Ite QUESTION

EXPLANATION AUTHOR TOPNOTCH

m # EXAM
597 Which will confer the highest risk factor for the It is known that HPV infection confers the highest TIMOTHY TANG MIDTERM 1
development of cervical cancer? risk but it should be the oncogenic serotypes and LEE SAY, MD EXAM - FEB
A. Multiple sexual partners the presence of a mass in the cervix will confer the (TOP 4 - AUG 2014
B. HPV 6 infection highest risk for malignancy 2013 MED
C. Intercourse at an early age BOARDS;
D. Genetic predisposition TOPNOTCH MD)
E. Exophytic mass on ectocervix
598 Which ovarian tumor has a higher chance of Granulosa theca cell tumor are funcional and TIMOTHY TANG MIDTERM 1
concommitant endometrial hyperplasia? secrete estrogen, so there is a risk for endometrial LEE SAY, MD EXAM - FEB
A. Serous epithelial tumor hyperplasia or carcinoma. (TOP 4 - AUG 2014
B. Endometrioid epithelial tumor 2013 MED
C. Granulosa-theca cell tumor BOARDS;
D. Dysgerminoma TOPNOTCH MD)
E. Meigs syndrome
599 Which parameter is not included in the Sassone Size of mass is not one of the 4 criteria of Sassone TIMOTHY TANG MIDTERM 1
criteria in diagnosis of ovarian malignancy by scoring. LEE SAY, MD EXAM - FEB
ultrasound? (TOP 4 - AUG 2014
A. Inner wall structure 2013 MED
B. Wall thickness BOARDS;
C. Size of mass TOPNOTCH MD)
D. Septa
E. Echogenicity
600 Which of the following structures in the female Ovaries, oviducts and uterus came from the TIMOTHY TANG MIDTERM 1
genital tract comes from the endoderm? mesoderm, the vagina, urethra comes from both the LEE SAY, MD EXAM - FEB
A. Ovaries endoderm and mesoderm. Endoderm from the (TOP 4 - AUG 2014
B. Oviducts cloaca which are part of the primitive hindgut. The 2013 MED
C. Uterus vulva is form from ectoderm. BOARDS;
D. Vagina TOPNOTCH MD)
E. Vulva
601 The female equivalent of the gubernaculum testis Round ligament is the female equivalent of RACHELLE FINAL EXAM -
is: gubernaculum testis. This ligament courses from MENDOZA, MD FEB 2013
A. Round ligament lateral uterus inserting to the labia majora. (TOP 9 - AUG
B. Ovarian epithelium 2012 MED
C. Suspensory ligament of the ovary BOARDS;
D. Epoophoron TOPNOTCH MD)
E. None of the above
602 Which of the following statements is/are true The average interval between cycles is 28 days. A RACHELLE FINAL EXAM -
regarding the normal menstrual cycle : normal menstrual cycle lasts from 21 to 35 days MENDOZA, MD FEB 2013
A. It has an average blood loss of 100 ml (average of 28 days, +/- 7 days) with 2 to 6 days of (TOP 9 - AUG
B. The average interval between cycles is 28 days flow (average of 4 days) and with a blood loss of 30 2012 MED
C. The average duration of flow is 7 days - 80 ml (average of 50 ml). Studies of large numbers BOARDS;
D. Luteal phase has a variable duration, while of normally cycling women have shown that only TOPNOTCH MD)
secretory phase is constant approximately 2/3 of adult women have cycles
E. All of the above lasting 21 - 35 days. Duration of luteal phase is
always constant (14 days), while that of the
secretory phase is variable.
603 A 34-year old G4P3 (3003) was sent to the OR for Theca-lutein cyst is common in pregnancy. It is a RACHELLE FINAL EXAM -
an emergency CS. Aftter repair of the uterus, the benign cyst that usually presents with honeycomb MENDOZA, MD FEB 2013
obstetrician noted that the left ovary has a cyst appearance on gross inspection. This cyst (TOP 9 - AUG
with a honeycomb appearance. The physician spontaneously regresses after completion of 2012 MED
should: pregnancy and menstruation resumes. BOARDS;
A. Do unilateral oophorectomy TOPNOTCH MD)
B. Obtain a biopsy specimen of the cyst
C. Refer intra-op to general surgery for possible
presence of gastric CA
D. Leave the cyst and do follow-up ultrasound
E. Proceed with TAHBSO
604 A 26-year old G1P1 (1001) seeks consult for Method effectiveness refers to the pregnancy rate RACHELLE FINAL EXAM -
contraception. She has no co-morbidity and had no of 100 women using a particular contraceptive MENDOZA, MD FEB 2013
complication during her previous pregnancy. method correctly for 1 year (100 women-years of (TOP 9 - AUG
Which of the following will be most effective for use). The effectiveness reflects failures due to 2012 MED
this patient? patient misuse of the contraceptive method and is BOARDS;
A. Intra-uterine device (IUD) less than method effectiveness. Oral contraceptive TOPNOTCH MD)
B. Spermicidal agent is proven by studies to be most effective among
C. Condom female patients when properly used. Coitus
D. Oral contraceptives interruptus is an unreliable contraceptive method
E. Coitus interruptus in which the penis is withdrawn from the vagina
prior to ejaculation.
605 Inlet contraction can be diagnosed with which of The obstetric conjugate is the most important RACHELLE FINAL EXAM -
the following clinical finding: anteroposterior diameter of the inlet which is the MENDOZA, MD FEB 2013
A. Obstetric conjugate of less than 11.5 cm shortest distance between the sacral promontory (TOP 9 - AUG
B. Diagonal conjugate of less than 11.5 cm and the mid posterior aspect of the symphysis 2012 MED
C. Interspinous diameter of less than 10.5 cm pubis through which the fetal head must pass. It BOARDS;
D. Sidewalls that are convergent measures 10 cm or more but may be considerably TOPNOTCH MD)
E. All of the above shortened in abnormal pelvis. The obstetric
conjugate cannot be measured directly with the
examining finger. Measurement is indirectly done
by getting the diagonal conjugate which is the
distance between the sacral promontory and
inferior margin of the symphysis pubis and subtract
1.5 to 2 cm. The diagonal conjugate length may vary
depending on the height and inclination of the
symphysis pubis. Therefore inlet contraction is
usually defined as a diagonal conjugate of less than
11.5 cm. Obstetric conjugate in inlet contraction
should be less than 10cm.
