Bexam.

William’s Obstetrics
1.The antidote for Magnesium sulfate toxicity is Recall
a.Calcium gluconate*
c.Diazepam 10.In diamnionic monochorionic monozygotic twinning, the division
b.Ca Channel blocker occurs at this time after fertilization-
d.Midazolam a.within 72 hours c.8 days
b.4-8 hour* d.after formation of embryonic
MPL 0.5 d
William’s Obstetrics i
Recall s
2.Which of the following is utilized for medical treatment of ectopic c
pregnancy? MPL 0.33
a.dexamethasone William’s Obstetrics p767
c.methotrexate* Recall
b.vincristine
d.adriamycin
11.Which is a cause of polyhydramnios?
MPL 0.5 a.esophageal atresia*
William’s Obstetrics c.prematurity
Recall b.renal agenesis
d.abruption
3.Of the following, which is most consistently associated with low
birthweight infants? MPL 0.5
a.placenta previa Williams Obstetrics p.1128
c.diabetes mellitus Recall
b.maternal ht.of <5 ft
d.smoking in pregnancy* 12. Which of the following is an example of Buttram and Gibbons Class
III abnormality of the reproductive tract?
MPL 0.25 a.vaginal hypoplasia c.bicornuate uterus
William’s Obstetrics b.unicornuate uterus d.uterine didelphys*
Recall
MPL 0.33
4.A 23 year old G1 at 35 weeks age of gestation comes in for severe Williams Obstetrics p.916
headache and visual blurring. On prenatal check-up 1 week prior, her Recall
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 13. A patient was diagnosed to have high risk gestational trophoblastic
contractions after ten minutes of observation. Cervix was 1cm, 30% tumor. This means that the patient has which of the following?
effaced,intact membranes, station-2. Most likely diagnosis is- a.disease duration of 10 weeks
a.chronic hypertension c.mild preeclampsia b.pretherapy hCG of 89,000 IU/ml*
b.severe preeclampsia* d.chronic hypertension with c.antecedent pregnancy terminated at 20 weeks
superimposed preeclampsia d.no previous chemotherapy
MPL 0.5
William’s Obstetrics MPL 0.33
Application William’s Obstetrics p.836
Comprehension
5.One of the maternal hazards of prolonged fetal death in utero is-
a.hemorrhege form placental abruption 14.On examining a pregnant patient with the ultrasound, the clinician
b.disseminated intravascular coagulation* noted that the lower pole of the placenta was at the edge of the internal
c.hypertensive disorders os. This type of placenta previa is-
d.placental retention from calcification a.low lying c.marginalis*
b.partialis d.totalis
MPL 0.5
William’s Obstetrics MPL 0.5
Recall William’s Obstetrics p 630
6.Cervicovaginal fibronectin is used as a predictor of which condition? Comprehension
a.preclampsia c.preterm labor*
b.fetal growth restriction d.PROM 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
MPL 0.33 means that she has this disorder-
William’s Obstetrics a.prolonged latent phase c.prolonged deceleration phase
Recall b.arrest of dilatation d.protracted active phase of dilatation
MPL 0.33
7.A G2P1 with 4 weeks missed period presents with one week duration William’s Obstetrics p.441 Comprehension
of vaginal bleeding and hypogastric pains. She also has watery vaginal
discharge before consultation. IE findings- 1 to 2 cm dilated with 16. A patient diagnosed to have asymptomatic bacteriuria is one who
ruptured BOW. What is the diagnosis? has
a.inevitable abortion* c.incomplete abortion A. persistently multiplying bacteria in the urine but no
b.imminent abortion d.missed abortion symptoms *
B. 100,000 organisms/ml in culture specimen with pyuria
MPL 0.5 C. a sterile urine culture with frequency and urgency
William’s Obstetrics D. microscopic hematuria and colony count of 50,000/ml
Application

