C. Blood pressure D. Potassium
MPL 1.0 p. 714
374. A 20 year old primigravida 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-gentamycin?
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 p. 1189
375. A puerperal women 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 as 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 0.33 p. 643
376. A pregnant women 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 p. 1025
377. A pregnant woman on her 1sttrimester 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 0.33 p. 1469
378. 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 mm Hg. Cardiopulmonary arrest rapidly ensued. What is the probable cause?
A. cerebrovascular accident B. eclampsia
C. amniotic fluid embolism D. postpartum cardiomyopathy
MPL 0.33 p. 660
379. A G5P4 pregnant uterine 39 weeks was in active labor for 3 hours. IE showed cervix 7 cms dilated, fetal head at station -1 to 0. Suddenly, fetal heart rate decelerated and maternal blood pressure dropped from 120/80 to 90/60 mm Hg. On doing IE, the presenting part appeared to retract. What is the most probable diagnosis?
A. abruption placenta
B. spontaneous uterine rupture C. acute cord torsion
D. uterine atony
MPL 0.5 p. 650
380. 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 ultrasound. What information can be derived from an ultrasound pertinent to management?
A. demonstration of site of bag rupture B. confirmation of fetal maturity
C. assessment of amniotic fluid volume D. detection of fetal meconium staining
MPL 0.33 p: 526
381. During clinical pelvimetry, the ischial spines were noted to be prominent, the sidewalls convergent and the sacraosciatic 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 p: 756
382. Anticipating a large baby, the patient’s 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 p: 461
383. A primigravida 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. oulet forceps extraction C. cesarean section
D. await vaginal delivery MPL 0.25 p: 487
384. 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 perieal area. IE showed 3 cm cervical dilatation, 50 % effaced, intact bag of waters, 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 p: 1496
385. A 53 A 29 year old, Gravida 5 Para 4 (4-0-0-4), Pregnancy uterine 37 weeks, complaining of hypogastric pain of 2 hours, came in the emergency room. Her vital signs were normal. Fundic height was 35 cms. Fundus is occupied by a hard, round, ballotable mass, fetal back palpated at the left, as well on the right, another hard, round mass on the hypogastric area, fetal heart tones of 143/min heard at the left periumbical area
and 152/min heard at the right lower quadrant. On internal examination, the cervix was 5 cms. Dilated, 1 cm long, ruptured bag of waters, cephalic, station -2. All her previous pregnancies were delivered at home. What is the recommended mode of delivery?
A. an outright cesarean section B. a vaginal delivery for both
C. a vaginal delivery for the first of twin then a cesarean section for the second
D. a vaginal delivery for the first of twin then an internal podalic version for the second of twin
MPL 0.25 p: 941
386. Which of the histological presentation is a characteristic of complete molar pregnancy?
A. hydropic degeneration and swelling of the villous stroma B. presence of blood vessels in the swollen villi
C. proliferation of trophoblastic epithelium with equal degree D. presence of fetus and amnion
MPL 0.25 p: 274
387. When the fetal breech presents with both legs extended and the hips flexed, it is classified as A. complete breech
B. incomplete breech C. frank breech D. footling breech
MPL 0.5 p: 567
388. Procedure where the cephalic presented fetus is converted to a footling breech presentation by grasping the fetal legs and turning the position is called
A. external cephalic version B. internal podalic version C. partial breech extraction D. piper’s forceps
MPL 0.5 p: 583
389. Which of the following is associated with Abruptio placenta?
A. Long cord B. Hypertension C. Cord prolapse D. High levels of B-hCG
MPL 1.0 p: 813
390. Which of the following conditions in NOT an indications for classical cesarean section?
A. Myoma occupying the fundus of the uterus B. Invasive carcinoma of the cervix
C. Placenta previa with posterior implantation D. Transverse lie of a large fetus
MPL 0.5 p: 598
391. What is considered as the major vestibular glands that lie under the constrictor muscles of the vagina A. Paraurethral glands
B. Skene’s glands C. Sebaceous glands D. Bartholin’s glands
MPL 0.5 p: 17
392. A 28 year G1P0 sought her first prenatal check up at 12 weeks gestation. Family history is positive for diabetes mellitus (father). When should she have her GCT?
A. 16 – 20 wks B. 24 – 28 wks C. 32 – 36 wks D. at term
MPL 0.33 p: 1171
393. What is the most accurate ultrasonographic parameter for fetal aging in the first trimester ? A. femur length
B. biparietal diameter C. head circumference D. crown – rump length
MPL 0.5 p: 391
394. What do you call a woman who had 3 pregnancies, all of which were aborted?
A. nulligravida B. nullipara C. multipara D. primipara
MPL 0.5 p: 207
395. What is the earliest age of gestation when fetal sex can be identified by gross examination of the external genitalia?
A. 6 weeks B. 10 weeks C. 14 weeks D. 20 weeks
MPL 0.33 p: 113 396. What is most common type of the female pelvis?