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
606 Cytomegalovirus is the most common cause CMV is the most common cause of perinatal RACHELLE FINAL EXAM -
perinatal infection. This may be transmitted by infection. This is transmitted horizontally by MENDOZA, MD FEB 2013
which of the following routes : droplet infection and contact with saliva and urine, (TOP 9 - AUG
A. droplet infections vertically from mother to fetus, infant and as a 2012 MED
B. coitus sexually transmitted disease. Williams, 21th ed, p BOARDS;
C. uteroplacental 1468. TOPNOTCH MD)
D. all of the above
E. A and C only
607 A 33-year old G0 came to your clinic complaining Pen G is the recommended treatment for adult with RACHELLE FINAL EXAM -
of genital lesions. Suspecting syphilis, the most primary, secondary or early latent syphilis. Patients MENDOZA, MD FEB 2013
appropriate drug therapy is: with latent (patients seroactive without evidence of (TOP 9 - AUG
A. Ceftriaxone 1gm IM single dose disease) syphilis should be given 3 doses of 2.4 2012 MED
B. Erythromycin 500 mg orally 4 x 1 day for 7 days million. Benzathine Pen G IM, at 1-week intervals. BOARDS;
C. Benzathine Penicillin G, 2.4 million units IM TOPNOTCH MD)
single dose
D. Cefoxitin 2 gms IM single dose
608 A 19 year old G1P0 PU 40 weeks, not in labor, was Reactive non-stress test biophysical scoring (8-10) RACHELLE FINAL EXAM -
seen at the OPD for decreased fetal movement. She shows normal findings and indicates favorable fetal MENDOZA, MD FEB 2013
was hooked to an electronic fetal monitor and survival. A non-reactive non-stress test (< 6) refers (TOP 9 - AUG
tracing showed: Baseline FHT- 140’s, good to poor fetal condition and may be an indication for 2012 MED
variability, with more than 2 accelerations of 20 an emergent delivery. BOARDS;
bpm lasting for 20 secs. The tracing is interpreted TOPNOTCH MD)
as:
A. reactive
B. non-reactive
C. positive
D. negative
E. inconclusive
609 An obstetrician who attempts to do forceps In trial forceps, the OPB is fully aware that vaginal RACHELLE FINAL EXAM -
extraction with the knowledge that there is certain delivery may not be successful. In elective forceps, MENDOZA, MD FEB 2013
degree of disproportion at the level of the vaginal delivery is possible even without operative (TOP 9 - AUG
midpelvis is doing a: delivery. 2012 MED
A. Failed forceps BOARDS;
B. Prophylactic forceps TOPNOTCH MD)
C. Elective forceps
D. Trial forceps
E. Structural forceps
610 A patient underwent THBSO omentectomy and Stage I Growth limited to the ovaries. RACHELLE FINAL EXAM -
lymph node dissection for an ovarian cancer. IA Growth limited to one ovary; no ascites MENDOZA, MD FEB 2013
Histopathological report showed the tumor in the present containing malignant cells. No tumor on the (TOP 9 - AUG
right ovary measured 10x8x8 cm ruptured with external surface; capsule intact. 2012 MED
extension to the fallopian tube and omentum. One IB Growth limited to both ovaries; no ascites BOARDS;
para aortic node showed malignant cells. Using the present containing malignant cells. No tumor on the TOPNOTCH MD)
FIGO staging, this patient can be categorized external surfaces; capsules intact.
under: IC Tumor either stage IA or IB but with tumor on
A. Stage II-C surface of one or both ovaries; or with capsule
B. Stage III-A ruptured; or with ascites present containing
C. Stage III-B malignant cells; or with positive peritoneal
D. Stage III-C washings.
II Growth involving one or both ovaries with pelvic
extension.
IIA Extension and/or metastases to the uterus
and/or tubes.
IIB Extension to other pelvic tissues.
IIC Tumor either stage IIA or IIB, but with tumor
on surface of one or both ovaries; or with
capsule(s) ruptured; or with ascites present
containing malignant cells; or with positive
peritoneal washings.
III Tumor involving one or both ovaries with
peritoneal implants outside the pelvis and/or
positive retroperitoneal or inguinal nodes.
Superficial liver metastasis equals stage III. Tumor
is limited to the true pelvis but with histologically
proven malignant extension to small bowel or
omentum.
IIIA Tumor grossly limited to the true pelvis with
negative nodes but with histologically confirmed
microscopic seeding of abdominal peritoneal
surfaces.
IIIB Tumor of one or both ovaries with
histologically confirmed implants of abdominal
peritoneal surfaces, none exceeding 2 cm in
diameter. Nodes are negative.
IIIC Abdominal implants greater than 2 cm in
diameter and/or positive retroperitoneal or
inguinal nodes.
IV Growth involving one or both ovaries with
distant metastases. If pleural effusion is present,
there must be positive cytology to allot a case to
stage IV.
IVA Parenchymal liver metastasis equals stage IV
611 In the above case, what is the chance that the Stage RACHELLE FINAL EXAM -
patient may still live for the next 5 years? IA 86.9%, IB 71.3%, IC 79.2%, IIA 66.6%, IIB 55.1, MENDOZA, MD FEB 2013
A. 11.1% IIC 57.0, IIIA 41.1, IIIB 24.9, IIIC 23.4, IV 11.1 (TOP 9 - AUG
B. 23.4% (Comprehensive Gynecology, 4th ed) 2012 MED
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
C. 36.7% BOARDS;
D. 41.1% TOPNOTCH MD)
E. 55.1%
612 The following statement is TRUE about Polycystic Polycystic Ovarian Syndrome (PCOS) is an RACHELLE FINAL EXAM -
Ovarian Syndrome, EXCEPT: endocrinologic disorder characterized by excessive MENDOZA, MD FEB 2013
A. This disorder begins perimenarcheally ovarian androgen production, abnormal (TOP 9 - AUG
B. Clinical manifestations include hirsutism, gonadotrophin secretion, and chronic anovulation 2012 MED
menstrual irregularity and obesity with morphologic changes in the ovary consisting BOARDS;
C. Ovaries contain multiple (>10) small (2- to 10- of multiple small subcapsular follicles, increased TOPNOTCH MD)
mm diameter) follicles in the periphery amounts of stromal tissue, and ovarian
D. Sonographic findings also include echogenicity enlargement. This disorder begins
of the stroma and ovarian enlargement perimenarcheally, and its clinical manifestations
E. None of the above include hirsutism, menstrual irregularity
(oligomenorrhea or amenorrhea), and obesity.
