JOSE REYES MEMORIAL MEDICAL CENTER 10.

10. The vein which is most commonly involved in pelvic thrombophlebitis is: b. valsalva maneuver
OBGYNE EXIT EXAM (0.25) c. ferguson’s reflex
MULTIPLE CHOICE. Choose the best answer a. femoral d. hoffman’s reflex
b. saphenous 21. The fundamental clinical change during the first stage of labor is(1.0):
1. The human decidua is formed from the effects of prolonged stimulation c. pelvic a. descent
of one or more the following hormones: (0.50) d. ovarian b. cervical dilatation
a. luteinizing hormone, estrogen and progesterone 11. Rina, a ramp model, pregnant for the first time on her 6th week AOG, c. internal rotation
b. chorionic gonadotropin, progesterone, estrogen needs to gain how much weight in pounds for the whole duration of her d. engagement
c. estrogen, progesterone pregnancy? (0.50) 22. The second stage of labor begins with: (1.0)
d. estrogen only a. 10 a. expulsion
2. Julene, a primi gravidocardiac, term, in labor, is indicated for forceps b. 14 b. 10 cm cervical dilatation
extraction. If the head has reached the perineal floor with the sagittal suture c. 18 c. station +1
along the A-P diameter of the outlet, what kind of forceps extraction will be d. 20 d. 100 % effacement
performed? (0.50) 12. The relation of the fetal parts to one another determines the: (0.50) 23. The major source of progesterone in early pregnancy is the: (1.0)
a. low mid forceps a. presentation a. placenta
b. low forceps b. lie b. placenta cytotrophoblast
c. high forceps c. attitude c. corpus luteum
d. trial forceps d. station d. syncytiotrophoblast
3. The female pelvis has an inlet that is commonly: (1.0) 13. After delivery, the pediatrician inspects the umbilical cord of a newborn, 24. Which of the following is characteristics of the pfannenstiel
a. android this would normally contain: (1.0) incision?(1.0)
b. platypelloid a. one artery and two veins a. transverse skin incision
c. gynecoid b. one artery and one vein b. incision just below the umbilicus
d. anthropoid c. two arteries and one vein c. transverse uterine incision
4. The labia majora is homologous with this male organ: (0.50) d. two arteries the two veins d. longitudinal muscle incision
a. penis 14. The major portion of the arterial blood supply to the pelvis is derived 25. Lourdes, a primigravid, diagnosed to be 10 weeks pregnant is
b. foreskin from the: (0.25) complaining of abdominal pain with vaginal bleeding. To confirm the
c. testicle a. internal iliac presence of a tubal pregnancy, which procedure should be performed?
d. scrotum b. uterine (0.50)
5. After menstruation, a portion of this layer of the endometrium remains to c. external iliac a. culdoscopy
regenerate: (0.50) d. pudendal b. culdocentesis
a. compact zone 15. The blood supply of the uterus is derived from the: (0.25) c. laparoscopy
b. spongy zone a. Hypogastric and uterine arteries d. laparotomy
c. basal zone b. Ovarian and uterine arteries 26. Who among the following women will be at risk to develop ectopic
d. functional zone c. Uterine and ileolumbar arteries pregnancy?(0.50)
6. Lina, a G1P0, on her 26th week AOG, was requested to undergo an d. Ileoinguinal and uterine arteries a. Arnie, a 24 year old, previously diagnosed to have
ultrasound examination. This finding will NOT be seen in her result: (1.0) 16. The cardinal movements of labor and delivery involve a certain sequence salpingitis
a. fetal aging of events that occur in an orderly fashion. Which of the following sequences b. Baby, a 21 year old, newly married, apparently healthy
b. diagnosis of pregnancy are correct? (0.50) c. Celia, a 38 year old, widow, diagnosed with adenomyosis
c. assessment of fetal growth rate a. descent/ internal rotation/ flexion d. Dina, a 44 year old S/P hysterectomy for multiple myoma
d. assessment of fetal lung maturity b. engagement/ flexion/ descent 27. Edna, a 27 year old secundi, with normal vital signs, is presently on the
7. Linda , an OFW, underwent curettage for incomplete abortion at 6-7 c. engagement/ descent/ internal rotation first half of pregnancy. She has vaginal spotting, full fornices, closed and non-
