BOARD EXAMINATION:

OBSTETRICS AND GYNECOLOGY

TEST BLUE PRINT:

TOPICS RECALL COMPRE- PROBLEM TOTAL

HENSION SOLVING
OBSTETRICS:
ANA/PHYSIO 3 2 5
PREGNANCY/DIAGNOSIS 2 1 3
OF PREGNANCY
LABOR/ ABNORMAL 7 2 1 10
LABOR/ DYSTOCIA
HEMORRHAGES 3 1 1 5
OB COMPLICATIONS 7 2 1 10
PUERPERIUM 1 1 2
MEDICAL COMPLICATIONS 7 2 1 10
FAMILY PLANNING 2 1 3
GYNECOLOGY:
PEDIATRICS/ADOLESCENT 1 1 2
INFECTIONS 7 2 1 10
DUB/AUB 3 1 1 5
BENIGN GYNE MASSES 7 2 1 10
CANCER 7 2 1 10
UROGYNECOLOGY 2 1 3
INFERTILITY 3 2 5
AMENORRHEA/ HIRSUTISM 1 1 2
MENOPAUSE/OSTEOPOROS 2 2 1 5
IS
TOTAL 65 25 10 100

References:

William’s Obstetrics

Philippine Textbook in Obstetrics by Sumpaico, et.al.

Comprehensive Gynecology by Droegemuller, et.al.

MULTIPLE CHOICE. Choose the best answer

1. The human decidua is formed from the effects of prolonged stimulation of one or
more the following hormones: (0.50)
a. luteinizing hormone, estrogen and progesterone
b. chorionic gonadotropin, progesterone, estrogen
c. estrogen, progesterone
d. estrogen only

2. Alona, a primi gravidocardiac, term, in labor, is indicated for forceps extraction. If the
head has reached the perineal floor with the sagittal suture along the A-P diameter of the
outlet, what kind of forceps extraction will be performed? (0.50)
a. low mid forceps c. high forceps
b. low forceps d. trial forceps

3. The female pelvis has an inlet that is commonly: (1.0)

a. android c. gynecoid
b. platypelloid d. anthropoid

4. The labia majora is homologous with this male organ: (0.50)

a. penis c. testicle
b. foreskin d. scrotum

5. After menstruation, a portion of this layer of the endometrium remains to regenerate:

(0.50)
a. compact zone c. basal zone
b. spongy zone d. functional zone

6. Lina, a G1P0, on her 26th week AOG, was requested to undergo an ultrasound
examination. This finding will NOT be seen in her result: (1.0)
a. fetal aging c. assessment of fetal growth rate
b. diagnosis of pregnancy d. assessment of fetal lung maturity

7. Linda , an OFW, underwent curettage for incomplete abortion at 6-7 weeks AOG. If
she were to perform a pregnancy test, a negative result will noted after ____ days: (0.25)
a. two c. ten
b. three d. fourteen

8. The minimum amount of radiation exposure which may produce damage to the fetus
in the first trimester of gestation is---- rads: (0.25)
a. 25 c. 100
b. 50 d. 150
9. During pregnancy, which portion of the uterus forms the lower uterine segment?
(0.50)
a. external cervical os c. fundus
b. cornua d. isthmus

10. The vein which is most commonly involved in pelvic thrombophlebitis is: (0.25)
a. femoral c. pelvic
b. saphenous d. ovarian

11. Rina, a ramp model, pregnant for the first time on her 6th week AOG, needs to gain
how much weight in pounds for the whole duration of her pregnancy? (0.50)
a. 10 c. 18
b. 14 d. 20

12. The relation of the fetal parts to one another determines the: (0.50)
a. presentation c. attitude
b. lie d. station

13. After delivery, the pediatrician inspects the umbilical cord of a newborn, this would
normally contain: (1.0)
a. one artery and two veins c. two arteries and one vein
b. one artery and one vein d. two arteries the two veins

14. The major portion of the arterial blood supply to the pelvis is derived from the:
(0.25)
a. internal iliac c. external iliac
b. uterine d. pudendal

15. The blood supply of the uterus is derived from the: (0.25)
a. Hypogastric and uterine arteries
b. Ovarian and uterine arteries
c. Uterine and ileolumbar arteries
d. Ileoinguinal and uterine arteries

