[OB] FINALS EDITED

1.A 36 y/o G6P6 came to the ER because of heavy vaginal bleeding. History revealed the patient was delivered a couple of hours ago at home by a midwife. PE revealed a BP of 70/40, HR of 105, and a fleshy reddish mass protruding out of her vaginal canal. Upon further investigation, the husband claims she saw the midwife tugging vigorously at the umbilical cord immediately after delivery of the baby. The most likely diagnosis would be: A. Placenta abruptio B. Placenta previa C. Cervical cancer D. Uterine inversion

Answer: D. Uterine inversion

2.A 20 y/o G2P1 PU 34 weeks came in tachypneic, with cold and clammy extremities associated with lumbar pain. VS showed BP of 80/60, HR 125, and IE is unremarkable. FHT is 140 bpm, CBC reveals leukocytosis with a predominance of segmenters. She had 3 PNCUs wherein cefuroxime 500mg/cap BID was prescribed, but the patient was noncompliant. Which among the following is the most likely reason for the patient’s condition? A. Hypovolemic shock due to occult bleeding B. Septic shock due to untreated pyelonephritis C. Cardiogenic shock due to untreated infection D. Septic shock due to obstructive uropathy

Answer: B. Septic shock due to untreated pyelonephritis

3.A 19 y/o nulligravid consulted the OPD due to dysmenorrhea. Initial impression is pelvic endometriosis. What are the internal exam findings on the patient? A. A fixed, anteverted uterus with scarring and tenderness posterior to the uterus. The characteristic nodularity of the cardinal ligaments and cul-de-sac of Douglas may be palpated on rectovaginal examination. B. A fixed, retroverted uterus with scarring and tenderness posterior to the uterus. The characteristic nodularity of the uterosacral ligaments and cul-de-sac of Douglas may be palpated on rectovaginal examination. C. A fixed, retroverted uterus with scarring and tenderness posterior to the uterus. The characteristic nodularity of the cardinal ligaments and cul-de-sac of Douglas may be palpated on rectovaginal examination. D. A fixed, anteverted uterus with scarring and tenderness posterior to the uterus. The characteristic nodularity of the uterosacral ligaments and cul-de-sac of Douglas may be palpated on rectovaginal examination.

Answer: B. A fixed, retroverted uterus with scarring and tenderness posterior to the uterus. The characteristic nodularity of the uterosacral ligaments and cul-de-sac of Douglas may be palpated on rectovaginal examination.

4.Interpret the results of a 100 gram OGTT. Results reveal FBS at 4.9 mmol/L, 1 hour at 6 mmol/L, 2 hours at 9 mmol/L and 3 hours at 7 mmol/L. (1 mmol = 18 mg/dL). A. Pregestational DM B. Normal 100 g OGTT C. Gestational DM D. Impaired glucose tolerance

Answer: B. Normal 100 g OGTT

5.A 16 y/o patient consulted due to what she perceives to be a breast mass. The physician however was not able to appreciate the said mass. When is the best time to perform a self breast mass examination? A. A week after menses B. Midcycle C. A week before menses D. During menses

Answer: A. A week after menses

6.Majority (>99%) of acute PID cases result from ascending infection coming from the: A. Cervix only B. Vaginal and cervix C. Vulva only D. Vagina only

Answer: B. Vaginal and cervix

7.Which of the following structures hold the uterus and upper vagina to proper location? A. Cardinal and broad ligaments B. Cardinal and uterosacral ligaments C. Ovarian and broad ligament D. Uterosacral and broad ligaments

Answer: B. Cardinal and uterosacral ligaments

8.What presents as a peritoneal hernia from the pouch of Douglas into the rectovaginal septum, often appearing as a distinct bulge above a rectocele or sometimes protruding through the vagina? A. Cystocele B. Rectocele C. Uterine prolapse D. Enterocele

Answer: D. Enterocele

9.Anemia in pregnancy is defined as hemoglobin of: A. Less than 12 g/dL B. Less than 11 g/dL C. Less than 9 g/dL D. Less than 10 g/dL