8. The initial maternal immunologic response to a primary rubella MPL 0.25

infection is the elaboration of: William’s p1253
a.IgG Comprehension
c.IgM*
b.IgA 17. Pigmentation of the face during pregnancy is considered as
d.IgD A. an indication of increased androgen from a male fetus
B. an temporary state rapidly regressing postpartum
MPL 0.25 C. a benign but persistent condition *
William’s Obstetrics D. an indication for immediate hydroxyquinone application
Recall
MPL 0.33
9.The vein which is most commonly involved in pelvic thrombophlebitis Williams Obstetrics p.1430
is: Comprehension
a.femoral c.pelvic
b.saphenous d.ovarian* 18. A 25 year old consulted for vaginal spotting and sharp pelvic pain.
History revealed 6 weeks amenorrhea. Pregnancy test was positive.
MPL 0.25 Physical exam elicited cervical wriggling tenderness with a vague
mass and tenderness in the left adnexal. Posterior vaginal fornix was examination, a sac-like structure was seen out of the introitus
full and bulging. BP was 100/60mmHg, PR 96/min. What should be with the placenta still attached. A crater-like depression was
done next to this patient? noted on abdominal palpation. Which of the following is part of
A. culdocentesis good management?
B. immediate exploration * A. immediate removal of the placenta before replacement
C. emergency TVS B. give oxytocin to facilitate replacement
D. blood transfusion C. administer fluids and magnesium sulfate for uterine
MPL 0.25 relaxation *
William’s Obstetrics p890-91 D. do a vaginal hysterectomy
Application
MPL 0.25
19.A 6 year old had difficulty in voiding and was brought for Williams Obstetrics p.643
consult.Inspection revealed agglutination of the labia minora with the Aplication
translucent vertical line pathognomonic for adhesive vulvitis. What
should be done? 26. A 17 yo primigravid on her 28 th week consulted for the first time at
A.observation the OPD. PE revealed pale palpebral conjunctivae. Hgb was 9.2g/dl.
B.testosterone How much elemental iron (mg/dl) does this patient require?
C.scalpel incision A. 100
D.topical estrogen* B. 200 *
C. 300
MPL 0.5 D. 400
Comprehensive Gynecology p.277 MPL 0.25
Application Williams Obstetrics p.1310
Application
20. A preeclamptic patient at 34 weeks was rushed to the ER because
of severe abdominal pain. The best evidence to support the clinician’s 27. A 32 yo G1P0 sought her first prenatal check up at 9 weeks AOG.
suspicion of abruption can be obtained from - Family history is positive for DM (father). When should she have her
A. physical examination * GCT?
B. ultrasonography A. at term
C. culdocentesis B. 32-36 weeks
D. abdominal tap C. 28-32 weeks
D. 24-28 weeks *
MPL 0.5
William’s Obstetrics p. 591 MPL 0.5
Application Williams Obstetrics p.1362
Application

21. A 33 year old parturient had postpartum atony and as a 28. A pregnant woman consulted because of itchy reddish wheal-like
consequence developed symptomatic anemia. Which can benefit her rashes. The lesions were first seen in the abdomen eventually
best? spreading to the rest of the body. She denied having any allergies to
A. fresh whole blood food or drugs. What treatment is appropriate?
B. whole blood A. antibiotics
C. packed RBC* B. estrogen cream
D. fresh frozen plasma C. corticosteroids *
D. lindane
MPL 0.33
Williams Obstetrics p.1310 MPL 0.33
Application Williams Obstetrics p.1025
Application
22. A woman on her 32nd week of gestation was admitted for
threatened preterm labor. Tocolytic management was initiated with 29. A pregnant woman on her 1st trimester of pregnancy was exposed
magnesium sulfate. Which of the following needs to be monitored to a neighbor with german measles. What is the initial step in the
closely while on tocolysis? management?
A. SGOT A. active immunization
B. Glucose B. immunoglobulins
C. Blood pressure * C. antiviral therapy
D. Potassium D. ask history of past infection *

MPL 1.0 MPL 0.5

Williams Obstetrics p714 Williams Obstetrics p.1469
Application Application

23.Despite multiple oxytocic administration, continuous bleeding was 30. A G1P0 PU 32 weeks was brought to the ER because of severe
still noted in a woman on the 4th stage of labor. Which should be done headache and blurring of vision. BP was 170/110 mm Hg. Fundic
first? height was 30 cms, FB on the left, FHT 157/min . There was also
a.begin transfusion grade II bipedal edema, edema of hands and face. What should be
b.manual exploration of uterine cavity done first?
c.inspect vagina and cervix A. Load MgSO4 *
d.bimanual compression* B. Give Hydralazine
C. Do immediate CS
MPL 0.33 D. Administer Diazepam IV
Williams Obstetrics p639 MPL 0.33
Application Williams Obstetrics p.599
Application

