Board Exams Ob Gyn 2009

8/10/2019 Board Exams Ob Gyn 2009

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OBSTETRICS & GYNECOLOGY

Physicians Licensure ExaminationJune 4, 2009; 1:00 5:00

1. Among the following ligaments, the one that gives major support to the uterus is the:a. broad ligamentb. cardinal ligament

c. infundibulopelvic ligamentd. round ligament

2. A 16 y.o. nulligravid was brought to the E due to a straddle injury. !n inspection, theright vulva was converted to a " # 6 cm bluish tender mass. $he most probable vessel thatis involved in this is the:

a. cervicovaginal branch of the uterine arteryb. vestibular arteryc. pudendal arteryd. inferior vesical artery

%. !ne of the major blood supplies of the pelvic organs is derived from:a. $he uterine arteries, which branch directly from the hypogastric arteriesb. the ovarian arteries, which branch directly from the internal iliac arteriesc. the e#ternal iliac arteries, which branch directly from the common iliac arteriesd. the cervico&vaginal branches of the uterine arteries

'. A patient with myoma uteri presents with pyelonephritis resulting from ureteral obstruction.$he most li(ely location of the myoma is

a. subserousb. intramuralc. intraligamentaryd. submucous

". $he best predictor of ovulation is:a. estrogen pea(b. )*+ surgec. + surged. ise in progesterone

6. A patient who regularly has a %'&day ovulatory cycle as(s for opinion as to when she ismost li(ely to conceive. +er ovulation most probably occurs on day:

a. 16b. 1-c. 2d. 22

/. ationale for giving high dose estrogen to stop bleeding in treating patients with severemenorrhagia secondary to anovulation:

a. increases platelet aggregationb. increased spiral artery recoilc. promotes synthesis of prostaglandind. promotes rapid endometrial growth

-. 0hich of the following is part of the ovarian phase of the menstrual cyclea. menstrual phase. secretory phasec. luteal phase!. proliferative phase

. $he patient with abnormal uterine bleeding is:a. 1- y.o. whose interval of menses is 2' to % daysb. '1 y.o. whose menses last - to 1 daysc. 2 y.o. on 345A with occasional vaginal spottingd. 22 y.o. leu(emic patient with menstrual blood loss of - ml

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1. $his refers to the violaceous discoloration of the vagina because of increased vascularitystarting on the 6th wee( of pregnancy:

a. +egars signb. 7oodells sign

c. 8hadwic(s signd. *paldings sign

11. 0hy is cardiac output in late pregnancy higher in the lateral recumbent rather than in thesupine position

a. the gravid uterus impedes cardiac venous return in the supine positionb. the uterine vessels become distended in the supine positionc. hormonal effects are greater in the lateral recumbent positiond. hormonal effects are greater in the lateral recumbent position

12. )or which reason is the pregnant woman with asthma more li(ely to develop hypo#iaa. increased residual volumeb. decreased functional residual capacityc. decreased tidal volumed. increased inspiratory capacity

1%. 0hich among the following contribute to pregnancy&induced ureteral dilatationa. hormonal effectb. compression of the uterus at the pelvic brimc. compression of the sigmoid colond. dilated right ovarian artery

1'. $rue statement regarding renal hemodynamics during pregnancy:a. serum creatinine and urea nitrogen values increaseb. renal plasma flow increasesc. protein, amino acid and glucose e#cretion decreased. serum osmolality increased by 1 m!sm9

1". $he nausea and vomiting commonly e#perienced by many women during the firsttrimester of pregnancy is an adaptation to the increased level of:

a. estrogenb. progesteronec. luteiniing hormoned. chorionic gonadotropin

16. 8onfirmatory diagnosis of pregnancy:a. positive pregnancy testb. cervical mucus beading on microscopyc. morning sic(nessd. fetal heart tones heard using a fetal 3oppler machine

1/. $he minimum daily re;uirement for ferrous


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1 & large nodular mass2 ? hard, resistant structure at the right side of the mother