Answer: B. Less than 11 g/dL

10.Standard imaging modality for diagnosing a H. mole: A. CT scan B. Pelvic UTZ C. MRI D. X-ray

Answer: B. Pelvic UTZ

11.Based on the new ACOG recommendation, cervical cancer screening for average-risk women >30 y/o should be performed A. Once every 3 years B. Every 2 years C. Annually D. Twice a year

Answer: A. Once every 3 years

12.A 37 y/o G5P5(5005) patient was admitted due to profuse vaginal bleeding. Her ultrasound revealed a 6cm myoma. What type of myoma would it most likely be if she has no other gynecologic pathology or systemic illness? A. Subserous B. Intramural C. Submucous D. Cervical

Answer: C. Submucous

13.Which of the following is a consequence of iron deficiency anemia in pregnancy? A. Bone marrow cellular morphology altered B. There is expansion of plasma volume without normal expansion of maternal hemoglobin mass C. Serum iron concentration is decreased whereas ferritin levels are elevated D. Expansion of plasma volume with normal expansion of maternal hemoglobin mass

Answer: B. There is expansion of plasma volume without normal expansion of maternal hemoglobin mass

14.What is the most widely accepted theory of endometriosis? A. Immunologic B. Metaplasia C. Genetic predisposition D. Retrograde menstruation

Answer: D. Retrograde menstruation

15.Which of the following statements is descriptive of the physiology of micturition? A. Sympathetic nervous system promotes bladder filling. B. As filling increases, detrusor muscle contractility is inhibited by activation of a spinal parasympathetic reflex C. Bladder filling promotes stimulation of alfa-adrenergic receptors in the bladder body D. Parasympathetic nervous system promotes decreased intravesical pressure

Answer: A. Sympathetic nervous system promotes bladder filling.

16.What is a CNS effect that is pathognomonic of menopause? A. Mood swings B. Alzheimer’s disease C. Irritability D. Hot flashes

Answer: D. Hot flashes

17.A 16 y/o consults for absence of menstruation. She has normal breast development but minimal pubic hair. Pelvic ultrasound shows absence of the uterus. What is the most likely diagnosis? A. 17, 20 desmolase activity B. Turner syndrome C. 46, XY pure gonadal dysgenesis D. Hypogonadotropic hypogonadism

Answer: ANDROGEN INSENSITIVITY SYNDROME (not in the choices; closest option: C. 46, XY pure gonadal dysgenesis)

18.A 32 y/o female with multiple sexual partners complains of a mucopurulent cervicovaginal discharge with presence of lymphadenopathy. What is the diagnosis based on clinical presentation? A. Neisseria infection B. Syphilis C. Bacterial vaginosis D. Chlamydia infection

Answer: D. Chlamydia infection

19.Which of the ff findings is least likely seen in a px with HELLP syndrome? A. Elevated SGPT/SGOT B. Presence of abnormal forms of RBC C. Platelet count of 160,000/cu mm D. Subscapular hematoma in the liver

Answer: C. Platelet count of 160,000/cu mm

20.A patient has the following findings. She is moderately anemic (~7 g/dL), hemodynamically stable, and not septic. The best management would be __? A. Iron sucrose then repeat hemoglobin after 48 hours B. Blood transfusion C. Iron therapy only for at least 3 months D. Folic acid 400 ug/day x 6 months

Answer: C. Iron therapy only for at least 3 months

21.Presence of the so called “strawberry cervix” on speculum exam is usually seen in” A. Pubic lice B. Trichomoniasis C. Candidiasis D. Bacterial vaginosis

Answer: B. Trichomoniasis

22.Condyloma acuminata is caused by: A. Hemophilus ducreyi B. Poxvirus C. Calymmatobacterium granulomatis D. Human papilloma virus

Answer: D. Human papilloma virus

23.The pathognomonic “groove sign” of Lymphogranuloma venereum is seen when an inflamed inguinal lymph node is divided into two equal halves by what ligament: A. Cooper’s ligament B. Uterosacral ligament C. Round ligament D. Poupart’s ligament