weeks AOG. If she were to perform a pregnancy test, a negative result will d. engagement/ descent/ flexion tender cervix and a uterine size bigger than the expected age of gestation.
noted after ____ days: (0.25) 17. Pathologic retraction ring means: (1.0) Your impression is: (0.50)
a. two a. impending uterine rupture a. ectopic pregnancy
b. three b. a normal physiologic change b. hydatidiform mole
c. ten c. imminent delivery c. abruptio placenta
d. fourteen d. a congenital uterine abnormality d. threatened abortion
8. The minimum amount of radiation exposure which may produce damage 18. Beth, a full term, G4P3 is admitted with an 8 cm cervical dilatation, LOT, 28. Consumptive coagulopathy in abruptio placenta is due to: (0.25)
to the fetus in the first trimester of gestation is---- rads: (0.25) BOW intact. She would benefit best with: (0.50) a. increased destruction of fibrinogen
a. 25 a. trial of labor b. cessation of the production of clotting factors
b. 50 b. forceps delivery c. release of thromboplastin to the circulation
c. 100 c. x-ray pelvimetry d. formation of couvelaire uterus
d. 150 d. cesarean section 29. The most common cause of early abortion is: (0.50)
9. During pregnancy, which portion of the uterus forms the lower uterine 19. The most important diameter in the clinical evaluation of the pelvis is: a. maternal illness
segment? (0.50) (0.25) b. abnormality of the placenta
a. external cervical os a. Boudelocque’s diameter c. fetal abnormality
b. cornua b. diagonal conjugate d. viral disease
c. fundus c. obstetrical conjugate 30. Which is most likely to be associated with profuse vaginal bleeding?(
d. isthmus d. true conjugate 0.50)
20. Mechanical stretching of the cervix that produces increased uterine a. incomplete abortion
activity is called: (0.50) b. missed abortion
a. moro reflex c. threatened abortion
d. dysfunctional bleeding
 b. abruptio placenta
31. Oxytocin infusion is contraindicated to this patient: (0.50) c. multiple pregnancy PART II (1 point deduction for every mistake)
a. Gina, 36 weeks AOG, with premature rupture of bag of d. traction on the umbilical cord before separation 1. Illustrate the Friedman’s curve, complete with labels on X- and Y-axis,
waters 41. The most distinctive clinical sign of eclampsia is: (1.0) divisions of labor, phases of cervical dilatation, stages of labor (10
b. Hilda, on her 42nd week AOG a. epigastric pain points)
c. Ina, 26 years old with previous multiple pregnancies b. convulsion
d. Joan, a 24 year old, secundi with previous classical cesarean c. pulmonary edema
section d. fetal distress
32. Kyla, a primigravid, on her 32 weeks AOG, came in for prenatal check- 42. Tina, a primigravid, on her 34th week AOG, is diagnosed to have severe
up. Auscultation of the FHT yields negative result and ultrasound revealed pre eclampsia. The best treatment for her is: ( 0.50)
fetal death in utero. How will you manage her? (0.50) a. magnesium sulfate
a. hysterotomy b. delivery
b. wait for spontaneous labor c. bed rest
c. prostaglandins d. antihypertensives
d. suction curettage 43. The most common form of abnormality during pregnancy is: (1.0)
33. Which of the following is an indication for cesarean hysterectomy? (0.50) a. diabetes
a. placenta previa b. toxemia
b. invasive cervical carcinoma c. iron deficiency anemia
c. placental abruption d. hemorrhage
d. placenta accreta 44. The renal lesion most associated with eclampsia is: (0.50)
34. A patient in labor has a prolapsed cord. There is a vertex presentation a. acute tubular necrosis
at station –2. The cervix is 5 cm dilated and the umbilical cord is at the vagina b. hydroureter
pulsating at 90 beats/minute. Your management begins with: (1.0) c. cortical necrosis
a. displacement of the fetal head out of the pelvis d. glomerular endothelial swelling
b. careful monitoring of the uterine contractions 45. An infection that may seriously affect the fetus during early pregnancy 2. Enumerate the 10 danger signs of pregnancy (5 points)
c. oxygen by mask to the mother is: (0.50)
d. d. empty the urinary bladder a. rubella
35. A secundigravida has been leaking fluid from the vagina for 12 hours at b. hepatitis