Findings upon sonographic visualization of the
ovaries include multiple (>10) small (2- to 10-mm
diameter) follicles in the periphery, increased
echogenicity of the stroma, and ovarian
enlargement. (Comprehensive Gynecology, 4th ed)
613 The major androgen produced by the ovaries is: The sources of androgen production in the human RACHELLE FINAL EXAM -
A. Testosterone female are the ovaries and the adrenal glands. The MENDOZA, MD FEB 2013
B. Dehydroepiandrosterone sulfate major androgen produced by the ovaries is (TOP 9 - AUG
C. Androstenedione testosterone and that of the adrenal glands is 2012 MED
D. Etiocholanolone dehydroepiandrosterone sulfate (DHEA-S). BOARDS;
E. The ovaries do not produce androgens (Comprehensive Gynecology, 4th ed) TOPNOTCH MD)
614 During active labor, the fetus was observed to have Early deceleration of the fetal heart rate consists of RACHELLE FINAL EXAM -
episodes of decreased fetal heart rate and return to a gradual decrease and return to baseline MENDOZA, MD FEB 2013
baseline in association with a contraction. The associated with a contraction. Freeman and co- (TOP 9 - AUG
degree of deceleration is generally proportional to authors (2003) defined early decelerations as those 2012 MED
the contraction strength and does not fall below generally seen in active labor between 4 and 7 cm BOARDS;
100 beats/min.Which of the following can be dilatation. In their definition, the degree of TOPNOTCH MD)
attributed to this phenomenon? deceleration is generally proportional to the
A. Fetal hypoxia contraction strength and rarely falls below 100 to
B. Utero-placental insufficiency 110 beats/min or 20 to 30 beats/min below
C. Umbilical cord occlusion baseline. Importantly, early decelerations are not
D. Head compression associated with fetal hypoxia, acidemia, or low
E. A and B Apgar scores. Ball and Parer (1992) concluded that
fetal head compression is a likely cause of early
deceleration. Head compression probably causes
vagal nerve activation as a result of dural
stimulation and that mediates the heart rate
deceleration (Paul and co-workers, 1964).
(William's obstetrics)
615 The following are associated with increased risk of According to William's obstetrics, placenta previa RACHELLE FINAL EXAM -
placenta previa, EXCEPT: may be assocaiated with 4 etiologies: advanced MENDOZA, MD FEB 2013
A. Advance maternal age maternal age, multiparity, prior CS and smoking. (TOP 9 - AUG
B. Previous caesarean section 2012 MED
C. Multiparity BOARDS;
D. Smoking TOPNOTCH MD)
E. Family history of placenta revia
616 A 26-year old G1P0 at 39 weeks AOG was noted to Types of amniotomy include: elective amniotomy, RACHELLE FINAL EXAM -
be 1 cm dilated but without regular uterine amniotomy induction and amniotomy MENDOZA, MD FEB 2013
contractions during her pre-natal check up. If her augmentation. Artificial rupture of the membranes (TOP 9 - AUG
obstetrician decides to admit her and plans to do can be used to induce labor, but it implies a 2012 MED
an early amniotomy, the type of amniotomy would commitment to delivery. The main disadvantage of BOARDS;
be a/an: amniotomy when used alone for labor induction is TOPNOTCH MD)
A. Elective amniotomy the unpredictable and occasionally long interval to
B. Amniotomy induction the onset of contractions. In a randomized trial,
C. Amniotomy augmentation Bakos and Backstrom (1987) found that
D. Therapeutic amniotomy amniotomy alone or combined with oxytocin was
E. Late amniotomy superior to oxytocin alone. Mercer and colleagues
(1995) randomized 209 women undergoing
oxytocin induction to amniotomy either at 1 to 2 cm
dilatation (early amniotomy) or at 5 cm (late
amniotomy). Early amniotomy was associated with
significantly shorter labor by approximately 4
hours. There was, however, an increased incidence
of chorioamnionitis and cord-compression patterns
with early amniotomy.
617 The most common malignancy gicing rise to a Malignant tumors rarely metastasize to the RACHELLE FINAL EXAM -
placnetal metastasis is: placenta. Of those that do, melanoma accounts for MENDOZA, MD FEB 2013
A. Gastric carcinoma nearly one third of reported cases, and leukemias (TOP 9 - AUG
B. Pilocytic astrocytoma and lymphomas comprise another third. 2012 MED
C. Rhabdomyosarcoma BOARDS;
D. Lung cancer TOPNOTCH MD)
E. Melanoma
618 A 3 year-old girl was brought to the ER because of Sarcoma Botryoides (Embryonal RACHELLE FINAL EXAM -
vaginal bleeding. On inspection of the external Rhabdomyosarcoma) is usually diagnosed in the MENDOZA, MD FEB 2013
genitalia, there was a mass protruding through the vagina of a young female. Rarely does it occur in a (TOP 9 - AUG
vaginal introitus. It measured 4x3 cm and young child over 8 years of age, although cases in 2012 MED
resembled a cluster of grapes forming multiple adolescents have been reported. The most common BOARDS;
polypoid masses. The most likely diagnosis is: symptom is abnormal vaginal bleeding, with an TOPNOTCH MD)
A. Sarcoma botyroides occasional mass at the introitus. The tumor grossly
B. Epidermoid carcinoma will resemble a cluster of grapes forming multiple
C. Vaginal adenosis polypoid masses.
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
D. Condyloma acuminata
E. Congenital vulvar malformation

619 The first index/indices of declining ovarian Inhibin is a glycoprotein produced by the granulosa RACHELLE FINAL EXAM -
function in perimenopausal women is/are: cells of developing follicles during the follicular MENDOZA, MD FEB 2013
A. Decrease in FSH phase of the cycle. The gonadal production of (TOP 9 - AUG
B. Decrease in LH inhibin is stimulated by FSH, and inhibin 2012 MED
C. Decrease estradiol suppresses pituitary FSH secretion as part of a BOARDS;
D. Decrease inhibin closed-loop feedback system. MacNaughton et al. TOPNOTCH MD)
E. A and C have shown that circulating follicular phase inhibin
levels are significantly lower among women aged
45 to 49 than among women younger than age 45
(Table 42-1) . The fall in inhibin levels may be due
to the decreased number of ovarian follicles or to
altered granulosa cell function that accompanies
increasing age. Because estradiol levels do not
undergo a similar significant decrease between
ages 45 and 49, it is possible that synthesis of these
two hormones are a result of separate functions of
the granulosa cells. As inhibin levels fall there is a
concomitant rise in FSH, which initially results in
greater secretion of estradiol from the follicle.