Answer: D. Poupart’s ligament

24.Which HPV type is most commonly associated with cervical adenocarcinoma? A. Type 16 B. Type 18 C. Type 11 D. Type 6

Answer: B. Type 18

25.What is the gold standard for determining osteoporosis? A. Radiogrammetry B. Radiographic absorptiometry C. Quantitative CT scan D. Dual x-ray absorptiometry

Answer: D. Dual x-ray absorptiometry

26.What is the folic acid requirement of women during pregnancy? A. 1000 ug/day B. 400 ug/day C. 300 ug/day D. 500 ug/day

Answer: B. 400 ug/day

27.Which of the ff criteria is a contraindication for Methotrexate management of an ectopic pregnancy? A. Mass 3.5 cm B. No fetal heart tones on UTZ C. Ruptured tubal pregnancy with a stable clot D. B-HCG > 15,000 mlU/ml

Answer: C. Ruptured tubal pregnancy with a stable clot

28.As a student assigned to monitor a preeclamptic patient undergoing MgSO4 therapy, which of the ff PE findings is indicative of MgSO4 toxicity? A. Urine output of 100 for the past 4 hours B. Absent deep tendon reflexes C. RR = 18 per min D. HR = 96 per mins

Answer: B. Absent deep tendon reflexes

29.A 23 y/o G1P1 has a benign slow-growing, circumscribed tumors of fat cells arising from the subcutaneous tissue of the vulva. What is the most logical diagnosis? A. Liposarcoma B. Fibroma C. Fibrosarcoma D. Lipoma

Answer: D. Lipoma

30.A patient complains of a curd-like yellow vaginal discharge associated with pruritus, which of the ff test is the most appropriate to support the clinical diagnosis? A. KOH wet mount B. Tsanck smear C. Saline wet mount D. Pap smear

Answer: A. KOH wet mount

31.A saline wet mount done reveals the presence of epithelial cells with numerous bacilli on the surface. This confirms the diagnosis of: A. Genital herpes B. Bacterial vaginosis C. Trichomoniasis D. Gonorrhea

Answer: B. Bacterial vaginosis

32.A pregnant patient who is moderately anemic (more than 7 g/dL), hemodynamically stable and not septic is best managed by: A. Iron sucrose then repeat hemoglobin after 48 hours B. Blood transfusion C. Oral iron therapy only for at least 3 months D. Folic acid 400 ug/day x 6 months

Answer: C. Oral iron therapy only for at least 3 months

33.What is the fetal response to maternal hypoxia? A. Decreased systemic vascular resistance B. Decreased pulmonary vascular resistance C. Decreased umbilical blood flow D. Increased cardiac output

Answer: C. Decreased umbilical blood flow

34.What is the primary long-term goal in the management of endometriosis? A. Promotion of fertility B. Restore normal pelvic anatomy C. Prevent progression or recurrence of disease D. Relief of pain

Answer: C. Prevent progression or recurrence of disease

35.A 38 y/o G3P3 suddenly develops amenorrhea for 6 months. What does elevated levels of FSH signify? A. Pregnancy B. Ovarian failure C. Outflow tract problem D. HP axis failure

Answer: B. Ovarian failure

36.In a patient who is continent, what happens during vigorous coughing? A. Intra-abdominal as well as intraurethral pressure is unaffected B. The increase in the intra-abdominal pressure relative to the intraurethral pressure makes the person void C. A greater increase in the intraurethral pressure brings about hypogastric/pelvic discomfort D. The increase in pressure brought about by coughing results in an increase in both intraurethral and intravesical pressure

Answer: D. The increase in pressure brought about by coughing results in an increase in both intraurethral and intravesical pressure

37.A 29 y/o G1P0, 29 weeks AOG was seen at the OPD during her 1st prenatal visit and was found to have a BP of 160/100. There is good fetal movement and the px does not complain of any untoward symptoms. As a clinical clerk, the next most logical thing to do is to: A. Advise hospitalization B. Perform an internal examination to see if patient is in preterm labor C. Advise the px to monitor her BP 2x a day and follow-up after a week D. Refer to the resident on duty for BP control

