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Davao City
Source: William Obstetrics
21st Edition
____ 1. Pain during the first stage of labor is mediated through:
A. 7th and 8th thoracic nerves
B. 9th and 10th thoracic nerves
C. 10th , 11th, 12th thoracic nerves & 1st lumbar nerve
D. 1st, 2nd, and 3rd lumbar nerves
Chapter 15, page 368
Ms. Paraso, 18 year-old, G1P0, 39-40 weeks AOG, was brought to the Delivery Suite because of
labor pains. On admission, BP=110/80; FH=34cm; FHT= 145 bpm. Internal examination: Cervix
3cm, 60% effaced; intact BOW, station -2; cephalic presentation. Uterine contractions were
occurring at every 5-6 minutes interval, 30 seconds duration; mild to moderate contractions.
____ 2. The patient in this case is already in what phase of labor?
A. latent case
B. acceleration phase
C. phase of maximum slope
D. deceleration test
Chapter 18, page 428
____3. The following pelvimetry suggest midpelvic contraction, except:
A. spines are prominent
B. pelvic sidewalls converge
C. sacral promontory can be reached at 8.0 cm
D. sacrosciatic notch is narrow
Chapter 18, page 437
___ 4. Which of the following statements is not a characteristic of cephalhematoma?
A. This is usually caused by injury to the periosteum of the skull during labor and
B. Hemorrhage can occur over one or both parietal bones
C. The periosteal limitations with definite palpable edges will not differentiate the
cephalhematoma from caput succedaneum
D. Cephalhematoma may not appear for hours after delivery, often growing larger and
disappearing only after several weeks
Chapter 39, page 1079
____ 5. Fetal Heart Rate Patterns suggesting true fetal distress is/are:
A. Zero beat-to-beat variability
B. Severe decelerations
C. Persistent baseline rate changes
D. All of the above
Chapter 14, page 349
____ 6. Which of the following statements regarding drug use in pregnancy is true:
A. Drugs cross the placenta in varying degrees depending on lipid solubility, molecular
size, maternal metabolism, protein binding and storage.
B. Drugs associated with cardiac malformations will exert their effect when ingested
after the eighth week from fertilization.
C. The fetus is safe from drug and substance effects during the fetal period.
D. As a general rule, drugs are safe until proven otherwise.
Chapter 38, page 1007

____ 7. A fetus in transverse lie becomes a fetus in oblique lie when the long axis forms a/an:
A. Right angle
B. Obtuse angle
C. Acute angle
D. All of the above
Chapter 12, page 293
____ 8. Choose the correct statement regarding the female reproductive organs:
A. The cardinal ligament of the uterus connects the cervix to the posterior surface of the
B. The uterine artery crosses over the ureter in its course
C. The ovarian veins (right and left) drain into the inferior vena cava.
D. Lymphatic drainage of the uterus and the upper of the vagina is directed towards
the pelvic nodes only that from the lower of the vagina is directed into the
superficial inguinal nodes.
Chapter 3, page 43
____9. The shortest distance between the promontory of the sacrum and the symphysis pubis:
A. Obstetric conjugate
B. Diagonal conjugate
C. True conjugate
D. None of the above
Chapter 3, page 58
____ 10. If the thighs are flexed on the abdomen and the legs upon the thighs, this is a:
A. Incomplete Breech Presentation
B. Complete Breech Presentation
C. Frank Breech Presentation
D. Footling Breech Presentation
Chapter 12, page 293
____ 11. A conclusive diagnosis of rupture membranes is made:
A. By testing the pH of the vaginal fluid
B. When amnionic fluid is seen pooling in the posterior fornix
C. By using the indicator nitrazine test
D. Detection of alpha-fetoprotein in the vaginal vault
Chapter 13, page 312
____ 12. Lacerations that include the skin and mucous membrane, the fascia and the muscles of
the perineal body are classified as:
A. Third-degree laceration
B. Second-degree laceration
C. First-degree laceration
D. Fourth-degree laceration
Chapter 13, page 325
____ 13. A 25-year-old G3P2 (2002) was referred to the hospital for prolonged second stage of
labor. What condition will not favor outlet forceps extraction?
A. The cervix is fully dilated
B. There is no cephalopelvic disproportion
C. The most dependent portion is at the level of the ischial spines
D. the sagittal suture of the fetal head is in the AP diameter
Chapter 21, page 487