A. android
B. anthropoid C. platypelloid D. gynecoid
MPL 1.0 p: 35
397. When does the 2ndstage of labor end?
A. when the cervix is fully dilated B. when the baby is fully delivered C. when the placenta is delivered D. right after episiotomy
MPL 0.5 p: 423
398. How much weight does a average weighted woman gain throughout her pregnancy?
A. 10 lbs B. 18 lbs C. 24 lbs D. 30 lbs
MPL 0.5 p: 452
399. On histopathology, a placenta is found to have dense stroma containing round cells with granular and vacuolated cytoplasm with vascular and eccentric nuclei. What is age of this placenta?
A. 8 weeks B. 14 weeks C. 24 weeks D. 40 weeks
MPL 0.33 p: 612
400. What CTG finding is indicative of head compression?
A. sinusoidal pattern
B. absent beat to beat variability C. early deceleration
D. late deceleration MPL 0.25 p: 452
401. A woman on her 41stweek 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 5 secs with fetal movement, amniotic fluid pocket of 3 cms in perpendicular planes. What should be done for this patients based on the BPS score?
A. Do a outright cesarean section B. Induce labor first
C. Repeat the BPS on the same day D. Repeat the BPS after a week
MPL 0.5 p: 1104
402. When can a puerperal patient start using a hormonal contraceptive method if does not intend to breast feed?
A. 2 - 4 weeks postpartum B. 4 - 6 weeks postpartum C. 6 – 8 weeks postpartum
D. when she starts menstruating again MPL 0.33 p: 412
403. On performing the third’s Leopold’s maneuver, 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 the sinciput MPL 0.33 p: 299
404. On the 2ndpostpartum day, a parturient developed a temperature of 39.0 C. 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 antibiotics
D. give bromocriptine for 7 days MPL 0.25 P: 413
405. On physical examination of a pregnant woman, the clinician 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 p: 1168
406. A 21 year old primigravida in labor for 10 hours presented with a 6 cm cervical dilatation. The bag of waters was ruptured and the presenting fetal head was palpated at station 0. What conclusion regarding the pelvis can be made?
A. pelvic inlet is adequate B. pelvic midplane is adequate C. pelvic inlet is inadequate D. pelvic midplane is inadequate
MPL 0.5 p: 423
407. What maneuver will the fetal head undergo right after engagement?
A. internal rotation
B. extension C. flexion D. descent
MPL 0.5 p: 416
408. What part of the uterus forms the lower uterine segment during labor? 21 A. external cervical os
B. cornua C. fundus D. isthmus
MPL 0.5 p: 21
409. What diameter of the pelvic inlet can be assessed clinically?
A. Obstetric conjugate B. Diagonal conjugate
C. Greatest transverse diameter
D. Posterior midsagittal diameter of the inlet MPL 0.33 p: 34
410. What is the major source of progesterone in early pregnancy?
A. placental cytotrophoblast B. placental syncytiotrophoblast C. corpus luteum
D. placenta
MPL 0.25 p: 124
411. Which of the following antibiotics are contraindicated during pregnancy?
A. metronidazole B. tetracycline C. amoxicil lin D. erythromycin
MPL 0.5 p: 342
412. Myrna, a primigravida, on her 32ndweek AOG, came in for prenatal check-up. Auscultation of the FHT yields negative result and the ultrasound revealed fetal death in utero. How will you manage her?
A. hysterotomy
B. wait for spontaneous labor * C. prostaglandins
D. curettage
MPL 0.5 p: 681
413. In which part of labor does the descent of the presenting part of the fetus is most marked?
A. preparatory division of labor B. 1ststage of labor
C. pelvic division of labor D. 3rdstage of labor
MPL 0.5 p:422
414. Which of the following maternal changes are decreased during pregnancy?
A. gastric emptying time
B. maternal circulating blood volume C. maternal insulin
D. resting pulse rate MPL 0.25 p: 140
415. What conclusions can be made when meconium passage in-utero in a term parturient is observed after amniotomy?
A. The GIT of the fetus is still immature B. Can be a sign of fetal hypoxia C. Fetal sympathetic system is stimulated D. Esophageal atresia is a consideration
MPL 0.25 pp: 675-676
416. What is the earliest histological evidence of progesterone action in the endometrium A. glandular mitoses
B. pseudostratification of nuclei C. stromal edema
D. basal vacuolation MPL 0.25 p: 451
417. Which is the most biologically potent estrogen in the normal menstrual cycle?
A. estrone B. estradiol C. estriol
D. androstenedione
MPL 0.33 pp: 43-44
418. If her last menstrual period is last Jan 23, 2007, when is her expected date of confinement?
A. April 30, 2007 B. June 26, 2007 C. Oct 23, 2007 D. Oct 30, 2007
MPL 1.0 p: 208-209 419. Lochia serosa is expected to occur
A. immediately after birth