Answer: A. Advise hospitalization

38.What disease entity is associated with mucinous ovarian tumors? A. Appendicitis B. Malignant transformation involving the GI tract C. Pseudomyxmoma peritonei D. Krukenberg tumors

Answer: C. Pseudomyxmoma peritonei

39.A patient has a history of rheumatic fever. Which of the following physiologic changes in pregnancy will be particularly harmful to her? A. Increase in heart rate B. Physiologic anemia C. Increased peripheral vascular resistance D. Decrease in blood volume

Answer: A. Increase in heart rate

40.What event coincides with the LH surge? A. Secretion of inhibin B. Sloughing off of the functionalis layer C. Greatest value of the level of progesterone D. Ovulation

Answer: D. Ovulation

41.A continent patient starts to void and then stops voiding completely before emptying the bladder. Which of the following happens? A. The striated muscles of the urethra the pelvic floor contract B. IUP increases above normal levels C. IV drops to below normal levels D. Detrusor muscle is reflexly stimulated

Answer: A. The striated muscles of the urethra the pelvic floor contract

42.What is the main reason for contraception following an episode and treatment of a molar-pregnancy? A. Pregnancy interferes with B-HCG monitoring B. High risk of metastatic disease C. CXR is not advised for pregnant pxs D. Possible toxic effects of chemotherapy on pregnancy

Answer: A. Pregnancy interferes with B-HCG monitoring

43.The most common congenital abnormality seen in a fetus with congenital rubella is A. Congenital cataracts B. Neonatal purpura C. Sensorineural deafness D. Patent ductus arteriosus

Answer: C. Sensorineural deafness

44.A patient has moderate iron deficiency anemia and you proceed to give her adequate iron replacement therapy. What laboratory test is the best method to assess the patients response to therapy? A. Serum hemoglobin B. Peripheral blood smear C. Serum hematocrit D. Reticulocyte count

Answer: D. Reticulocyte count

45.Based on the new ACOG recommendation, what is the baseline age for cervical cancer screening? A. 18 B. 20 C. 16 D. 21

Answer: D. 21

46.As recommended by ACOG, what age should a physician advise young woman to start having CLINICAL breast examinations? A. 18 B. 16 C. 22 D. 20

Answer: D. 20

47.Which of the following may explain the reason for cyclic pelvic pain in patients with pelvic endometriosis? A. Obstruction of vascular supply resulting to necrosis B. Pressure on adjacent tissues resulting from the sterile inflammation C. Metaplasia of the surrounding structures D. Swelling and the extravasation of blood and menstrual debris into the surrounding tissue

Answer: D. Swelling and the extravasation of blood and menstrual debris into the surrounding tissue

48.Which among the following gynecologic malignancies causes the most menstruality? A. Cervical cancer B. Ovarian cancer C. Endometrial cancer D. Vulvar cancer

Answer: C. Endometrial cancer

49.What is the functional bladder capacity? A. 400 to 600 ml B. 800 to 1000 ml C. 200 to 400 ml D. 600 to 800 ml

Answer: A. 400 to 600 ml

50.The most accurate method of diagnosing PID is by: A. CT scan B. Direct visualization by a laparoscopy C. Transvaginal UTZ D. MRI

Answer: B. Direct visualization by a laparoscopy

51.Which among the ff medications is most effective in preventing recurrent convulsions in eclamptic patients? A. MgSO4 B. Diazepam C. Valproic acid D. Phenytoin

Answer: A. MgSO4

52.When should a patient with hyperemesis gravidarum be admitted? A. If she only eats 2 full meals a day B. If she vomits more than 4 times an hour C. If she has acidosis D. If she is not gaining weight

Answer: C. If she has acidosis

53.What disease entity is one of the common causes of ovulatory disorder in women of reproductive age group causing primary or secondary infertility? A. Career-oriented women marrying at >30 y/o B. Polycystic ovarian syndrome (PCOS) C. Hyperandrogenism D. Obesity

Answer: B. Polycystic ovarian syndrome (PCOS)