16. The cardinal movements of labor and delivery involve a certain sequence of events
that occur in an orderly fashion. Which of the following sequences are correct? (0.50)
a. descent/ internal rotation/ flexion
b. engagement/ flexion/ descent
c. engagement/ descent/ internal rotation
d. engagement/ descent/ flexion
17. Pathologic retraction ring means: (1.0)
a. impending uterine rupture
b. a normal physiologic change
c. imminent delivery
d. a congenital uterine abnormality

18. Beth, a full term, G4P3 is admitted with an 8 cm cervical dilatation, LOT, BOW
intact. She would benefit best with: (0.50)
a. trial of labor c. x-ray pelvimetry
b. forceps delivery d. cesarean section

19. The most important diameter in the clinical evaluation of the pelvis is: (0.25)
a. Boudelocque’s diameter c. obstetrical conjugate
b. diagonal conjugate d. true conjugate

20. Mechanical stretching of the cervix that produces increased uterine activity is called:
(0.50)
a. moro reflex c. ferguson’s reflex
b. valsalva maneuver d. hoffman’s reflex

21. The fundamental clinical change during the first stage of labor is(1.0):
a. descent c. internal rotation
b. cervical dilatation d. engagement

22. The second stage of labor begins with: (1.0)

a. expulsion c. station +1
b. 10 cm cervical dilatation d. 100 % effacement

23. The major source of progesterone in early pregnancy is the: (1.0)

a. placenta c. corpus luteum
b. placenta cytotrophoblast d. syncytiotrophoblast

24. Which of the following is characteristics of the pfannenstiel incision?(1.0)

a. transverse skin incision
b. incision just below the umbilicus
c. transverse uterine incision
d. longitudinal muscle incision

25. Lourdes, a primigravid, diagnosed to be 10 weeks pregnant is complaining of

abdominal pain with vaginal bleeding. To confirm the presence of a tubal pregnancy,
which procedure should be performed? (0.50)
a. culdoscopy c. laparoscopy
b. culdocentesis d. laparotomy
26. Who among the following women will be at risk to develop ectopic pregnancy?
(0.50)
a. Arnie, a 24 year old, previously diagnosed to have salpingitis

b. Baby, a 21 year old, newly married, apparently healthy

c. Celia, a 38 year old, widow, diagnosed with adenomyosis

d. Dina, a 44 year old S/P hysterectomy for multiple myoma

27. Edna, a 27 year old secundi, with normal vital signs, is presently on the first half of
pregnancy. She has vaginal spotting, full fornices, closed and non-tender cervix and a
uterine size bigger than the expected age of gestation. Your impression is: (0.50)
a. ectopic pregnancy c. abruptio placenta
b. hydatidiform mole d. threatened abortion

28. Consumptive coagulopathy in abruptio placenta is due to: (0.25)

a. increased destruction of fibrinogen
b. cessation of the production of clotting factors
c. release of thromboplastin to the circulation
d. formation of couvelaire uterus

29. The most common cause of early abortion is: (0.50)

a. maternal illness c. fetal abnormality
b. abnormality of the placenta d. viral disease

30. Which is most likely to be associated with profuse vaginal bleeding?( 0.50)
a. incomplete abortion c. threatened abortion
b. missed abortion d. dysfunctional bleeding

31. Oxytocin infusion is contraindicated to this patient: (0.50)

a. Gina, 36 weeks AOG, with premature rupture of bag of waters
b. Hilda, on her 42nd week AOG
c. Ina, 26 years old with previous multiple pregnancies
d. Joan, a 24 year old, secundi with previous classical cesarean section

32. Kyla, a primigravid, on her 32 weeks AOG, came in for prenatal check-up.
Auscultation of the FHT yields negative result and ultrasound revealed fetal death in
utero. How will you manage her? (0.50)
a. hysterotomy c. prostaglandins
b. wait for spontaneous labor d. suction curettage

33. Which of the following is an indication for cesarean hysterectomy? (0.50)

a. placenta previa c. placental abruption
b. invasive cervical carcinoma d. placenta accreta
34. A patient in labor has a prolapsed cord. There is a vertex presentation at station –2.
The cervix is 5 cm dilated and the umbilical cord is at the vagina pulsating at 90
beats/minute. Your management begins with: (1.0)
a. displacement of the fetal head out of the pelvis
b. careful monitoring of the uterine contractions
c. oxygen by mask to the mother
d. empty the urinary bladder