36 weeks gestation. The fetus is in cephalic presentation with an estimated c. chicken pox
weight of 2500 gms. The cervix is effaced and 2 cm dilated. There are no d. trichomonas
contractions. Nitrazine test is positive. Which of the following is the best 46. Hypofibrinogenemia is a potential hazard of: (0.25)
course of action? (0.50) a. complete abortion
a. discharge and await labor at home b. incomplete abortion
b. broad spectrum antibiotics c. missed abortion
c. intravenous oxytocin induction of labor d. impending abortion
d. ceasarean section 47. The initial maternal immunologic response to a primary rubella infection
36. Mona, a primigravid, diagnosed with H mole is preferably treated by: is elaboration of: (0.25)
(0.50) a. IgG
a. hysterectomy c. IgM
b. hysterotomy b. IgA
c. methotrexate d. IgD
d. oxytocin and suction curettage 48. The most commonly observed abnormal laboratory test in pre eclampsia
37. Nina, primigravida at term with abruption placenta and moderate is: (0.50)
vaginal bleeding is best managed by: (0.50) a. fibrinogen level
a. induce labor after amniotomy c. SGOT level
b. cesarean section b. serum uric acid
c. watchful observation d. platelet count
d. forceps delivery 49. This antihypertensive drug has been banned for use during pregnancy
38. A G2P1 with 4 weeks missed period presents with one week duration of because of the increased incidence of early abortions: (0.75)
3. Differentiate: fetal lie, fetal position, fetal attitude, fetal presentation
vaginal bleeding and hypogastric pains. She also has watery vaginal a. hydralazine
(5 points)
discharge before consultation. IE findings: 1-2 cm dilated with BOW c. calcium channel blockers
ruptured. What is your diagnosis?(0.50) b. reserpine Lie:relationship between the fetal and
a. inevitable abortion d. ACE inhibitors maternal dorsal columns (the longitudinal
b. imminent abortion 50. Immunization with one of the following is absolutely contraindicated
c. incomplete abortion during pregnancy: (0.75) axis of the human body)
d. missed abortion a. tetanus
39. Couvelaire uterus is characterized by: (1.0)
a. enlargement and invasion by choriocarcinoma
c. cholera
b. hepatitis B
relation of the various parts of the
Attitude:
b. a congenital anomalous development d. rubella fetus to each other.
c. uteroplacental apoplexy
d. adherence to the cul-de-sac
40. Inversion of the uterus almost always follows: (1.0) lowermost structure of the fetus
Presentation:
a. difficult forceps delivery in the maternal pelvis
  difficult repair
determining the position of the
Position:
presenting part. This is a description of the
relation of the presenting part of the fetus  higher risk of long-term
to the maternal pelvis. discomfort, especially during
4. Differentiate median and mediolateral episiotomy based on the
following parameters: repair, healing, post op pain, anatomical results,
sexual intercourse
blood loss, dyspareunia, extensions. (10 points)
5. Enumerate the drill for shoulder dystocia (10 points)
In a midline episiotomy, the
Midline:

incision is made in the middle of

the vaginal opening, straight
down toward the anus.
advantages of a midline
episiotomy include easy repair
and improved healing. This type
of episiotomy is also less painful
and is less likely to result in long-
term tenderness
main disadvantage of a midline
episiotomy is the increased risk 6. Interpret the tracing below (10 points)

for tears that extend into or

through the anal muscles

incision begins in the

Mediolateral:
middle of the vaginal opening and
extends down toward the
buttocks at a 45-degree angle. BONUS:
primary advantage of a 1. Oldest 1st year resident (2 points)
2. Department’s most favorite drink (1 point)
mediolateral episiotomy is that 3. Number 1 cause of skin aging (1 point)
4. Name 2 pokemon that can talk like humans (2 points)
the risk for anal muscle tears is 5. Previous name of Jose R. Reyes Memorial Medical Center (1
point)
much lower, however: 6. The highest land structure (mountain, volcano) in our solar
system is found on what planet? (1 point)
7. What is the required time in for OB residents? (1 point)
 increased blood loss 8. Name the oldest religion in the world.

 more severe pain