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IMU

SOAL OBSTETRI I
1. In the primigravida, engagement usually takes place at:
a.
b.
c.
d.

35
36
37
38

weeks
weeks
weeks
weeks

2. During palpation, you find fetal head lies on the fundus of the uterus. This is an
abnormally on:
a.
b.
c.
d.

Lies
Presentation
Attitude
Position

3. You are going to determine whether the fetus flexed or deflexed. Which of the
following Leopold maneuver is used?
a.
b.
c.
d.

L-I
L-II
L-III
L-IV

4. The first maneuver of Leopold is used to determine which of the following?


a.
b.
c.
d.

Lies
Presentation
Engagement
Position

Case
A 40 y.o woman referred to Sardjito hospital by a midwife because of retained placenta
bleeding about 20 minutes after delivery. Examination on the emergency unit revealed
that blood pressure 60/30 mmHg and pulse rate was 132 bpm. RL infusion and 4 L
oxygen were given. She was survived after blood transfusion was given.
6. Which is the most likely diagnosis in such a case?
a.
b.
c.
d.

Primary shock
Impending shock
Secondary shock
Irreversible shock

7. Which of following solution would be given first?


a.
b.
c.
d.

Dextrose 5% solution
Dextrose 10% solution
Electrolyte solution
Colloid solution

8. Which of the following shock in the above case classified?


a. Neurogenic shock
b. Septic shock

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c. Anaphylactic shock
d. Hypovolemic shock
9. Which of the following is the first sign of hemorrhagic shock?
a.
b.
c.
d.

Decreased blood pressure


Increased pulse rate
Increased respiratory rate
Increased urinary output

10. Which of the following is the simplest way to monitor that homeostasis has been
recovered after fluid resuscitation during treatment of hypovolemic shock?
a.
b.
c.
d.

Blood pressure
Urinary output
Respiratory rate
Pulse rate

11. What causes Respiratory distress syndrome?


a.
b.
c.
d.

Decreased alveolar surface tension


Decreased alveolar surfactant
Increased alveolar fluid
Increased mucus plugging

12. Which of the following stimulates newborn respiration?


a.
b.
c.
d.

O2
O2
O2
O2

accumulation and CO2 accumulation


accumulation and CO2 deprivation
deprivation and CO2 deprivation
deprivation and CO2 accumulation

13. A low 1-min Apgar score helps identify which of the following?
a.
b.
c.
d.

Infant who need special attention


Infant with birth asphyxia
Infant destined to develop neurological problems
Normal infant

14. What is Apgar Score of a male infant at 5 minutes of life whose respiratory effort
irregular, pulse is 90, who is floppy, cyanotic and with minimal grimaces?
a.
b.
c.
d.

1
3
4
7

15. Which of the following is NOT part of APGAR Score?


a.
b.
c.
d.

Heart rate
Respiratory rate
Color
Amniotic fluid consistency

16. Primary germ layer consist of


a. Only 1 layer called inner cell mast
b. Ectoderm & endoderm
c. Consist 3 layers consist of ectoderm, mesoderm & endoderm

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d. Syncytial trophoblast & cellular trophoblast


17. What must be released from sperm to break through corona radiates & zone
pellucid?
a.
b.
c.
d.

Glyceraldehydes 3-phosphate dehydrogenate 9


Hexakinase
Enzyme amylase
Enzyme hyaluronidase

18. What hormone that will maintain corpus luteum thorough 1 st four months
a.
b.
c.
d.

hCG
hPL
hCS
Estrogen & progesterone

A 15 y.o G1P0A0 came to emergency room with chief complaint with excessive
vomiting. She was 10 weeks pregnant. Her blood pressure 100/60 mmHg & pulse rate
100 bpm. Her skins turgor was decreased.
21. These statements below are the differential diagnosis of the disease, EXCEPT
a.
b.
c.
d.
e.

Acute pyelonefritis
Gastritis
Hydatidiform mole
Pancreatitis
Bladders stone

22. If you find the fundal height is higher than the expected gestational age, what
should do next to confirm the diagnosis?
a.
b.
c.
d.
e.

Chest X-Ray
USG
MRI
Serial urine -hCG level
CT scan

23. On the physical examination you found flank pain on the right costovertebral
region. She also suffered from high fever. What was the likely diagnosis?
a.
b.
c.
d.
e.

Acute pyelonefritis
Gastritis
Hydatidiform mole
Pancreatitis
Bladders stone

24. What is the initial management for this patient?


a.
a.
b.
c.
d.

Rehydration
Perform USG
Administer antiemetic
Administer antibiotics
Administer endoscopy

25. These statements below are required to establish the diagnosis, EXCEPT

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a.
b.
c.
d.
e.

Physical examination
Complete blood count
Chemical blood examination
USG
Perform pregnancy test

26. About puerperium


a. The 3rd trimester
b. Interval between birth of baby and the return of reproductive organs to
nonpregnant state
c. Last in about 8 weeks
d. Last in 4 weeks
27. Symptom in non lochial bleeding
a.
b.
c.
d.