54.Which of the followinhg conditions presents with 1o (primary) amenorrhea, congenital tract abnormality, and 46 XX karyotype? A. Gonadal enzyme deficiency B. Rokitansky-kuster-hauser syndrome C. Testicular regression D. Androgen insensitivity

Answer: B. Rokitansky-kuster-hauser syndrome

55.What is the diagnosis of an infertile couple when ovulation, tubal patency, and normal sperm analysis are all present? A. Genetic incompatibility B. Misdiagnosed infertility C. Immunologic incompatibility D. Unexplained infertility

Answer: D. Unexplained infertility

56.Which of the following refers to various techniques utilized to increase fecundability by non-physiologic methods of enhancing probability of fertilization? A. Advance Fertility Techniques B. Assisted/Advance Reproductive Technology (ART) C. Assisted Fertility Techniques D. Assisted Pregnancy Technique

Answer: B. Assisted/Advance Reproductive Technology (ART)

57.A patient is about to give birth. What step can a physician take as prophylaxis against incontinence? A. Give anesthesia B. Perform adequate episiotomy C. Kegel’s exercises after delivery D. Empty bladder after delivery

Answer: B. Perform adequate episiotomy

58.Drug of choice for the treatment of Trichomoniasis? A. Ceftriaxone 250 mg IM B. Fluconazole 150 mg single oral dose C. Metronidazole 4 gm single oral dose D. Doxicycline 100 mg BID for 7 days

Answer: C. Metronidazole 4 gm single oral dose

59.Which among the following malignancies has the highest mortality rate? A. Endometrial cancer B. Vulvar cancer C. Cervical cancer D. Ovarian cancer

Answer: D. Ovarian cancer

60.In the treatment of pulmonary TB in pregnancy which drug is contraindicated? A. Rifampicin B. Streptomycin C. PZA D. INH

Answer: B. Streptomycin

61.What is the initial management for uterine atony? A. Emergency hysterectomy B. Start oxytocin infusion C. Massage uterine fundus and apply ice cap D. Carboprost IV

Answer: C. Massage uterine fundus and apply ice cap

62.What is the most reproducible biometric parameter to obtain during performance of fetal biometry? A. Abdominal circumference B. Femoral length C. Biparietal diameter D. Head circumference

Answer: D. Head circumference

63.If the initial management in a postpartum patient with a soft, enlarged, boggy uterus does not control the bleeding, the next logical step would be to: A. Do hypogastric artery ligation B. Give Carboprost IV C. Infuse IV oxytocin D. Remove the placenta

Answer: C. Infuse IV oxytocin

64.Which of the following is its most dangerous consequence of Marfan’s Syndrome affecting pregnancy? A. Arachnodactyl B. Mitral stenosis C. Dilated aortic root D. Scoliosis

Answer: C. Dilated aortic root

65.A 21 y/o primigravid consulted due to dysuria and hypogastric pain, with occasional chills. Urinalysis showed pyuria, and antimicrobials were started. After 1 month, the symptoms recurred and a urine CS was done. Results showed a sterile culture. Which microorganism can explain the findings in the patient? A. E. Coli B. Streptococcus C. Chlamydia D. Klebsiella

Answer: C. Chlamydia

66.A 39 y/o G9P9 recently uneventfully by NSD to a 7lb baby boy. You notice heavy vaginal bleeding 2 hours postpartum. Examination reveals a large, soft boggy uterus enlarged to 32 weeks AOG. The most likely cause of postpartum bleeding would be: A. Uterine atony B. Retained placenta C. Genital tract laceration D. Uterine rupture

Answer: A. Uterine atony

67.For high risk women at what age should mammography be performed? A. 50 B. 45 C. 40 D. 35

Answer: No correct option listed — high-risk screening starts at age 30

68.A 14 y/o girl who never had menses with no breast or pubic hair development A. Has Primary Gonadal failure B. Has Secondary amenorrhea C. Has normal findings for her age D. Has Primary amenorrhea

Answer: D. Has Primary amenorrhea

69.Which among the ff is the most important factor that will influence the mode and timing of termination of pregnancy in severe PIH? A. Age of gestation B. Deteriorating maternal-fetal condition C. Presence of other existing medical problems D. Capability of neonatal ICU