35. A secundigravida has been leaking fluid from the vagina for 12 hours at 36 weeks
gestation. The fetus is in cephalic presentation with an estimated weight of 2500 gms.
The cervix is effaced and 2 cm dilated. There are no contractions. Nitrazine test is
positive. Which of the following is the best course of action? (0.50)
a. discharge and await labor at home
b. broad spectrum antibiotics
c. intravenous oxytocin induction of labor
d. ceasarean section

36. Mona, a primigravid, diagnosed with H mole is preferably treated by: (0.50)
a. hysterectomy c. methotrexate
b. hysterotomy d. oxytocin and suction curettage

37. Nina, primigravida at term with abruption placenta and moderate vaginal bleeding is
best managed by: (0.50)
a. induce labor after amniotomy c. watchful observation
b. cesarean section d. forceps delivery

38. 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: 1-2 cm dilated with BOW ruptured. What is your diagnosis?
(0.50)
a. inevitable abortion c. incomplete abortion
b. imminent abortion d. missed abortion

39. Couvelaire uterus is characterized by: (1.0)

a. enlargement and invasion by choriocarcinoma
b. a congenital anomalous development
c. uteroplacental apoplexy
d. adherence to the cul-de-sac

40. Inversion of the uterus almost always follows: (1.0)

a. difficult forceps delivery
b. abruptio placenta
 c. multiple pregnancy
d. traction on the umbilical cord before separation

41. The most distinctive clinical sign of eclampsia is: (1.0)

a. epigastric pain c. pulmonary edema
b. convulsion d. fetal distress

42. Tina, a primigravid, on her 34th week AOG, is diagnosed to have severe pre
eclampsia. The best treatment for her is: ( 0.50)
a. magnesium sulfate c. bed rest
b. delivery d. antihypertensives

43. The most common form of abnormality during pregnancy is: (1.0)
a. diabetes c. iron deficiency anemia
b. toxemia d. hemorrhage

44. The renal lesion most associated with eclampsia is: (0.50)
a. acute tubular necrosis
b. hydroureter
c. cortical necrosis
d. glomerular endothelial swelling

45. An infection that may seriously affect the fetus during early pregnancy is: (0.50)
a. rubella c. chicken pox
b. hepatitis d. trichomonas

46. Hypofibrinogenemia is a potential hazard of: (0.25)

a. complete abortion c. missed abortion
b. incomplete abortion d. impending abortion

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

elaboration of: (0.25)
a. IgG c. IgM
b. IgA d. IgD

48. The most commonly observed abnormal laboratory test in pre eclampsia is: (0.50)
a. fibrinogen level c. SGOT level
b. serum uric acid d. platelet count

49. This antihypertensive drug has been banned for use during pregnancy because of the
increased incidence of early abortions: (0.75)
a. hydralazine c. calcium channel blockers
b. reserpine d. ACE inhibitors
50. Immunization with one of the following is absolutely contraindicated during
pregnancy: (0.75)
a. tetanus c. cholera
b. hepatitis B d. rubella

51. In a pregnancy complicated with diabetis mellitus, which of the following carries the
worst prognosis for the fetus? (0.50)
a. Control of diabetes with insulin
b. An amniotic creatinine of 2 – 37 weeks
c. Repeated episodes of maternal diabetic ketoacidosis
d. Cesarean section at 37 weeks

52. Use of birth control pills is contraindicated to which woman? (0.50)

a. Pia, a 27 year old with menstrual disorder
b. Rica, a 30 year old, diagnosed with severe kidney disease
c. Sitas, a 25 year old with history of thrombophlebitis
d. Tonet, a 26 year old, current user of DMPA injectable

53. How many weeks does it take for the entire endometrium to regenerate after
delivery? (0.50)
a. 1 c. 3
b. 2 d. 4

54. Division of the ovum 8 days after fertilization will result in: (1.0)
a. monoamnionic, monochorionic twin
b. diamnionic, dichorionic twin
c. diamnionic, monochorionic twin
d. conjoined twin

55. Puerperium covers this period: (1.0)

a. 4-6 weeks from delivery
b. 1-2 week from delivery
c. 6-8 weeks from delivery
d. 5-6 months from delivery