*mall, irregular, mobile parts on the left side of the mother% ? movable hard round mass

' ? tips of the fingers able to meet

a. right lower ;uadrantb. left lower ;uadrantc. right upper ;uadrantd. left upper ;uadrant

2. 4s. @, a fashion model, is very figure&conscious. *he in;uires about weight gain duringpregnancy and how soon she can get bac( into shape postpartum. 0hat information willyou tell her

a. the average weight gain during pregnancy is 1' (g, and is easily shed off duringthe puerpueriumb. recommended weight gain during pregnancy depends on pre&pregnancy weightc. weight gain should be about 2./ (g9month, and should commence as early as thefirst trimesterd. regardless of the route of delivery, she can start e#ercising ' wee(s postpartum

21. A 2" y.o. primigravid, wee(s A!7, sought consult with you for the first time for prenatalchec( up. 0hich among the labs will you re;uest for

a. 1 g !7$$b. $!8+ titersc. 8omplete blood countd. complete +epatitis profile

22. 0hich vaccine is contraindicated during pregnancya. tetanusb. measlesc. influenad. pneumococcus

2%. +epatitis virus screening of pregnant women prior to delivery will identify new infantswho:

a. have passive immunity to the hepatitis virusb. need hepatitis virus vaccinationc. need hepatitis immunoglobulin injectiond. are carriers of hepatitis virus

2'. Bn a mother positive for +epatitis antigen who plans to breastfeed her baby, you tell herthat:

a. breastfeeding is contraindicated. Cust give mil( formulab. breastfeeding is not contraindicatedc. breastfeeding is allowed once baby has been immuniedd. breastfeeding may be done as long as mother is not highly infective

2". $he fre;uency of prenatal visits from 2- to %6 wee(s is:a. every wee(b. every 2 wee(sc. every % wee(sd. every month

26. *mo(ing during pregnancy has been lin(ed with the following e#cept:a. placental abruptionb. placenta previac. fetal deathd. fetal macrosomia

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2/. 4rs. @ is unsure of her last normal menstrual period since she has irregular menstrualcycle. !n abdominal e#amination, you noted that the fundus is palpable at the level of theumbilicus. 0hat is your estimated age of gestation

a. 16 wee(s

b. 1- wee(sc. 2 wee(sd. 2' wee(s

2-. $rue statement regarding ra#ton&+ic(s contractions:a. may occur every 1&2 minutesb. fre;uently occurs during the second trimesterc. almost always painlessd. intensity varies between " and /" mm +g

2. A characteristic of true labor:a. intervals lengthenb. discomfort is relieved by sedationc. contractions occur at regular intervalse. cervi# remains closed

%. 0ho among the following women has an abnormal pattern of labora. %297%52


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a. cephalic prominenceb. cephalhematomac. caput succedaneumd. molding

%6. Advantage of mediolateral episiotomy versus midline episiotomy:a. fourth degree laceration is uncommonb. surgical repair of midline episiotomy is more difficultc. postoperative pain is minimald. faulty healing is rare

%/. >ou are tas(ed to deliver a mother whom you have been monitoring since admission.After spontaneous delivery of the baby and clamping9cutting of the cord, you note suddengush of blood. $he ne#t best step would be:

a. give o#ytocin drip to decrease blood lossb. wait for other signs of placental separationc. start pulling on the cord to assist placental deliveryd. do manual e#traction of the placenta

%-. $he placenta should be delivered within what period of time following deliverya. 1&2 minutesb. %&1 minutesc. 12 ? 1" minutesd. 1" ? 2 minutes

%. A 2- y.o. 7%52


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c. pre&eclampsia, severed. chronic hypertension with superimposed pre&eclampsia