Answer: B. Deteriorating maternal-fetal condition

70.What is the most common for gynecological cancer worldwide? A. Ovarian cancer B. Cervical cancer C. Endometrial cancer D. Breast cancer

Answer: B. Cervical cancer

71.A 36 y/o G4P4 patient on injectable form of contraceptive for 1 year. Based on the effect of the contraceptive on the endometrium what type of dysfunctional uterine bleeding will she most likely have? A. Menometrorrhagia B. Amenorrhea C. Oligomenorrhea D. Polymenorrhea

Answer: B. Amenorrhea

72.What will be observed if a cough stress test is performed to a patient with stress incontinence? A. Delayed loss of urine upon coughing B. Quantity of urine lost is greater than 10cc C. No incontinence is observed D. Immediate loss of urine upon coughing

Answer: D. Immediate loss of urine upon coughing

73.A patient had her menarche at 12 y/o. She had on and off episodes of amenorrhea. Her OB score is G4P4 and she had her menopause at age 50. Which of the following is NOT contributory for ovarian cancer? A. OB score B. Her menarche C. Age of menopause D. Episodes of amenorrhea

Answer: No unique answer — A. OB score and D. Episodes of amenorrhea are both protective

74.Which of the following sonographic characteristics points to a benign etiology? A. Papillary excrescences B. 8mm wall thickness C. Low level echopattern D. Presence of neovascularization on doppler studies

Answer: C. Low level echopattern

75.The gold standard for the diagnosis of PID caused by a gram (-) intracellular dipolococci is: A. Nucleic acid amplification test B. Dark-field microscopy C. Salient wet mount D. Saboraud’s medium

Answer: A. Nucleic acid amplification test

76.What is the gold standard for the diagnosis of pelvic endometriosis? A. Biopsy B. Laparoscopy C. Completed history and PE D. UTZ

Answer: B. Laparoscopy

77.The greatest risk for congenital rubella is when an infected pregnant women manifests the characteristic maculopapular rash at what age of gestation? A. B. Late 2nd trimester C. Mid 2nd trimester D. Before 12 weeks

Answer: D. Before 12 weeks

78.A 22 y/o patient has regular menses occurring every 30 days. How long must she miss her menses based on the definition of amenorrhea. A. 6 mos. B. 1 month C. 3 mos. D. 1 year

Answer: C. 3 mos.

79.In the Philippines which examination is the least useful with regards to the diagnosis of pulmonary TB A. Sputum AFB B. PPD C. Clinical history and PE D. Chest Xray

Answer: B. PPD

80.It is an epithelial malignancy of trophoblastic cells formed by the abnormal proliferation of cytotrophoblasts and syncitiotrophoblasts at the absence of chronionic villi: A. PSTT B. Invasive mole C. ETT D. Choriocarcinoma

Answer: D. Choriocarcinoma

81.What is the most common location of urethral caruncles? A. Post-menopausal women B. Children C. Infants D. Perimenopausal women

Answer: A. Post-menopausal women

posterior urethral meatus

82.When is the best time to do an internal exam on a patient with endometriosis? A. 8th to 10th day of cycle B. 3rd to 5th day of cycle C. 1st to 2nd day of menstrual cycle D. Just before the onset of menses

Answer: D. Just before the onset of menses

83.A 23 y/o G2P2 patient has a dermoid cyst. What is the surgical procedure of choice if the patient has no desire for pregnancy? A. TH, USO, since the patient has a completed family size B. USO, PO, PFC C. Cystectomy D. USO

Answer: C. Cystectomy

84.Which of the following is NOT seen in a patient with Tetralogy of Fallot? A. Patent ductus arteriosus B. Right ventricular hypertrophy C. Transposition of the great vessels D. Pulmonary stenosis

Answer: C. Transposition of the great vessels

85.An 18 y/o G0 patient has regular menses occuring every 32 days. She suddenly has amenorrhea. What is the primary consideration? A. Polycystic ovarian syndrome B. Pregnancy C. Infection D. Premature ovarian failure