____ 14. A 29-year-old primigravid was admitted for labor pains. The cervix remained 9 cms.
dilated for 3 hours and the fetal head was at station O in right occiput posterior
position. The correct management is:
A. Forceps extraction
B. Low segment cesarean section
C. Internal podalic version
D. Cesarean hysterectomy
Chapter 18, page 431
____ 15. Of the hematologic changes associated with preeclampsia, the following is the most
A. hemolysis
B. thrombocytopenia
C. decreased plasma clotting factors
D. increase plasma clotting factors
Chapter 24, page 575
____ 16. The most important information that the obstetrician has for a successful management
of pregnancy complicated by hypertension is:
A. knowledge of the gestational age of the fetus
B. knowledge of the weight of the fetus
C. knowledge of the fetal biophysical score
D. knowledge of the maternal-fetal Doppler blood flow studies
Chapter 24, page 591
____17. During puerperium the uterus descends into the cavity of the true pelvis within:
A. one (1) week
C. two (2) weeks
B. ten (10) days
D. four (4) weeks
Chapter 17, page 404
____ 18. If a woman does not nurse, her menses usually return within:
A. 4-6 weeks
C. 8-10 weeks
B. 6-8 weeks
D. 3 months
Chapter 17, page 419
____ 19. Antimicrobial regimens for pelvic infection following cesarean delivery proven to have
the greatest efficacy which is widely studied:
A. Ampicillin-Gentamicin
B. extended spectrum PCN
C. extended spectrum Aps
D. Quipenem and cilatasis
Chapter 26, page 677
____ 20. An acute febrile illness with severe multi-system derangement characterized by fever,
headache, mental confusion, macular erythematous rash, subcut, edema, nausea,
vomiting and watery diarrhea and marked hemoconcentration:
A. toxic shock syndrome
B. Group AB-hemolytic strep infection
C. Pelvic abscess
D. Septic pelvis thrombophlebitis
Chapter 26, page 685
____ 21. The best method of diagnosing uterine atony is by:
A. observation of vaginal bleeding
B. cervical and vaginal inspection
C. palpation of the uterus
D. careful BP and RR observations
Chapter 25, page 638

____ 22. In the immediate puerperium, in a setting of excessive of vaginal bleeding, the guide to
instituting blood transfusion therapy is:
A. the amount of blood lost
B. the pulse rate
C. the diastolic blood pressure
D. the systolic blood pressure
Chapter 25, page 653
____ 23. Inversion of the uterus is almost always subsequent upon:
A. difficult forceps delivery
B. abruptio placenta
C. multiple pregnancy
D. traction of the umbilical cord before the separation
Chapter 25, page 642
____ 24. Fetal growth is divided into the following 3 consecutive cell growth phases:
A. Hyperplasia, Hypertrophy, Hyperplasia and Hypertrophy
B. Hypertrophy, Hyperplasia and Hypertrophy, Hyperplasia
C. Hyperplasia, Hypertrophy and Hyperplasia, Hypertrophy
D. None of the above
Chapter 29, page 744
____ 25. The following screening and identification of fetal growth restriction should be done:
A. Uterine fundal height
B. Ultrasonic measurements
C. Doppler Velocimetry
D. All of the above
Chapter 29, page 753
____ 26. This placental disorder is associated with certain maternal diseases such as
hypertension wherein there is reduction in functioning placenta, which may lead to
enarteritic thickening and obliteration termed hemorrhagic endovasculitis (HEV):
A. placenta accreta
B. abruptio placenta
C. vasa previa
D. placental infarction
Chapter 32, page 829
____ 27. Amniotomy in abruptio:
A. hasten delivery
B. reduce entry of thromboplastin into maternal circulation
C. character of the fluid increases the suspicion of abruptio
D. all of the above choices
Chapter 25, page 629
____ 28. Which of the following is NOT associated with an increased abortion rate?
A. advanced paternal age
B. Class A1 Diabetes Mellitus
C. Advanced maternal age
D. Pregnancy within 3 months of a live birth
Chapter 33, page 857
____ 29. Which of the following uterine abnormalities has the greatest likelihood of spontaneous
A. Asherman's syndrome
B. Bicarnuate uterus
C. Leimyomata
D. Uterine septa
Chapter 33, page 862

____ 30. Which of the following signs/symptoms most strongly implies a ruptured ectopic
pregnancy with sizable intraperitoneal hemorrhage?
A. shoulder pain on inspiration
B. Heavy vaginal bleeding
C. nausea and vomiting
D. abdominal mass, unilateral
Chapter 34, page 890
____ 31. This is characteristic of complete H-mole:
A. usually triploid 69XXY, XYY
B. composed of a mixture of N-sized chorionic villi mixed with large hydropic ones
C. is 46XX or YY coming from father 90% of the time
D. fetus is usually present
Chapter 32, page 836
____ 32. Patient is considered at high risk of developing persistent gestational trophoblastic
disease when the following risk factor/s is/are present:
A. theca luteum cyst of 5 cm.
B. age less than 40
C. hCG level> 100,000
D. uterine enlargement of 3 months AOG
Chapter 32, page 839
____ 33. Pre-operative evaluation of cervical incompetence is best done:
A. before 14 weeks
B. after 14 weeks and not later than 20 weeks
C. after 20 weeks
D. after the 2nd trimester
Chapter 33, page 863
___ 34. The effect of myoma on pregnancy includes:
A. Abruptio is common on placentas implanted over or in contact with a myoma
B. Growth of myomas increases with gestational age
C. It is an absolute indication for CS delivery
D. Fetal malposition and preterm labor are not commonly seen
Chapter 35, page 929
____ 35. In Ovarian masses, complicating pregnancy:
A. The most common ovarian tumors are cystic
B. Solid ovarian masses are most likely benign
C. Cysts of less than 5 cm should be removed
D. Cyst rupture is the most frequent and serious complication
Chapter 35, page 931
____ 36. Uterine rupture in trauma:
A. Rupture of the uterus is common with blunt trauma
B. Clinical findings may be identical to placental abruption
C. Usually associated with indirect impact to the uterus
D. All of the above
Chapter 43, page 1173
____ 37. The most common skin symptom during pregnancy:
A. burning sensation
B. pruritus
C. pain
D. cold sensation
Chapter 54, page 1430