24. A 20 yo primigravid at 39 weeks came in due to labor pains. This 31. A G5P4 PU 39 weeks was in active labor for 3 hours. IE showed
patient was a diagnosed case of rheumatic heart disease. When cervix 7 cm dilated, fetal head at station -1 to 0. Suddenly, fetal head
should she receive the initial dose of ampicillin-gentamicin? rate decelerated and maternal blood pressure dropped from 120/80
A. about 2-3 hours after admission mmHg to 90/60 mmHg. On doing IE, the presenting part appeared to
B. prior to amniotomy retract. What is the most probable diagnosis?
C. after the first internal examination A. Abruptio placenta
D. 30 minutes prior to anticipated delivery * B. Spontaneous uterine rupture *
C C. Acute cord torsion
MPL 0.25 D D.Uterine atony
Williams Obstetrics p 1189-91
Application MPL 0.5
Williams Obstetrics p.650
25. A puerperal woman was rushed to the ER because of profuse Analysis
bleeding. On
32. Immediately after an apparently normal labor and delivery, the
mother suddenly manifested with dyspnea and went into convulsions. 39. A woman consulted due to increased vaginal discharge with musty
Blood pressure likewise dropped sharply from 120/80 mmHg. odor most pronounced after coitus with her husband.She appeared
Cardiopulmonary arrest rapidly ensued. What is the probable cause? distressed as this is the first time she experienced this. Her pap smear
A. Cerebrovascular accident 1 month prior was normal. She denied pruritus, dyspareunia, or any
B. Eclampsia missed priod. Howevere, she recently had a bout of AURI which was
C. Amniotic fluid embolism * treated with an antibiotic regimen. Exam showed a thin homogenous,
D. Postpartum cardiomyopathy grayish, white discharge with a pH of 5.5. Which of the following most
likely predisposed her to this type of vaginitis?
MPL 0.33 A.autoinoculation from her AURI
Williams Obstetrics p.660 B.coital activity with the husband
Analysis C.intake of antibiotics*
D.alkaline pH of 5.5

33. A G2P1 PU 31 weeks came to the clinic with complaints of watery MPL 0.33
vaginal discharge. After noting some fluid pooling at the culdesac, the Comprehensive Gynecology p.670-72
clinician requested for an ultrasonographic examination. What Analysis
information can be derived from an UTZ pertinent to management?
A. Demonstration of site of bag rupture 40. A 20 year old, primigravid , PU 39 weeks, presented at the ER in
B. Confirmation of fetal maturity labor for 3 hours.PE revealed multiple vesicular lesions in the vulva
C. Assessment of AFV * and perineal area. IE showed 3 cm cervical dilatation, 50% effaced,
D. Detection of fetal meconium staining (+) BOW, cephalic , station -1. Clinical pelvimetry was adequate. What
is the best route of delivery?
MPL 0.33 A. Cesarean section *
Williams Obstetrics B. vacuum extraction
Analysis C. Outlet forceps extraction
D. Spontaneous vaginal delivery
34. As part of management during observation period, the clinician
advised a patient with a growth restricted infant to obtain adequate bed MPL 0.5
rest. Which position can best benefit or augment fetal growth? Williams Obstetrics p.1496-97
A. Supine Analysis
B. Half reclining
C. Prone 41.Damage to these muscles during vaginal delivery may cause rectal
D. Lateral recumbent * incontinence-
A.Coccygeus
MPL 0.5 B.Deep transverse perineal
Williams Obstetrics C.External and internal sphincter ani*
Analysis D.Bulbocavernosus