620 A 33 year-old G3P2 (2002) went to OPD due to Waiting for spontaneous labor is the treatment of RACHELLE FINAL EXAM -
spotting. Her LMP was 28 weeks ago and she choice for intra-uterine fetal death (IUFD). MENDOZA, MD FEB 2013
claims that she has not felt any fetal movement for Induction of labor may be done 72 hours without (TOP 9 - AUG
the past month. On examination, fundal height is spontaneous labor. 2012 MED
18 cm, no fetal heart tone detected. Ultrasound BOARDS;
was done, revealing no cardiac acitivity. TOPNOTCH MD)
Management of this patient would be:
A. Wait for spontaneous labor
B. Induction of labor
C. Dilatation & Curettage
D. Hysterotomy
E. Prostaglandin
621 In the clinical pelvimetry of a pateint in the third Interspinous diameter and Diagonal conjugate can VON ANDRE DIAGNOSTIC
trimester of pregnancy, which of the following can be measured clinically. MEDINA, MD EXAM - AUG
be measured clinically? (TOP 4 - FEB 2012
A. Transverse diameter of the inlet 2012 MED
B. Obstetric conjugate BOARDS;
C. Interspinous diameter TOPNOTCH MD)
D. Posterior sagittal diameter of the outlet
E. None of the above
622 The iron deficiency anemia of pregnancy is due to: VON ANDRE DIAGNOSTIC
A. Expected decreased absorption of iron from MEDINA, MD EXAM - AUG
the GI tract during pregnancy (TOP 4 - FEB 2012
B. Nausea and vomiting that causes dehydration 2012 MED
and electrolyte imbalance BOARDS;
C. Expansion of plasma volume without normal TOPNOTCH MD)
expansion of maternal hemoglobin mass
D. Decreased expansion of RBC mass because of
decreased erythropoietin activity during
pregnancy
E. Any of the above choices
623 Which of the folloqwing is true regarding maternal Highest rate is seen in age group 40-44. VON ANDRE DIAGNOSTIC
mortality in the Philippines? MEDINA, MD EXAM - AUG
A. Fifty (50%) percent of the women who died (TOP 4 - FEB 2012
had prenatal care 2012 MED
B. Hypertension is the leading cause of mortality BOARDS;
C. Pulmonary disease is the leading medical TOPNOTCH MD)
cause
D. Highest rate is seen in the 40-44 years old age
group
E. Cervical cancer remain as the second leading
cause of maternal mortality
624 At what age of gestation is scanning for congenital congenital scanning is usually done at 16-18weeks VON ANDRE DIAGNOSTIC
abnormalities best done? MEDINA, MD EXAM - AUG
A. 5-6 weeks (TOP 4 - FEB 2012
B. 10-14 weeks 2012 MED
C. 16-18 weeks BOARDS;
D. 24-28 weeks TOPNOTCH MD)
E. 30-32 weeks
625 The following are components of quadruple Quadruple screen- AFP, BHCG, Estriol and Inhibin VON ANDRE DIAGNOSTIC
marker screen, EXCEPT? MEDINA, MD EXAM - AUG
A. AFP (TOP 4 - FEB 2012
B. B-HCG 2012 MED
C. Estriol BOARDS;
D. Estradiol TOPNOTCH MD)
E. Inhibin
626 Th e following structures originate from ureteric glomerulus originates from metanephric VON ANDRE DIAGNOSTIC
bud/ metanephric duct , EXCEPT? mesenchyme. MEDINA, MD EXAM - AUG
A. Ureter (TOP 4 - FEB 2012
B. Renal pelvis 2012 MED
C. Calyces BOARDS;
D. Collecting system TOPNOTCH MD)
E. Renal glomerulus
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
627 In females, what is the remnant of mesonephric Gartners duct is a remnant of mesonephric duct VON ANDRE DIAGNOSTIC
duct/ wolffian duct ? MEDINA, MD EXAM - AUG
A. Gartner's Duct (TOP 4 - FEB 2012
B. Bartholin's Gland 2012 MED
C. Skene's gland BOARDS;
D. Uterus TOPNOTCH MD)
E. Nabothian cyst
628 The most sensitive test for the diagnosis of Laparoscopy is the gold standard in the diagnosis of VON ANDRE DIAGNOSTIC
abdominopelvic tuberculosis is? abdominopelvic tuberculosis MEDINA, MD EXAM - AUG
A. Tissue biopsy (TOP 4 - FEB 2012
B. Peritoneal fluid culture 2012 MED
C. ELISA BOARDS;
D. Laparoscopy TOPNOTCH MD)
E. Exploratory laparotomy
629 Forcep delivery is NOT recommended in which of VON ANDRE DIAGNOSTIC
the following conditions? MEDINA, MD EXAM - AUG
A. Class II-IV gravidocardiac (TOP 4 - FEB 2012
B. Vaginal delivery after Cesarian section 2012 MED
C. Presence of acute pulmonary edema BOARDS;
D. Presence of persistent late decelerations at TOPNOTCH MD)
station +4
E. None of the above
630 Of the following possible complications, which postpartum hemorrhage is a common complication VON ANDRE DIAGNOSTIC
should be anticipated in a multifetal pregnancy? following a multifetal pregnancy MEDINA, MD EXAM - AUG
A. Shoulder dystocia (TOP 4 - FEB 2012
B. Postmaturity 2012 MED
C. Multiple congenital abnormalities BOARDS;
D. Postpartum hemorrhage TOPNOTCH MD)
E. All of the above
631 Fetal flexion, rotation , extension and expulsion VON ANDRE DIAGNOSTIC
occur during which phase of labor? MEDINA, MD EXAM - AUG
A. Preparatory division (TOP 4 - FEB 2012
B. Acceleration phase 2012 MED
C. Phase of maximum slope BOARDS;
D. Deceleration phase TOPNOTCH MD)
E.Latent phase
632 A 25 year old at 32 weeks AOG is noted to have a CS is the only cure for eclampsia. VON ANDRE DIAGNOSTIC
BP of 160/100 mmHg with the presence of +2 MEDINA, MD EXAM - AUG
proteinuria. The platelet count and liver function (TOP 4 - FEB 2012
tests were abnormal. After few hours, patient went 2012 MED
into seizure. What is the best management plan in BOARDS;
this case? TOPNOTCH MD)
A. Induction of labor
B. Intelligent expectancy
C. Control the seizure then expectant
management
D. Cesarian section
E. Forcep delivery
633 A 26 year old came in to the emergency This is a case of ectopic pregnancy. PID is the most VON ANDRE DIAGNOSTIC
department due to vaginal bleeding and severe common predisposing factor. MEDINA, MD EXAM - AUG
abdominal pain. She was amenorrheic for about 2 (TOP 4 - FEB 2012
months. On physical examination, patient was pale 2012 MED
looking and hypotensive. Which of the following BOARDS;
events would be most likely predispose this patient TOPNOTCH MD)
to your diagnosis?