56. Ella, a five year old girl is brought in by her mother because of a blood-tinged,
yellowish, vaginal discharge. The most likely diagnosis is: (0.50)
a. trauma c. foreign body
b. gonorrhea d. precocious puberty

57. Abdominal pain at the time of ovulation is called: (1.0)

a. hartman’s sign c. placental sign
b. spinnbarkeit d. mittelschmerz
58. One of these end organ problems DOES NOT cause amenorrhea: (0.50)
a. Mullerian agenesis c. asherman’s syndrome
b. imperforate hymen d. tuberculous endometritis

59. Vina, a 19 year old GRO consulted an OB-GYN due to vaginal discharge. Speculum
exam revealed strawberry-like appearance of the vagina. This is a characteristic of:
a. gonorrhea c. mycosis
b. trichomonas d. syphilis

60. Winnie, a 28 year old female, married, presents with endocervical purulent discharge
and urethritis. Gram stain of the exudates showed polymorphonuclear leucocytes and an
absence of gram negative intracellular diplococci. The most likely diagnosis is: (0.50)
a. Syphilis c. Chlamydia trachomatis
b. Gonorrhea d. Herpes Simplex

61. Diagnostic tests for Acquired Immune Deficiency Syndrome in the Philippines for
local hospitality girls is: (0.50)
a. Dark Field illumination
b. Sabin Feldman dye test
c. Microimmunofluorescent test with monoclonal antibody
d. ELISA ( HTLV ) and Western Blot tests

62. Tuberculosis of the genital tract INVARIABLY involves the: (1.0)

a. fallopian tubes c. cervix
b. ovaries d. vagina

63. The diagnosis of one of the following cannot be ascertained with

hysterosalpingography: (0.50)
a. endometrial polyp c. tuberculous salpingitis
b. uterine synechiae d. chronic PID

64. Endoscopic procedure that is utilized to evaluate tubal diseases: (1.0)

a. colposcopy c. proctoscopy
b. laparoscopy d. hysteroscopy

65. Chlamydia trachomatis infection is best treated with: (0.50)

a. Cephalosporin c. Chloramphenicol
b. Oxytetracycline d. Erythromycin

66. This discharge is characteristic of Gardnerella vaginalis infection: (0.50)

a. grayish discharge with a fishy odor
b. greenish discharge with a foul odor
c. thin, watery discharge
 d. yellowish white and curd-like

67. One of the following is best treated by marsupialization: (1.0)

a. ovarian cyst c. gartner’s duct cyst
b. sebaceous cyst d. bartholin’s duct cyst

68. The initial step in the management of abnormal uterine bleeding in a 52 year old
woman is: (.0.50)
a. endometrial sampling c. observation
b. ultrasound examination d. TAH-BSO

69. Adenomyosis of the uterus is often NOT associated with one of the following: (0.50)
a. dysmenorrhea c. menorrhagia
b. dyspareunia d. infertility

70. Anna, a 37 year old woman, complains of bleeding from the umbilicus with each
menstrual period. Without other symptoms, the most likely condition is: (0.50)
a. bleeding diasthesis c. patent urachal cyst
b. endometriosis d. carcinoma

71. Uterine bleeding which is usually not excessive but occurring at irregular intervals is
termed: (0.50)
a. hypermenorrhea c. menorrhagia
b. metrorrhagia d. polymenorrha

72. Endometrial hyperplasia, with dysfunctional uterine bleeding is the result of: (1.0)
a. unopposed estrogen stimulation
b. unopposed progesterone stimulation
c. birth control pill intake
d. unopposed prolactin stimulation

73. Withdrawal bleeding after challenge with progesterone suggests: (0.50)

a. hypothalamic incompetence
b. pituitary failure
c. end-organ failure
d. anovulation

74. The most common epithelial tumor of the ovary is: (0.50)
a. dermoid cyst c. mucinous cyst
b. endometrial cyst d. teratoma

75. The most common clinical complication of an ovarian cyst is: (0.50)
a. rupture c. hemorrhage
b. suppuration d. torsion

76. The most common tumor abnormality of the female reproductive tract is: (0.50)
 a. leiomyoma c. endometriosis
b. adenomyosis d. ovarian cyst

77. The most important criterion in the correct diagnosis of the Stein-Leventhal
Syndrome is: (0.50)
a. obesity c. bilateral ovarian enlargement
b. oligomenorrhea d. infertility