35. During clinical pelvimetry, the ischial spines were noted to be MPL 0.5
prominent, the Williams Obstetrics
sidewalls convergent and the sacrosciatic notch is narrow. Of the Recall
following, what is the most common consequence of these
findings? 42. The most accurate ultrasonic parameter for fetal aging in the first
A. This promotes cord prolapse trimester
B. There is increase likelihood for transverse arrest of fetal is-
head * a.biparietal diameter
C. Extreme posterior asynclitism is favored b.crown-rump length*
D. Production of abnormal presentation is facilitated c.head circumference
MPL 0.25 d.femur length
Williams Obstetrics p.756
Analysis MPL 0.5
Williams Obstetrics
36. Anticipating a large baby, the patient’s legs were removed from the Recall
stirrups and sharply flexed upon her abdomen. What will be the effect
of this maneuver? 43.A woman who had three pregnancies, all of which were aborted is
A. Increase pelvic dimension a-
B. Facilitate bearing down effort A.nulligravid
C. Rotates symphysis pubis toward maternal head * B.nullipara
D. Dislodges the posterior shoulder C.multipara*
MPL 0.25 D.primipara
Williams Obstetrics p.461
Analysis MPL 0.5
Williams Obstetrics
37. A primigravid was brought to the ER by the attending midwife after Comprehension
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 44.A second degree perineal laceration involves up to the-
without separating the labia. The sagittal suture was at AP diameter. A.skin and mucosa
The mother appeared weakened by her efforts to bear down. What is B.fascia and muscles*
the best management? C.anal sphincter
A. Strong fundal pressure D.rectal mucosa
B. Outlet forceps extraction *
C. Cesarean section MPL 0.5
D. Await vaginal delivery Williams Obstetrics
MPL 0.25 Comprehension
Williams Obstetrics p.487
Analysis 45.One of the followinbg becomes the new source of endometrium
after delivery-
38. To deliver a foot in the vagina in cases of frank breech A. placental implantation site
presentation, why is it B. decidua vera
important for the clinician to push a fetal knee away from the C. decidua basalis*
midline? D. decidua serosa
A. This facilitates spontaneous flexion so that foot can be
grasped * MPL 0.33
B. The maneuver will facilitate descent of fetal breech Williams Obstetrics
C. This will push the umbilical cord out of the way Recall
D. This will initiate rotation to occiput anterior
MPL 0.5 46.The earliest age of gestation when fetal sex can be identified by
Williams Obstetrics p.520 gross examination of the external genitalia is at-
Analysis A.10 weeks
 B.12 weeks
C.14 weeks* 55. On histopath, a placenta is found to have dense stroma containing
d.16 weeks round cells with granular and vacuolated cytoplasm with vascular and
eccentric nuclei. In terms of age, this placenta is most probably-
MPL 0.33 A.8 weeks
Williams Obstetrics B.14 weeks
Recall C.24 weeks
D.40 weeks
47.This is the midline brownish black pigment that is observed in MPL 0.33
pregnant patients- Williams Obstetrics p.97
A.striae gravidarum Comprehension
B.linea nigra
C.melasma 56.If a neonate has increased IgM antibodies, it means that-
D.chloasma gravidarum A.this was passively transferred from the mother
B.the neonate has congenital infection*
MPL 1.0 C.this is a healthy normal newborn
Williams Obstetrics D.the baby was born post term
Recall
MPL 0.33
48.How many weeks does it take for the entire endometrium to Williams Obstetrics p.148
regenerate after delivery? Comprehension
A.1
B.2 57.Amniotic fluid pocket of <1 cm vertical dimension is suggestive of-
C.3* A.oligohydramnios*
D.4 B.normohydramnios
C.borderline oligohydramnios
D.polyhydramnios
MPL 0.5
Williams Obstetrics MPL 0.5
Recall Williams Obstetrics p.821
Comprehension
49.The female pelvis has an inlet that is commonly-
A.android 58.What CTG finding can be anticipated if the mother develops
B.platypelloid chorioamnionitis during labor?
C.gynecoid* A.sinusoidal pattern
D.anthropoid B.bradycardia
C.tachycardia*
MPL 1.0 D.variable decelerations
Williams Obstetrics
Recall MPL 0.5
Williams Obstetrics
50.A 24 year old patient on her 35th week of gestation has a Comprehension
hemoglobin level of 11.8 g/dl. What should be done for her?
A. request for blood transfusion 59.A pregnant mother developed UTI. Which of the following antibiotics
B. double daily dose of iron supplement* is safest to give?
C. continue daily iron supplementation until puerperium A.erythromycin*
D. order for a peripheral smear B.tetracycline
MPL 0.5 C.chloramphenicol
Williams Obstetrics D.sulfonamides
Application
MPL 1.0
51.The third stage of labor commences – Williams Obstetrics p.1254
A. when cervix is fully dilated Application
B. after epissiorraphy
C. after delivery of the fetus* 60.A woman on her 41st week of pregnancy had a BPS with the
D. after expulsion of placenta following findings during the 30 minutes test-sustained breathing
MPL 0.5 movement of 45 secs, five simultaneous limb and trunk movements, 2
Williams Obstetrics episodes of arm flexion and extension, 3 episodes of fetal heart rate
Recall accelerations each for 15 secs with fetal movement, amniotic fluid
pocket of 3 cms in 2 perpendicular planes. What should be done for
52.This division /phase of labor is most sensitive toanalgesia and this patient based on the BBS score?
maternal sedation- A.induce labor immediately
A.preparatory division* B.repeat BPS after a week*
B.dilatational division C.Do CS
C.pelvic division D.Repeat test on same day
D.deceleration phase
MPL 0.5
MPL 1.0 Williams Obstetrics p/1104
Williams Obstetrics Analysis
Recall
61.Shortly before hospital discharge, a puerperal patient asked when