Greater with uterine contraction


Gush with fundal massage
Continues to bleed bright red or excessive
Dark red indicates pooled blood and should lessen

28. Which is true about lochia?


a.
b.
c.
d.

Lochia
Lochia
Lochia
Lochia

rubra bright red going to reddish brown (3-4 day pp)


serosa pink or brown (usually lasting about 32-34 days)
albans yellow or white (can last up to 8 weeks pp)
rubra bright red going to reddish brown (13-14 day pp)

29. Retained placenta fragments


a.
b.
c.
d.

The uterus return to nonpregnant state


Within 12 hours of delivery, the fundus is about 1 cm above the umbilicus
Subinvolusion
The cervix doesnt return to circular or shape

30. Changes that you have to observe at the abdomen


a.
b.
c.
d.

Decrease estrogen affects rugae & mucosa of vagina


Episiotomy and/or lacerations
Hemorrhoids
Diastasis recti abdominis

31. Signs of labor EXCEPT


a.
b.
c.
d.
e.

Braxton Hicks
Regular uterine contraction
Bloody show
Rupture of the amniotic membrane
Cervical dilatation

32. Most cause of early postpartum bleeding


a.
b.
c.
d.
e.

Uterine atonia
Placental retention
Perineal laceration
Cervical laceration
Abnormal coagulation

33. Signs of stage two of labor

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a.
b.
c.
d.
e.

Opening of both vulva & anus


Showing of the lowest fetal part at the vulva
Bearing down effort of the mother
Full dilatation of the cervix
All above

34. Mechanism of vaginal delivery


a.
b.
c.
d.
e.

Flexion Internal rotation - extension external rotation


Internal rotation flexion external rotation extension
Extension Internal rotation - Flexion external rotation
Flexion external rotation - extension Internal rotation
Not all above

35. Signs of placental separation should be recognized


a.
b.
c.
d.
e.

Sudden gush of blood


Umbilical cord protrudes farther out of the vagina
Uterus becomes globular & firmer
All above
None

36. The LMP was June 30. The expected date of confinement (EDC) is approximately
a.
b.
c.
d.
e.

March 23
April 7
March 28
April 23
March 7

37. Pregnancy may occur during a period of amenorrhea such as during lactation or
following discontinuance of hormonal methods of contraception. In such situation,
determination of the most accurate estimated date of delivery can then be made by:
a.
b.
c.
d.
e.

Eliciting when breast tenderness or morning sickness began


Assessing uterine size by physical exam
Counting 280 days from the first positive serum pregnancy test
Asking the patient when she first felt pregnant
Obtaining fetal biometry by ultrasound prior 20 weeks of gestation

38. 20 y.o primigravida who is 24 pregnant weeks expresses concern about the
normality of her fetus after learning that a close friend has just delivered an infant with
hydrocephalus. Details about hydrocephalus that should be included in her counseling
include the fact that:
a.
b.
c.
d.
e.

Occurs spontaneously in 1 of 500 pregnancies


Has a multifactorial etiology
Usually an isolated defect
Can be cured by intrauterine placement of shunts
Can be identified as early as 10 weeks of gestation

39. Fundal height, part of obstetric examination, is taken of the top of the symphisis
pubis to the top of the fundus. It is measured:
a. By calipers, approximating the weeks of gestation

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b.
c.
d.
e.

In inches, approximating the lunar month of gestation


In centimeters, divided 3.5 approximating the lunar month of gestation
In centimeters, approximating the weeks of gestation between 18 to 34 weeks
By calipers in centimeters, prognosticating the fetal weight

40. On the following, the most worry sign or symptom of potentially pathology in late
pregnancy is
a.
b.
c.
d.
e.

Swollen ankles
Constipation
Visual changes
Nocturia
Heartburn

41. Which one gives very accurate estimation of the gestational age can be made
between 7 to 13 weeks?
a.
b.
c.
d.

CRL
BPD
FL
AC

42. When the earliest time we can use BPD to estimate the gestational age?
a.
b.
c.
d.

8 weeks
10 weeks
13 weeks
16 weeks

43. For 1st trimester ultrasonic soft markers of Down Syndrome are
a.
b.
c.
d.

Absence of fetal nasal bone and increased fetal nuchal translucency


Choroid plexus cysts
Single umbilical artery
Banana sign

44. False-positive results for diagnosis placenta previa with abdominal ultrasonography
can occur caused by:
a.
b.
c.
d.

Number of fetus
Parity
Scar cause by previous cesarean section
Bladder distention

45. What the anatomical landmarks should must be seen when we measure BPD be
used to estimate gestational age?
a.
b.
c.
d.

Midline falx, thalami symmetrically positioned, septum pellucidum


Orbita & thalami symmetrically positioned
Cerebellum & thalami symmetrically positioned
Cisterna magna, Cerebellum & thalami symmetrically positioned