A. Pelvic inflammatory disease
B. Use of IUD
C. Previous tubal surgery
D. Exposure to diethylstilbestrol
E. None of the above
634 Amor is pregnant and visits your clinic for a G4P2 (1 1 1 3) VON ANDRE DIAGNOSTIC
regular pre-natal check up. She had one ectopic MEDINA, MD EXAM - AUG
pregnancy at 4 weeks. She has one baby born at 40 (TOP 4 - FEB 2012
weeks and one born at 32 weeks which is a set of 2012 MED
twins. What is her OB score? BOARDS;
A. G3P3 (1113) TOPNOTCH MD)
B. G4P2 (1113)
C. G3P3 (2113)
D. G4P2 (2113)
E. G4P2 (1213)
635 A primigravid consulted for amenorrhea of 12 This is a case of missed abortion VON ANDRE DIAGNOSTIC
weeks. Home pregnancy test was positive but you MEDINA, MD EXAM - AUG
were unable to appreciate fetal heart tones by (TOP 4 - FEB 2012
doppler. Transvaginal ultrasound showed a fetus 2012 MED
within an enlarged uterus without cardiac or BOARDS;
somatic activity. IE revealed a closed cervix. The TOPNOTCH MD)
most likely diagnosis is?
A. Blighted ovum
B. Missed abortion
C. Threatened abortion
D. Imminent abortion
E. Inevitable abortion
636 The structure that is cut during median episiotomy VON ANDRE DIAGNOSTIC
is the: MEDINA, MD EXAM - AUG
A. Ischiocavernosus (TOP 4 - FEB 2012
B. Bulbocavernosus 2012 MED
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
C. Internal anal sphincter BOARDS;
D. Rectal mucosa TOPNOTCH MD)
E. None of the above
637 When the fetus is in "military attitude", the VON ANDRE DIAGNOSTIC
presenting diameter is? MEDINA, MD EXAM - AUG
A. Suboccipitobregmatic (TOP 4 - FEB 2012
B. occipitomental 2012 MED
C. Occipitofrontal BOARDS;
D. Submentobregmatic TOPNOTCH MD)
E. None of the above
638 The most common clinical manifestation of molar VON ANDRE DIAGNOSTIC
pregnancy is: MEDINA, MD EXAM - AUG
A. Vagial bleeding (TOP 4 - FEB 2012
B. Uterine size smaller than the age of gestation 2012 MED
C. Uterine size larger than the expected AOG BOARDS;
D. Fetal heart tones absent at 20 weeks AOG TOPNOTCH MD)
E. None of the above
639 A 41 year old had a baby with Down syndrome 5 Chorionic villous sampling is usually done in the 1st VON ANDRE DIAGNOSTIC
years ago. She is now anxious to know the trimester. MEDINA, MD EXAM - AUG
chromosome status of her fetus in her current (TOP 4 - FEB 2012
pregnancy . The test that has the fastest lab 2012 MED
processing time for karyotyping is? BOARDS;
A. Amniocentesis TOPNOTCH MD)
B. Cordocentesis
C. Chorionic villous sampling
D. Doppler flow ultrasound
E. None of the above
640 Zavanelli, as a management of shoulder dystocia Zavanelli- cephalic placement into pelvis followed VON ANDRE DIAGNOSTIC
refers to: by CS MEDINA, MD EXAM - AUG
A. Cephalic placement into pelvis followed by (TOP 4 - FEB 2012
Cesarian section 2012 MED
B. Pressure is applied to the infants jaw and neck BOARDS;
in the direction of the mother's rectum with strong TOPNOTCH MD)
fundal pressure applied by the assistant as anterior
shoulder is freed
C. Cutting of the clavicle with scissors or other
sharp instruments
D. Surgical incision into the fibrocartilage of the
symphysis pubis
E. None of the above choices
641 Maja Rotzky, a 19 y/o primigravid consulted on at 12 weeks, FH is at the level of symphysis pubis. LITO JAY DIAGNOSTIC
your clinic for her first prenatal check-up. The At 16 weeks, FH is halfway between the symphysis MACARAIG, MD EXAM - AUG
fundic height was measured to be at the level of and umbilicus. At 20 weeks at the level of (TOP 8 - FEB 2013
umbilicus. Assuming that this is NOT a mutifetal umbilicus. At 32 weeks about the level of xiphoid 2013 MED
pregnancy and there is NO structural, or medical process. BOARDS;
abnormality, approximately how many weeks AOG TOPNOTCH MD)
is this pregnancy?