53.The relation of the fetal parts to one another determines the- she should start protecting herself from subsequent pregnancy. If she
A.presentation has no intention to fully breast feed, protection should be advised ____
B.lie weeks after delivery.
C.attitude* A.1-2
D.station B.2-4
MPL 0.5 C.6-8*
Williams Obstetrics D.9-11
Recall
MPL 0.33
54.Rina, a ramp model, pergnant for the first time on her 6th week AOG Williams Obstetrics p.412
needs to gain how much weight in pounds for the whole duration of her Application
pregnancy?
A.10 62.Two pregnant women were admitted at the same time both for
B.14 induction of labor with oxytocin. Patient A was at 27 weeks AOG IUFD
C.18 while patient B was postterm at 42 weeks, EFW 2,700 grams. Both
D.20* cervices were closed. Which patient will probably be delivered first?
MPL 0.5 A. Patient A because the baby is smaller
Williams Obstetrics B. Patient B because the term uterus has more oxytocin
Application receptors*
 C. Both will deliver at about the same time since oxytocin Analysis/synthesis
dose is the same
D. It is impossible to predict 70.On the second postpartum day, a parturient developed a
temperature of 39.0C pertinent PE included breast that were
MPL 0.5 edematous,tender,firm and nodular.What must be done for this
Williams Obstetrics p.274 patient?
Application A.give analgesic and breast support*
B.stop breastfeeding immediately
63.In attending the a delivery, the clinician observed that with each C.give antistaphylococcal agents
contraction the fetal head already distends the perineum and opens D.give bromocriptine for 7 days
the introitus to a diametr of 6 cms.What should the clinician do?
A.hyperflex the mother’s thighs MPL 0.25
B.catheterize the bladder Williams Obstetrics p.413
C.administer anesthesia Analysis
D.perform Ritgen manuever*
71. Which of the following events is associated with menstrual flow-
MPL 0.25 A.withdrawal of progesterone*
Willaims Obstetrics p.217 B.prolonged maintenance of estrogen
Application C.withdrawal of LH
D.prolonged maintenace of progesterone
64.A pregnant 85 lbs woman sought her very first prenatal consult.
Being underweight, the physician formulated a good nutritional MPL 0.25
surveillance for her. Which of the following constitute a sound part of Comprehensive Gynecology
the plan? Comprehension
A.ensure she force feeds herself everyday
B.serially weigh her to achieve appropriate weight gain* 72.A 47 year old woman has poorly differentiated endometrial
C.monthly hgb and hct determination carcinoma and a uterine cavity that measures 10 cm in depth. The
D.give 60 mg iron tablets 3x a day endocervix has stromal invasion of endometrial carcinoma but no other
structure is involved. What is the stage of her disease?
MPL 0.33 A.IA
Williams Obstetrics p.228 B.IB
Analysis/Synthesis C.IIA
D.IIB*
65.During CTG intrapartum monitoring, minimal variability was noted
with one episode of deceleration (15 beats below the baseline) after a MPL 0.5
contraction in a 10 minute period of observation. Which of the following Comprehensive Gynecology
is an appropriate next step? Application
A.do amnioinfusion
B.place the patient on left lateral recumbent*
C.prepare for immediate 73.Endoscopic procedure utilized to evaluate tubal disease-
D.perform scalp bllod pH determination A.colposcopy
B.laparoscopy*
MPL 0.33 C.hysteroscopy
Williams Obstetrics p.342 D.hysterosalpingography
Analysis
MPL 0.5
66.If a pregnant woman on her 24 weeks of gestation was accidentally Comprehensive Gynecology
administered oxytocin in her IVF instead of the antibiotic prescribed for Recall
her, what will be the effect on her pregnancy?
A.she will have tetanic uterine contractions 74.Tuberculosis of the genital tract invariably involves the-
B.her cervix will efface A.fallopian tubes*
C.no labor pains is likely tio set in * B.ovaries
D.there will be immediate lactation C.cervix
MPL 0.33 D.vagina
Williams Obstetrics p.476
Analysis MPL 1.0
Comprehensive Gynecology
67.On performing the third Leopold’s manuever, the cephalic Recall
prominence is palpated on the left lower quadrant and the fetal heart
tones is maximally heard at the right lower quadrant, which of the 75.A 26 year old G1P1 had cervical intraepithelial neoplasia involving
following can be concluded? the entire thickness of the cervical epithelium. This is best managed
A.the head is already engaged by-
B.the vertex is presenting* A.cryosurgery
C.the head is extended B.electrocautery
D.the presenting part is sinciput C.conization*
D.hysterectomy
MPL 0.33
Williams obstetrics p.299-300 MPL 0.33
Analysis Comprehensive Gynecology
Application
68.On physical examination of a pregnant woman, the clincian
detected a 2/6 systolic murmur intensifying during inspiration. What 76.A 25 year old woman and her husband use natural family planning
should be done for this patient with regards this finding? as their method of contraception. Her menstrual cycle length range
A.cardiology referral from 26 to 32 days. She does not measure her basal body
B.ECG temperature. The time of her maximum or peak fertility with the first
C.no intervention needed* day of her menses defined as day 1 would be between cycle days-
D.echocardiogram A.hari 1-14
B.hari 8-14
MPL 0.5 C.hari 8-21*
Wiliams Obstetrics p.1184 D.hari 14-21
Application
MPL 0.5
69.Which of the following is a component of a good plan for conducting Comprehensive Gynecology
labor and delivery? Application
A.pain reliever every 3 hours
B.strict bed confinement from 2 cms on
C.hourly internal examination 77.The drug of choice for vaginal trichomoniasis is-
D.IV hydration for lengthly labor* A.tetracycline
MPL0.33 B.fluconazole
Williams Obstetrics p.314 C.cefoxitin
 D.metronidazole*