78. A 45 year old G4P4 patient with symptomatic adenomyosis, is the best managed
with? (0.50)
a. TAH-BSO c. TAHBSO with irradiation
b. Fractional D & C d. Hormonal therapy

79. Chocolate cysts of the ovary are most probably: (1.0)

a. dermoid cysts c. Brenner tumor
b. serous cystadenomas d. endometriomas

80. The most common type of degeneration that myomas undergoe is: (0.50)
a. cystic c. calcific
b. hyaline d. fatty

81. Calcareous granules found in histopathological reports of serous cystadenomas of the

ovary are called: (0.50)
a. tubercles b. psammoma bodies
b. giant cells d. papillomas

82. Myxoma peritonei may occur as a consequence of rupture of which ovarian cyst?
(0.50)
a. dermoid c. serous cyst
b. struma ovarii d. mucinous cyst

83. Bilateral ovarian cystic masses in association with a hydatidiform mole are usually:
(1.0)
a. granulose theca cell tumor c. cystadenoma
b. theca lutein cyst d. dermoid cyst

84. If you are suspecting an ovarian malignancy, the usual initial manifestation is: (0.50)
a. ascites c. abdominal mass
b. abdominal pain d. vaginal bleeding

85. Rose, a 26 year old, G1P1, diagnosed with Carcinoma in situ of the cervix is best
managed by: (0.50)
a. conization c. electrocautery
b. cryosurgery d. hysterectomy
86. Schiller’s test is used for: (0.50)
a. cervical mucus examination c. endometrial status evaluation
b. cervical cancer screening d. tubal patency

87. The ovarian tumor with characteristic “signet-ring cells” and primary gastro-
intestinal involvement is: (0.50)
a. brenner’s tumor c. krukenberg tumor
b. arrhenoblastoma d. teratoma

88. The most common site of metastasis of choriocarcinoma is the: (0.50)

a. brain c. lungs
b. kidneys d. ovaries

89. If Marie, a 56 year old postmenopause complains of ascites with abdominal mass
and weight loss; your most likely consideration is a carcinoma of the : (1.0)
a. vagina c. vulva
b. cervix d. ovary

90. Screening test for the recognition of potential malignancy of the cervix is best
accomplished with: (1.0)
a. aspiration of endocervical mucus
b. posterior fornix aspiration
c. cervical canal curettage
d. papanicolau smear

91. The most frequent cause of death from cervical carcinoma is: (0.25)
a. infection c. distant metastases
b. hemorrhage d. uremia

92. The initial gastrointestinal organ that is affected in Krukenberg tumor of the ovary is
the: (0.50)
a. gallbladder c. small intestines
b. rectum d. pylorus

93. Amy, a 30 year old female, married for 5 years is desirerous of pregnancy. Basal
body temperature is 97.2º to 97.4ºF throughout the 35 days cycle. Endometrial biopsy 3
days before menses showed proliferative endometrium. Probable diagnosis is: (0.50)
a. galactorrhea c. endometriosis
b. unovulatory cycle d. tubal occlusion
94. Chromotubation is a test of tubal patency with the use of: (0.50)
a. hypaque c. indigo carmine
b. distilled water d. air

95. In a 30 year old single woman who has amenorrhea, the initial diagnostic step to do
is: (0.50)
a. Progesterone challenge c. ultrasound
b. Estrogen and Progesterone d. endometrial sampling

96. Eny, a 26 year old gravida 0 came in because of amenorrhea of 6 months duration.
She has normal sexual characteristics and pelvic examination was normal. Part of the
initial work-up should include: (0.50)
a. prolactin assay c. karyotype
b. FSH assay d. LH assay

97. The most common benign condition causing post menopausal bleeding is: (0.50)
a. atrophic vaginitis c. myomas
b. endometrial hyperplasia d. cervical polyp

98. A uterine prolapse that is through the vaginal barrel to the region of the introitus, is:
a. first degree c. third degree
b. second degree d. total prolapse

99. The age at which menopause occurs is: (0.50)

a. related to body mass c. genetically predetermined
b. related to number of ovulation d. affected by pregnancy/lactation

100. One of the following is NOT a physiologic alteration noted in a woman’s body after
menopause: (1.0)
a. atrophy of the vagina
b. increased tonicity of the uterine ligaments
c. urinary stress incontinence
d. urge incontinence