a
uterine cavity that measures 10 cm in depth. The endocervix has stromal
invasion of endometrial carcinoma but no other structure is involved. What is the
stage of her disease?
A.IA
B.IB
C.IIA
D.IIB*

MPL 0.5
Comprehensive Gynecology
Application
73.Endoscopic procedure utilized to evaluate tubal disease-
A.colposcopy
B.laparoscopy*
C.hysteroscopy
D.hysterosalpingography

MPL 0.5
Comprehensive Gynecology
Recall

74.Tuberculosis of the genital tract invariably involves the-

A.fallopian tubes*
B.ovaries
C.cervix
D.vagina

MPL 1.0
Comprehensive Gynecology
Recall

75.A 26 year old G1P1 had cervical intraepithelial neoplasia involving the entire
thickness of the cervical epithelium. This is best managed by-
A.cryosurgery
B.electrocautery
C.conization*
D.hysterectomy

MPL 0.33
Comprehensive Gynecology
Application

76.A 25 year old woman and her husband use natural family planning as their
method of contraception. Her menstrual cycle length range from 26 to 32 days.
She does not measure her basal body temperature. The time of her maximum or
peak fertility with the first day of her menses defined as day 1 would be between
cycle days-
A.hari 1-14
B.hari 8-14
C.hari 8-21*
D.hari 14-21

MPL 0.5
Comprehensive Gynecology
Application

77.The drug of choice for vaginal trichomoniasis is-

A.tetracycline
B.fluconazole
C.cefoxitin
D.metronidazole*

MPL 1.0
Comprehensive Gynecology
Recall
78. This type of myoma insinuates itself between the leaves of the braod
ligament-
A.parasitic
B.serosal
C.interstitial
D.intraligamentary*

MPL 0.5
Comprehensive gynecology
Recall

79.The tumor marker HCG is positive in this tumor-

A.embryonal carcinoma
B.choriocarcinoma*
C.endodermal sinus tumor
D.adenocarcinoma

MPL 0.5
Comprehensive Gynecology
Recall

80.Uterine bleeding excessive in amount and duration of flow occuring at regular

intervals is-
A.menorrhagia*
B.metrorrhagia
C.polymenorrhea
D.menometrorrhagia

MPL 0.5
Comprehensive Gynecology
Recall

81.A 67 year old had episodes of vaginal bleeding 15 years after menopause.
Biopsy reveals cystic endometrial hyperplasia. Transvaginal sonogram reveals a
solid adnexal mass of 4 cm diameter. She is not on hormonal replacement
therapy. Most likely cause of bleeding is-
A.sertoli-leydig tumor
B.granulosa cell tumor*
C.serous cystadenocarcinoma
D.endodermal sinus tumor

MPL 0.5
Comprehensive Gynecology
Analysis

82.A 40 year old housewife complains of foul smelling vaginal discharge. On

examination, discharge was greenish-gray in color, foul-smelling and
frothy. Primary consideration is-
A.Yeast
B.Trichomoniasis*
C.Chlamydia
D.Bacterial vaginosis

MPL 0.5
Comprehensive Gynecology
Application
83.A 36 year old G2P2 has amenorrhea of 11 months with hot
flushes.Examination reveals a small uterus. If this is a case of premature
ovarian failure, which finding is applicable?
A.biphasic basal body temperature
B.endometrial hyperplasia
C.elevated FSH >40 iu/ml*
D.tonically raised LH

MPL 0.5
Comprehensive Gynecology
Application

84. Contraindication to hormonal replacement therapy-

A.history of pulmonary thromboembolism*
B.hot fluches, insominia in a 50 y.o with irregular menses
C.history of fibrocystic disease of the breast
D.elevated serum lipids

MPL 0.5
Comprehensive Gynecology
Recall

85.Which of these is the most likely site for implantation of endometriosis-

A.omentum
B.appendix
C.bladder mucosa
D.Peritoneum of cul-de-sac*

MPL 0.5
Comprehensive gynecology
Recall

86.Which disease of the vulva is best treated with wide excision?