MPL 1.0
Comprehensive Gynecology
Recall 85.Which of these is the most likely site for implantation of
endometriosis-
78. This type of myoma insinuates itself between the leaves of the A.omentum
braod ligament- B.appendix
A.parasitic C.bladder mucosa
B.serosal D.Peritoneum of cul-de-sac*
C.interstitial
D.intraligamentary* MPL 0.5
Comprehensive gynecology
MPL 0.5 Recall
Comprehensive gynecology
Recall 86.Which disease of the vulva is best treated with wide excision?
A.hidradenitis suppurativa*
79.The tumor marker HCG is positive in this tumor- B.invasive vulvar cancer
A.embryonal carcinoma C.angioma
B.choriocarcinoma* D.contact dermatitis
C.endodermal sinus tumor
D.adenocarcinoma MPL 0.5
Comprehensive Gynecology
MPL 0.5 Recall
Comprehensive Gynecology
Recall 87. The ovarian tumor that most commonly causes precocious puberty
is-
80.Uterine bleeding excessive in amount and duration of flow occuring A.teratoma
at regular intervals is- B.luteoma
A.menorrhagia* C.granulosa cell tumor*
B.metrorrhagia D.sertoli leydig tumor
C.polymenorrhea
D.menometrorrhagia MPL 0.5
Comprehensive Gynecology
MPL 0.5 Recall
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
81.A 67 year old had episodes of vaginal bleeding 15 years after descent in labor-
menopause. A. platypelloid
Biopsy reveals cystic endometrial hyperplasia. Transvaginal sonogram B. anthropoid
reveals a C. gynecoid*
solid adnexal mass of 4 cm diameter. She is not on hormonal D. android
replacement
therapy. Most likely cause of bleeding is- MPL 1.0
A.sertoli-leydig tumor Comprehensive Gynecology p571
B.granulosa cell tumor* Comprehension
C.serous cystadenocarcinoma
D.endodermal sinus tumor 89. Stage III vaginal cancer means extension of lesion up to-
A. vaginal wall
MPL 0.5 B. subvaginal tissue
Comprehensive Gynecology C. pelvic wall*
Analysis D. rectal mucosa