A. 12 weeks
B. 16 weeks
C. 18 weeks
D. 20 weeks
E. 24 weeks
642 Cathy Poe is a 31 year old female who is Endometriosis is the presence of endometrial tissue LITO JAY DIAGNOSTIC
complaining of cyclic pelvic pains since 8 months outside the uterus. Hence accumulation of blood to MACARAIG, MD EXAM - AUG
PTC. She thought this was just an ordinary case of solid organs during menstrual periods, causes (TOP 8 - FEB 2013
dysmenorrhea hence she self-medicated with cyclic pain. 2013 MED
NSAID's. However, 2 weeks PTC, patient BOARDS;
experienced defecating with blood. You requeste TOPNOTCH MD)
dultrasound which revealed hyperechoic sacs on
both ovaries which possibly blood-containing.
What is your diagnosis?
A. Teratoma
B. Theca Lutein Cysts
C. Endometriosis
D. Adenomyosis
E. Polycystic ovarian syndrome
643 Halley is a 23 year old promiscuous lady who came Fitz Hugh Curtis Syndrome is a rare complication of LITO JAY DIAGNOSTIC
in due to right upper abdominal pain. Further PID due to ascending infection from lower genital MACARAIG, MD EXAM - AUG
history revealed previous episodes of STD but did tract towrds uterus, oviduct and upto the hepatic (TOP 8 - FEB 2013
not comply with the complete treatment course. capsule. 2013 MED
Laparoscopy was done and showed periportal BOARDS;
hepatitis with characteristic violin string TOPNOTCH MD)
adhesions. What is your impression?
A. Fitz-Hugh Curtis Syndrome
B. Weil's Syndrome
C. Waterhouse Friderichsen syndrome
D. Sheehan's Syndrome
E. Asherman Syndrome
644 You are consulted by a 28 year multigravid who is Sheehan's syndrome is the postpartum pituitary LITO JAY DIAGNOSTIC
on her 2nd week post-partum because she was necrosis. During gestation, the pituitary gland MACARAIG, MD EXAM - AUG
unable to express milk for her child. Further increases it's size to almost 130%. If there is acute (TOP 8 - FEB 2013
history revealed profuse bleeding during her last blood loss, ischemic necrosis may occur hence 2013 MED
childbirth. With that kind of history, you are able to oxytocin is not produced, leading to lack of milk BOARDS;
diagnose the patient with? ejection, and amenorrhea. TOPNOTCH MD)
A. Fitz-Hugh Curtis Syndrome
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
B. Weil's Syndrome
C. Waterhouse Friderichsen syndrome
D. Sheehan's Syndrome
E. Asherman Syndrome

645 A 24 year-old primigravid with 9 weeks AOG this is a case of Complete abortion, hence watchful LITO JAY DIAGNOSTIC
consulted due to passing of meaty material. History observation is warranted to prevent severe MACARAIG, MD EXAM - AUG
started a day PTC, patient had crampy abdominal bleeding, sepsis and alike. D and C is not indicated, (TOP 8 - FEB 2013
pain (7-8/10 in pain scale) asscociated with just like Oxytocin, Tranex and antibiotics (as long 2013 MED
spotting. Few hours PTC, patient noted passing-out that this is NOT an instrumentally-induced) BOARDS;
of meaty material per vagina. Speculum exam TOPNOTCH MD)
showed closed cervix. To be sure, you requested
ultrasound and revealed empty uterine cavity.
What is your next step?
A. Dilatation and curettage
B. Give Tranexamic acid 500mg, 2 capsules 3x a
day for 3 days
C. Administer 10 units of Oxytocin via 30 minute
drip
D. Administer 1.2 grams of Co-amoxiclav IV every
12 hours for 3 days
E. Do watchful observation
646 The most common type of breech presentation is Frank breech is the most common type of breech LITO JAY DIAGNOSTIC
characterized by? and is characterized by lower extremities flexed at MACARAIG, MD EXAM - AUG
A. Lower extremities extended at the hips and the hips and extended at the knees (TOP 8 - FEB 2013
extended at the knees 2013 MED
B. Lower extremities flexed at the hips and flexed BOARDS;
at the knees TOPNOTCH MD)
C. Lower extremities extended at the hips and
flexed at the knees
D. Lower extremities flexed at the hips and
extended at the knees
E. None of the above
647 The most common symptom found in complete the question is asking for the MOST COMMON LITO JAY DIAGNOSTIC
mole is? SYMPTOM hence vaginal bleeding is the only and MACARAIG, MD EXAM - AUG
A. Vaginal bleeding definite answer (TOP 8 - FEB 2013
B. Abdominal pain 2013 MED
C. Uterine enlargement BOARDS;
D. Nausea and vomiting TOPNOTCH MD)
E. A and D
648 A 25 year-old female, with several previous The one being asked is the discriminatory level of LITO JAY DIAGNOSTIC
episodes of PID, came in due to severe right lower beta-hCG. Meaning, if beta-hCG is >1,500 units, a MACARAIG, MD EXAM - AUG
quadrant pain. No associated fever, diarrhea or gestational sac should be seen via ultrasound (TOP 8 - FEB 2013
vomiting noted. Further history revealed missed 2013 MED
menses for 2 months. Pregnancy test revealed BOARDS;
positive and you are entertaining ectopic TOPNOTCH MD)
pregnancy. If you are to perform ultrasound, you
should know that a gestational sac should be seen
once the level of hCG is?