A.hidradenitis suppurativa*
B.invasive vulvar cancer
C.angioma
D.contact dermatitis

MPL 0.5
Comprehensive Gynecology
Recall

87. The ovarian tumor that most commonly causes precocious puberty is-
A.teratoma
B.luteoma
C.granulosa cell tumor*
D.sertoli leydig tumor

MPL 0.5
Comprehensive Gynecology
Recall
88. A woman with this type of pelvis is more prone to urethrocoele because of
more force of the fetal head on this area during descent in labor-
A. platypelloid
B. anthropoid
C. gynecoid*
D. android

MPL 1.0
Comprehensive Gynecology p571
Comprehension

89. Stage III vaginal cancer means extension of lesion up to-

A. vaginal wall
B. subvaginal tissue
C. pelvic wall*
D. rectal mucosa

MPL 0.33
Comprehensive gyncelogy p.1028
Comprehension

90.On endometrial biopsy, glycogen-rich subnuclear vacuoles were seen in the

base of the cells lining the glands. What does this mean?
A.the woman is in her late luteal phase
B.ovulation has occurred*
C.she is progesterone deficient
D.mestruation is about to set in

MPL 0.33
Comprehensive gynecology p.104
Comprehension

91.Which theory of endometriosis best explains remote sites if the disease such
as in the spinal cord, nasal septum or lungs?
A.iatrogenic dissemination
B.coelomic metaplasia
C.immunologic changes
D.lymphovascular metastasis*

MPL 0.33
Comprehensive Gynecology
Comprehension

92.Which is an abnormal semen parameter?

A.white cell count of 105 per ml
B.sperm morphology 31%*
C.sperm count 40 x 105 per ml
D.progressive motility in 65%

MPL 0.33
Comprehensive Gynecology
Comprehension

93.A 32 year old has been having her regular pap testing for the last ten years.
Her latest result however revealed low grade SIL.What is the next step to do?
A.colposcopic examination
B.repeat smear in 4 months*
C.conization
D.laser ablation

MPL 0.33
Comprehensive Gynecology p.873
Application

94.A 19 year old was brought to the ER because of acute pain. There was also
vaginal spotting. Examination revealed a small tender adnexal mass. Based on
her LMP, she is on day 25 of her cycle. Pregnancy test was negative. What is the
most likely diagnosis?
A.ectopic pregnancy
B.acute salpingitis
C.ruptured corpus luteum*
D.ruptured endometrial cyst

MPL 0.33
Comprehensive Gynecology p.509
Analysis

95.A 28 year old nulligravid with primary infertility and cyclic pelvic pain was
diagnosed to have endometriosis. She was placed on hormonal treatment.
However, while on this drug, syhe developed acne,hirsutism, and deepening of
the voice. What is a better alternative?
A.laparoscopic fulguration
B.GnRH agonist*
C.progesterone injectables
D.Oral contraceptives

MPL 0.33
Comprehensive gynecology p.546
Analysis

96.A 35 year old consulted because of vesicular lesions in the vulva. She related
that several days prior to the appearance of the vesicles, she felt numbing
sensation over her vulvar skin. Which is the best treatment?
A.metronidazole
B.acyclovir*
C.doxycyline
D.penicillin

MPL 0.33
Comprehensive Gynecology p.659
Analysis

97.A 17 year old consulted because of lower abdominal pain of 3 days duration
described as constant and dull.On speculum exam, purulent vaginal discharge
was noted. Patient was febrile at 38.5 C. Perinent finding on internal exam:
tenderness with motion of the uterus and cervix. Which is the most pressing
reasoin for admitting this patient?
 A.purulent discharge
B.fever
C.tenderness on IE
D.age*

MPL 0.5
Comprehensive Gynecology p.724
Analysis

98.A woman consulted because of spontaneous milky discharge and missed

period of 8 weeks. Pregnancy test was negative. Prolactin levels after
appropriate blood collection was 35 ng/ml. What should be the next step in the
work-up?
A.repeat prolactin in a quiet room
B.CT scan of the brain
C.Cone view of the sella turcica
D.TSH determination*

MPL 0.33
Comprehensive Gynecology p.1133
Analysis

99.A patint was diagnosed to have squamous cell cervical cancer. Clinical
evaluation revealed that the disease has involved the upper third of the vagina.
Parametrial tissues were indurated. However, there was no evidence of pelvic
wall involvement. What is the best treatment for her?
A.radiotherapy
B.chemoradiation*
C.RHBLND
D.chemotherapy

MPL 0.5
Comprehensive Gynecology p.905
Analysis

100. A 19 year old consulted because of primary amenorrhea. On clinical

evaluation,the patient was found to have breast development but absent uterus.
Which of the following can best help arrive at diagnosis?
A.progesterone challenge test
B.GnRH level determination
C.Karyotyping*
D.Gonadal biopsy

MPL 0.33
Comprehensive Gynecology p.1106
Analysis