MPL 0.33
82.A 40 year old housewife complains of foul smelling vaginal Comprehensive gyncelogy p.1028
discharge. On examination, discharge was greenish-gray in Comprehension
color, foul-smelling and frothy. Primary consideration is-
A.Yeast
B.Trichomoniasis*
C.Chlamydia
D.Bacterial vaginosis

MPL 0.5
Comprehensive Gynecology 90.On endometrial biopsy, glycogen-rich subnuclear vacuoles were
Application seen in the base of the cells lining the glands. What does this mean?
A.the woman is in her late luteal phase
83.A 36 year old G2P2 has amenorrhea of 11 months with hot B.ovulation has occurred*
flushes.Examination reveals a small uterus. If this is a case C.she is progesterone deficient
of premature ovarian failure, which finding is applicable? D.mestruation is about to set in
A.biphasic basal body temperature
B.endometrial hyperplasia MPL 0.33
C.elevated FSH >40 iu/ml* Comprehensive gynecology p.104
D.tonically raised LH Comprehension

MPL 0.5 91.Which theory of endometriosis best explains remote sites if the
Comprehensive Gynecology disease such as in the spinal cord, nasal septum or lungs?
Application A.iatrogenic dissemination
B.coelomic metaplasia
84. Contraindication to hormonal replacement therapy- C.immunologic changes
A.history of pulmonary thromboembolism* D.lymphovascular metastasis*
B.hot fluches, insominia in a 50 y.o with irregular menses
C.history of fibrocystic disease of the breast MPL 0.33
D.elevated serum lipids Comprehensive Gynecology
Comprehension
MPL 0.5
Comprehensive Gynecology 92.Which is an abnormal semen parameter?
Recall 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%
99.A patint was diagnosed to have squamous cell cervical cancer.
MPL 0.33 Clinical evaluation revealed that the disease has involved the upper
Comprehensive Gynecology third of the vagina. Parametrial tissues were indurated. However, there
Comprehension was no evidence of pelvic wall involvement. What is the best treatment
for her?
93.A 32 year old has been having her regular pap testing for the last A.radiotherapy
ten years. Her latest result however revealed low grade SIL.What is B.chemoradiation*
the next step to do? C.RHBLND
A.colposcopic examination D.chemotherapy
B.repeat smear in 4 months*
C.conization MPL 0.5
D.laser ablation Comprehensive Gynecology p.905
Analysis
MPL 0.33
Comprehensive Gynecology p.873 100. A 19 year old consulted because of primary amenorrhea. On
Application clinical evaluation,the patient was found to have breast development
but absent uterus. Which of the following can best help arrive at
94.A 19 year old was brought to the ER because of acute pain. There diagnosis?
was also vaginal spotting. Examination revealed a small tender A.progesterone challenge test
adnexal mass. Based on her LMP, she is on day 25 of her cycle. B.GnRH level determination
Pregnancy test was negative. What is the most likely diagnosis? C.Karyotyping*
A.ectopic pregnancy D.Gonadal biopsy
B.acute salpingitis
C.ruptured corpus luteum* MPL 0.33
D.ruptured endometrial cyst Comprehensive Gynecology p.1106
Analysis
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