Answer: B. Pregnancy

86.Histopathologic findings if an ovarian mass revealed that it resembles that of the intestines. What type of tumor is it? A. Serous tumors B. Mucinous tumors C. Clear cell tumors D. Brenner tumors

Answer: B. Mucinous tumors

87.Theca lutein cysts of an symptomatic patient with complete molar pregnancy are best managed by: A. TAGBSO B. Chemotherapy C. Prophylactic bilateral oophorectomy D. Observation to possible signs of complications

Answer: D. Observation to possible signs of complications

88.A patient has a menstrual of every 21 days. In between, her menses she experiences irregular bleeding both in amount and duration. What is her type of menses? A. Polymenorrhea B. Hypermenorrhea C. Metrorrhagia D. Menometrorrhagia

Answer: D. Menometrorrhagia

89.Based on the new ACOG recommendation, cervical cancer screening for average risk women 30 y/o should be performed A. Twice a year B. Every 2 years C. Every 3 years D. Annually

Answer: C. Every 3 years

90.What is the drug of choice for the treatment of bacterial vaginosis? A. Fluconazole B. Metronidazole C. Ceftriaxone D. Tetracycline

Answer: B. Metronidazole

91.According to the FIGO 2000 anatomic staging for GTN, GTN that extended to the lungs classified as: A. Stage III B. Stage II C. Stage I D. Stage IV

Answer: A. Stage III

92.What biometric parameter is the single most accurate predictor of growth disturbance? A. BPD B. AC C. FL D. HC

Answer: B. AC

93.What is the most common cancer-related cause of death among women worldwide? A. Endometrial cancer B. Cervical cancer C. Lung cancer D. Ovarian cancer

Answer: C. Lung cancer

94.What is the most common of the vaginal malignancies and accounts for 90% of primary vaginal cancers? A. Sarcoma B. Clear cell adenocarcinoma C. Malignant melanoma D. Squamous cell carcinoma

Answer: D. Squamous cell carcinoma

95.Asymptomatic bacteriuria is defined as: A. Presence of >500,000 organisms/ml of urine B. Presence of 50-100,000 organisms/ml of urine C. Presence of >100,000 organisms/ml of urine D. Presence of 50,000 organisms/ml of urine

Answer: C. Presence of >100,000 organisms/ml of urine

96.A 68 year old woman complained of a vaginal mass protruding associated with difficulty in defecation. Small bowel contents were visualized on transillumination of the bulge. What is the most likely diagnosis? A. Rectocele B. Cystocele C. Enterocele D. Vaginal vault prolapse

Answer: C. Enterocele

97.A 24 y/o G1 has been diagnosed to have asthma since childhood. She is on her 26th week AOG. Her last attack was 5 years ago. What is the effect of pregnancy on asthma? A. Dependent on co-morbidities present B. Worsened C. It has no effect D. Improved

Answer: A. Dependent on co-morbidities present (closest available choice; course is variable)

98.A 30 y/o G2P1(1001) LMP 12/3/13 came in due to hypogastric pain, leukocyte esterase-nitrite dipstick test was positive. The patient had no other signs and symptoms. What is the next step in management A. Admit and start IV Ampicillin 2g QID for 3 days B. Give nitrofurantoin 100mg QID for 7-10 days C. Start isoxsuprine 10mg QID for 5 days D. Refer for pelvic ultrasound with cervical funnelling

Answer: B. Give nitrofurantoin 100mg QID for 7-10 days

99.Which of the following is not a peak of cardiac activity in pregnancy? A. During labor B. During delivery C. During puerperium D. During early 2nd trimester

Answer: D. During early 2nd trimester

100.An 11 y/o is referred for cyclic abdominal pain and gradual abdominal enlargement of 3 months duration. General PE reveals secondary sexual characteristics. Pelvic exam shows a bluish bulging mass at the vaginal introitus. What is the most likely diagnosis? A. Prolapsed submucous myoma B. Transverse vaginal septum C. Imperforate hymen D. Carunculae myrtiformis

Answer: C. Imperforate hymen