____ 38. Major risk for maternal mortality during pregnancy:

A. atrial septal defect
B. ventricular septal defect
C. patent ductus arteriosus
D. pulmonary hypertension
Chapter 44, page 1194
____ 39. The most accurate and safest method to diagnose heart disease in pregnancy is:
A. electrocardiogram
B. chest x-ray
C. two-dimensional echocardiogram
D. coronary angiogram
Chapter 44, page 1184
Mrs. Williams delivered to a live term baby boy, with no complications noted. On the boy's
second year of life, he was noted that he does not answer when his name is called, and does not
react if other children are shouting in front of him. Maternal history revealed maternal fever and
a three-day generalized maculopapular rash.
____40. The most common cause(s) of the deafness in children is/are:
A. Maternal influenza
B. Maternal Rubella
C. Maternal cytomegalovirus
D. B and C are correct
Chapter 56, page 1468
Bella, a 23 year-old commercial sex worker, went to the Social Hygiene clinic for her regular
check-up. On examination, she was noted to have variable rash on the palms and soles of both
____ 41. The following are characteristics of primary chancre of syphilis:
A. characterized by a painless firm ulcer with raised edges and a granulation base
B. persists for 2 to 6 weeks and heals spontaneously
C. often accompanied by nontender, enlarged inguinal lymph nodes
D. all the above are correct
Chapter 57, page 1487
Gloria, a 27-year-old G1P0, on her 20 th week gestation, was known to be HIV positive one year
prior to this pregnancy.
____ 42.

Prevention of vertical (mother to infant) transmission of HIV infection is/are the

Cesarean delivery
Antiretroviral therapy and vaginal delivery
Antiretroviral therapy and cesarean section
Antiretroviral therapy
Chapter 37, page 1503

A 29 years old female, married, G1P0 AOG 16 weeks, complained of vague abdominal
wall pain for 3 days, with slight fever and urgency. She took Paracetamol 500 mg and there was
temporary relieved of symptoms.
A few minutes prior to consultation, she noticed blood tinged urine.
Husband is an overseas worker (Seaman).
____43. What is the probable clinical impression on consultation?
A. acute pyelonephritis uncomplicated
B. acute urethritis syndrome
C. acute cystitis, hemorrhagic
D. acute pyelonephritis complicated
Chapter 47, page 1255

____ 44. The following is true about cholestasis of pregnancy:

A. Occurs in the third trimester but can occur earlier
B. The initial and most characteristic symptom is pruritus which is most severe during
the day
C. Jaundice develops in a majority of patients
D. Amelioration of symptoms is not achieved with delivery
Chapter 48, page 1284
____ 45. Which of the following maternal metabolic adaptations does not occur in normal
A. Decreased insulin secretion
B. Increased resistance to insulin action
C. Relative fasting hypoglycemia
D. Increased plasma lipids
Chapter 51, page 1360
____ 46. Which of the following laboratory tests will help the clinician diagnose
hyperthyroidism in pregnancy?
B. Free T4
C. Free T3
D. All of the above
Chapter 50, page 1341
____ 47. Which among these measures of pulmonary function is expected to increase during
A. Residual volume
B. Expiratory reserve volume
C. Functional residual capacity
D. Minute ventilation
Chapter 46, page 1225
____ 48. True statement as regards asthma and pregnancy:
A. With mild asthma, carbon dioxide retention in the blood is expected.
B. Asthma has predictable worsening during pregnancy
C. Monitoring of efficacy of treatment is by symptoms alone.
D. Maternal alkalosis may cause fetal hypoxemia even before maternal oxygenation is
Chapter 46, page 1231
____ 49. Anemia in pregnant woman is defined as hemoglobin value:
A. less than 12 g/L
B. less than 14 g/L
C. less than 10 g/L
D. less than 8 g/L
Chapter 49, page 1309
____ 50. The total iron in normal pregnancy is about:
A. 200 mg
B. 300 mg
C. 800 mg
D. 1000 mg
Chapter 49, page 1309