''. $herapeutic levels of magnesium sulfate are maintained at this level to prevent eclamptic

seiures:a. '&/ me;9b. -&1 me;9c. 1&12 me;9d. more than 12 me;9

'". $he patient at the Bntensive 4aternal Fnit was given a loading dose of magnesiumsulfate. As the intern&on&duty, you will monitor the following before administering the ne#tdose e#cept:

a. patellar refle#b. urine outputc. respiratory rated. muscle strength

'6. A 2- y.o. 715 admitted at %2 wee(s age of gestation with a blood pressure of 1912,jaundiced, with hematuria, gum bleeding and petechiae all over. $he most li(elydiagnosis is:

a. severe pre&eclampsiab. acute fatty liver of pregnancyc. +E5 *yndromee. fulminant hepatitis

'/. 0hen managing a 1' y.o. who is pregnant, the physician should recognie that theadolescent is at ris( for:

a. glucose intoleranceb. fetal chromosomal abnormalitiesc. incompetent cervi#d. iron deficiency anemia

'-. 8ause of insulin resistance in pregnancy:a. increased human chorionic gonadotropin levelsb. decreased cortisone levelsc. decreased human placental growth hormoned. increased chorionic somatomammotropin hormone

'. A 2/ y.o. 715, on her 16th wee( of pregnancy consults for prenatal chec( up. othparents are diabetic. >ou will advise her to do a:

a. 1 gram oral glucose tolerance test immediatelyb. " gram glucose challenge test immediatelyc. 1 gram oral glucose tolerance test at 2'&2- wee(s A!7d. " gram glucose challenge test at 2'&2- wee(s

". 8ornerstone in the management of gestational diabetes mellitus e#cept:a. blood glucose monitoringb. e#ercisec. nutritiond. oral hypoglycemics

"1. A %6 y.o. 7%52


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umbilical cord was noted to be coming out of the vagina. Bmportant management at thispoint:

a. place the patient in trendelenburg positionb. apply downward pressure on the presenting part

c. await spontaneous vaginal deliveryd. as( the patient to start bearing down

"%. After a successful cesarean section delivery for breech, the 7151 mother as(ed her !&7>G if she has a chance to have vaginal delivery ne#t time she gets pregnant. 0hich ofthe following conditions may ma(e vaginal delivery possible

a. mother has contracted pelvisb. previous scar is a low segment cesareanc. malpresented fetusd. abnormal placentation&previa

"'. A ' y.o. 7/56


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6. 0hich of the following organisms is associated with high fever in the first 2' hours afterchildbirth

a. group A *treptococcus

b. acteroides biviusc. 5eptostreptococcusd. acteroides fragilis

61. $he only appropriate drug for syphilis during pregnancy:a. do#ycyclineb. tetracyclinec. benathine penicillind. ceftria#one

62. A 1 y.o. primigravid came in at the E with vaginal bleeding. +er amenorrhea is 12wee(s. !n pelvic e#am, the cervi# is open and the corpus - wee(s sie.>our diagnosis is:

a. incomplete abortionb. completed abortionc. threatened abortiond. septic abortion

6%. At least " D of early abortions are caused by:a. infectionsb. immunological factorsc. drug used. chromosomal anomalies

6'. A 1 y.o. pregnant cousin as(s you regarding a medication which is classified ascategory 8. >ou tell her that it means that the drug has:

a. no fetal ris(s in human studiesb. no fetal ris(s in human studiesc. fetal ris(s outweigh benefitsd. adverse effects in animal studies but no human data

6". $he triad of ectopic pregnancy includesa. amenorrhea, abdominal pain, and vaginal bleedingb. amenorrhea, positive pregnancy test and vaginal spottingc. positive pregnancy test, vaginal bleeding, and hypotensiond. positive pregnancy test, adne#al tenderness, and vaginal bleeding

66. is( factors that are classified as high ris( for ectopic pregnancy include the followinge#cept:

a. tubal corrective surgeryb. tubal steriliationc. previous ectopic pregnancyd. previous pelvic or abdominal surgery

6/. A "" y.o. 7"5"


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portion of the uterus. $he left ovary was grossly normal. All other abdominopelvic organswere grossly normal. ased on the information given, the Bntraoperative stage of thispatient is

a. BA

b. Bc. B8d. BBA

6. +istopath of a a '/ y.o. nulligravid who underwent 5)8, $+*!, G3 was read asfollows:

Endometrial adenocarcinoma, endometrioid type, well&differentiated with less than "D myometrial invasion.8hronic endocervicitis with s;uamous metaplasiaGegative for tumor: peritoneal fluid, all harvested lymph nodes.5ositive lymphovascular space invasion.Go diagnostic abnormality recognied, both ovaries and fallopian tubes

0hat is the stage of the patienta. *tage Bb. *tage B8c. *tage BBd. *tage BBB8

/. $his woman is at high ris( to develop endometrial carcinoma:a. "2 y.o. breast cancer patient on tamo#ifenb. %" y.o. nulligravid with 58!*

c. %/ y.o. with 4B of %" (g9m2

d. all of the above

/1. Bn an epithelial carcinoma of the ovary, the tumor mar(er that is most li(ely to be elevatedis:

a. alpha fetoproteinb. lactic dehydrogenasec. 8A 12"d. &hcg

/2. $he most common genital tract malignancy in )ilipino women based on the 2"5hilippine 8ancer )acts and Estimates is:

a. vulvar cancerb. cervical cancerc. endometrial cancerd. ovarian cancer

/%. A 1/ y.o. nulligravid consulted for an Abdominopelvic mass. !n physical e#amination,there were viriliing signs and symptoms. Even before a pelvic e#am is done, the primaryconsideration if this were an ovarian pathology is:

a. epithelial tumorb. germ cell tumorc. se#&cord stromal tumord. metastatic tumor

/'. A 2/ y.o. primigravid consults at the E for vaginal spotting of one wee( duration. *hehas an amenorrhea of 1 wee(s. !n pelvic e#am, you note the uterus to be boggy andenlarged to 2 wee(s age of gestation. Fltrasound showed an endometrial mass withsnowstorm pattern. est management for this case would be:

a. subtotal hysterectomyb. total hysterectomyc. suction curettagee. dilatation and curettage

/". According to the American 8ancer *ociety 7uidelines for 8ervical 8ancer *creening,screening using 5ap smear should be started

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a. age 12b. age 1-c. age 21d. once the woman is se#ually active

/6. Bn low resource settings li(e the 5hilippines, this has become an acceptable method ofcervical cancer screening:

a. *chillers testb. $oluidine blue testc. '&;uadrant cervical biopsyd. visual inspection with acetic acid

//. *taging of ovarian cancer is:a. clinicalb. surgicopathologicc. clinicopathologicd. histopathologic

/-. *peculum e#am of a 2/ y.o. complaining of leucorrhea showed copious frothy greenishvaginal discharge with strawberry&li(e mucosa. $his is most li(ely due to:

a. candidiasisb. trichomoniasisc. gonococcal infectiond. bacterial vaginosis

/. Bn a patient with mucopurulent cervicitis, the patient is also given do#ycycline to ta(e careof:

a. Geisseria gonorrheab. Freaplasma urealyticumc. 8hlamydia trachomatisd. 7ardnerella vaginalis

-. 0hich of the following is not considered a se#ually transmitted diseasea. 8andidiasisb. $richomoniasisc. *yphilisd. 7enital warts

-1. A 2 y.o. commercial se# wor(er came to you because of multiple, pruritic warty massesat the vulva. $he largest measured 2 # % cm. 8ausative agent of these warts:

a. po# virusb. bacterialc. treponemesd. human papilloma virus

-2. $he most accurate method of diagnosing acute 5B3 is:a. historyb. pelvic e#aminationc. ultrasoundd. diagnostic laparoscopy

-%. A '- y.o. 7%5%


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e#amination is difficult due to guarding. !n e#ploratory laparotomy, the left ovary isconverted to a 6 # - cm cystic mass with a 1 cm point of rupture e#truding brownish fluid.est management for this case would be:

a. left oophorocystectomy

b. left salpingo&oophorectomyc. $+, *!d. $+*!

-". A %6 y.o. 7151


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Board Exams Ob Gyn 2009

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