A. > 1,500 units
B. > 1.50 units
C. > 2, 500 units
D. > 2.5 units
E. > 3,500 units
649 Which among the following statements is/are tru LITO JAY DIAGNOSTIC
regarding medical treatment of Ectopic pregnancy? MACARAIG, MD EXAM - AUG
A. < 6 weeks AOG (TOP 8 - FEB 2013
B. < 3.5 cms in length 2013 MED
C. Beta hCG of < 15,000 miU/mL BOARDS;
D. A and C only TOPNOTCH MD)
E. All of the above
650 What is the most common cause of DIC in pregnant premature separation of placenta causes activation LITO JAY DIAGNOSTIC
women? of coagulation cascade via exposure to tissue factor MACARAIG, MD EXAM - AUG
A. Placenta Previa which leads to a viscious cycle called DIC. (TOP 8 - FEB 2013
B. Vasa Previa 2013 MED
C. Placenta Acreta BOARDS;
D. Abruptio Placenta TOPNOTCH MD)
E. Placenta Increta
651 Vaginal delivery follows a series of fetal movement Descent occurs even before engagement and is LITO JAY DIAGNOSTIC
in relation to uterine contractions, which are called continuous until the fetus is delivered. MACARAIG, MD EXAM - AUG
Cardinal movements. Which cardinal movement is (TOP 8 - FEB 2013
the most important and is the first prerequisite for 2013 MED
vaginal birth? BOARDS;
A. Engagement TOPNOTCH MD)
B. Descent
C. Flexion
D. Extension
E. Internal rotation
652 Which of the following is/are criteria for using The judicial use of Oxytocin should start when the LITO JAY DIAGNOSTIC
Oxytocin? labor is already at the active phase (4cms cervical MACARAIG, MD EXAM - AUG
A. Cervix should atleast 4cms opened dilatation), no CPD and the child is on cephalic (TOP 8 - FEB 2013
B. CPD is ruled out presentation. 2013 MED
C. Cephalic presentation BOARDS;
D. B and C only TOPNOTCH MD)
E. All of the above
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
653 A 27 year-old nulligravid have undergone explore Dermoid cyst is the most common ovarian tumor in LITO JAY DIAGNOSTIC
laparotomy due to ovarian tumor. Grossly, the patients less than 30 years old. Since it is derived MACARAIG, MD EXAM - AUG
tumor contains teeth, hair and bone. What is your from all germ layers, it can differentiate into any (TOP 8 - FEB 2013
impression? other tissues like bones, teeth, or cartilage. 2013 MED
A. Dermoid cyst BOARDS;
B. Seminoma TOPNOTCH MD)
C. Teratoma
D. A and C only
E. All of the above
654 Which of the following is/are probable sign/s of Probable signs are changes related to placenta or LITO JAY DIAGNOSTIC
pregnancy? uterus MACARAIG, MD EXAM - AUG
A. Positive pregnancy test (TOP 8 - FEB 2013
B. Braxton-Hicks contractions 2013 MED
C. Goodell's sign BOARDS;
D. A and B only TOPNOTCH MD)
E. All of the above
655 Human Placental Lactogen is being pointed-out as HPL is at its peak between 24-28 weeks, and this is LITO JAY DIAGNOSTIC
the cause of gestational diabetes. Its peak levels the ideal time to screen for GDM MACARAIG, MD EXAM - AUG
can be detected on what age of gestation? (TOP 8 - FEB 2013
A. 20-22weeks 2013 MED
B. 22-26weeks BOARDS;
C. 24-28 weeks TOPNOTCH MD)
D. 28-32weeks
E. 30 weeks
656 The minimum criteria for diagnosing Pelvic These are the 3 minimun criteria for diagnosing LITO JAY DIAGNOSTIC
Inflammatory Disease includes PID. MACARAIG, MD EXAM - AUG
A. Cervical tenderness (TOP 8 - FEB 2013
B. Uterine tenderness 2013 MED
C. Adnexal tenderness BOARDS;
D. A and C only TOPNOTCH MD)
E. All of the above
657 Call Exner bodies are the pathognomonic finding LITO JAY DIAGNOSTIC
in? MACARAIG, MD EXAM - AUG
A. Sertoli-Leydig cell tumor (TOP 8 - FEB 2013
B. Granulosa-theca tumor 2013 MED
C. Endodermal Sinus tumor BOARDS;
D. Struma Ovarii TOPNOTCH MD)
E. Choriocarcinoma
658 This is an abnormal uterine bleeding characterized Hypomenorrhea refers to scanty menstruation. LITO JAY DIAGNOSTIC
by scanty menstruation. Oligomenorrhea refers to prolonged intervals of MACARAIG, MD EXAM - AUG
A. Menorrhagia menstruation. (TOP 8 - FEB 2013
B. Hypomenorrhea 2013 MED
C. Oligomenorrhea BOARDS;
D. Polymenorrhea TOPNOTCH MD)
E. Metrorrhagia
659 The most common cause of secondary amenorrhea SPERM is the most common cause of secondary LITO JAY DIAGNOSTIC
is? amenorrhea ! ! ! MACARAIG, MD EXAM - AUG
A. Ovarian tumor (TOP 8 - FEB 2013
B. PCOS 2013 MED
C. Imperforated hymen BOARDS;
D. A or B TOPNOTCH MD)
E. None of the above
660 A 28 year-old primigravid consulted at ER due to Internal exam is a NO NO!! The patient is possibly LITO JAY DIAGNOSTIC
painless vaginal bleeding. She is currently on her having placenta previa and IE can only be done on a MACARAIG, MD EXAM - AUG
32nd week of gestation. The least you would do is? double set-up. You may induce bleeding that is very (TOP 8 - FEB 2013
A. Perform an internal examination hard to control. 2013 MED
B. Do an emergency ultrasound BOARDS;
C. Check the Fetal heart tone TOPNOTCH MD)
D. Non-stress test
E. No excemption. You should do all of the above
661 True of physiologic discharge of puberty? Physiologic discharge is grayish - white in color. HAZEL KAREN MIDTERM 2 -
A. Occurs 6-12 months before menarche RAZ, MD (TOP 6 - AUG 2013
B. Due to desquamation of vaginal epithelium FEB 2013 MED
C. Greenish white in color BOARDS;
D. A and b TOPNOTCH MD)
E. All of the above
662 True of nabothian cyst, except? A nabothian cyst (or nabothian follicle) is a mucus- HAZEL KAREN MIDTERM 2 -
A. Most common cervical cyst filled cyst on the surface of the cervix. They are RAZ, MD (TOP 6 - AUG 2013
B. Most common in postmenopausal women most often caused when stratified squamous FEB 2013 MED
C. Due to intermittent blockage of endicervical epithelium of the ectocervix (toward the vagina) BOARDS;
gland grows over the simple columnar epithelium of the TOPNOTCH MD)
D. Treatment is supportive endocervix (toward the uterus). This tissue growth
E. All of the above can block the cervical crypts (subdermal pockets
usually 2-10 mm in diameter), trapping cervical
mucus inside the crypts. The transformation of
tissue types is called metaplasia. Occurs most
comonly in menstruating women.
663 A 35 year old obese female presented with An endometrial polyp or uterine polyp is a mass in HAZEL KAREN MIDTERM 2 -
bleeding in between periods, what would be the the inner lining of the uterus.They may have a large RAZ, MD (TOP 6 - AUG 2013
initial diagnostic modality of choice? flat base (sessile) or be attached to the uterus by an FEB 2013 MED
A. Ultrasound elongated pedicle (pedunculated). Can be detected BOARDS;
B. Biopsy by vaginal ultrasound (sonohysterography), TOPNOTCH MD)
C. Laparotomy hysteroscopy and dilation and curettage.
D. Progesterone withdrawal test
E. None
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
664 Triad of polycystic ovary syndrome includes which The principal features are anovulation, resulting in HAZEL KAREN MIDTERM 2 -
of the following? irregular menstruation, amenorrhea, ovulation- RAZ, MD (TOP 6 - AUG 2013
A. Hirsutism related infertility, and polycystic ovaries; excessive FEB 2013 MED
B. Amenorrhea amounts or effects of androgenic hormones, BOARDS;
C. Obesity resulting in acne and hirsutism; and insulin TOPNOTCH MD)
D. Abdominal Pain resistance, often associated with obesity, Type 2
E. A, b and c diabetes, and high cholesterol levels.
665 Normal semenalysis values? Concentration >20M/mL HAZEL KAREN MIDTERM 2 -
A. Concentration >20M/mL Volume 2 - 5 mL RAZ, MD (TOP 6 - AUG 2013
B. pH 8 - 9 pH 7.2 - 7.8 mL FEB 2013 MED
C. Motility>30% motility >50% BOARDS;
D. Normal forms>50% Normal forms > 30% TOPNOTCH MD)
E. A and b only
666 Grade of pelvic organ prolapse wherein the Grade 1 - descend halfway to hymen HAZEL KAREN MIDTERM 2 -
prolapsed organ is halfway past the hymenal ring? Grade 2 - level of hymen RAZ, MD (TOP 6 - AUG 2013
A. 1 Grade 3 - halfway past hymenal ring FEB 2013 MED
B. 2 Grade 4 - Prolapsed organ completely outside BOARDS;
C. 3 vagina TOPNOTCH MD)
D. 4
E. 5
667 The Paramesonephric duct if the female genital In males, the paramesonephric or mullerian duct HAZEL KAREN MIDTERM 2 -
tract corresponds to which organ in the males? regress to form the appendix of testes. RAZ, MD (TOP 6 - AUG 2013
A. Prostate gland FEB 2013 MED
B. Testicular appendix BOARDS;
C. Prostatic utricle TOPNOTCH MD)
D. Bulbourethral gland
E. Urinary bladder
668 Derivatives of the Urogenital Sinus in females The phallic part of the definitive SUG enlarges to HAZEL KAREN MIDTERM 2 -
except? become the vaginal vestibule that is caudally closed RAZ, MD (TOP 6 - AUG 2013
A. Lower 3/4 vagina off externally by the urogenital membrane. It then FEB 2013 MED
B. Vestibule tears in the course of the 7th week BOARDS;
C. Bladder TOPNOTCH MD)
D. Urethra
E. Ureter
669 Strongest ligament supporting the uterus? It attaches the cervix to the lateral pelvic wall by its HAZEL KAREN MIDTERM 2 -
A. Mesovarium attachment to the Obturator fascia of the Obturator RAZ, MD (TOP 6 - AUG 2013
B. Cardinal ligament of Mackenrodt internus muscle, and is continuous externally with FEB 2013 MED
C. Utersacral ligament the fibrous tissue that surrounds the pelvic blood BOARDS;
D. Suspensory ligament of the Ovary vessels. It thus provides support to the uterus TOPNOTCH MD)
E. Broad ligament
670 True of pelvic conjugates? OC - measured by substracting 1.5 to 2 cms from HAZEL KAREN MIDTERM 2 -
A. Obstetrical conjugate is the one which can be the diagonal conjugate which is the one that can be RAZ, MD (TOP 6 - AUG 2013
directly measured clinically measured clinically. True anatomic conjugate is the FEB 2013 MED
B. True anatomic conjugate is the shortest distance between between the promontory and the BOARDS;
distance between the midpoint of the promontory UPPER border of the inner surface of syphysis. TOPNOTCH MD)
and inner surface of the symphysis
C. Diagonal conjugate cannot be measured
clinically
D. The obstetrical conjugare is adequate if
distance > 10 cms.
E. all of the above
671 The fetal heart tones can be heard by Doppler by 6 - 7 weeks by Transvaginal UTZ HAZEL KAREN MIDTERM 2 -
how many weeks AOG? 10 weeks by UTZ RAZ, MD (TOP 6 - AUG 2013
A. 6 - 7 19 weeks by Stethoscope FEB 2013 MED
B. 10 BOARDS;
C. 12 TOPNOTCH MD)
D. 19
E. 20
672 This is the earliest histological evidence of At the time of ovulation the endometrium slows in HAZEL KAREN MIDTERM 2 -
progesterone action in the endometrial lining. its growth, and it ceases mitotic activity within days RAZ, MD (TOP 6 - AUG 2013
A. Glandular mitoses after ovulation, at which time the corpus luteum is FEB 2013 MED
B. Stromal edema producing progesterone in addition to estrogen. BOARDS;
C. Basal vacuolization The postovulatory endometrium is initially marked TOPNOTCH MD)
D. Secretion by secretory vacuoles beneath the nuclei in the
E. Pseudostratification of nuclei glandular epithelium . This secretory activity is
most prominent during the third week of the
menstrual cycle, when the basal vacuoles
progressively push past the nuclei.
673 For pregnancy to occur, implantation of what Blastocyst implants at around 7 days post - HAZEL KAREN MIDTERM 2 -
structure must occur on the 8th day of conception within the superior wall of the uterus. RAZ, MD (TOP 6 - AUG 2013
fertilization? FEB 2013 MED
A. zygote BOARDS;
B. blastomere TOPNOTCH MD)
C. morula
D. blastocyst
E. Fetus
674 Goodell sign? Goodell's sign is an indication of pregnancy. It is a HAZEL KAREN MIDTERM 2 -
A. Softening and compressibility of the isthmus significant softening of the vaginal portion of the RAZ, MD (TOP 6 - AUG 2013
occuring on the 6th - 8th week AOG cervix from increased vascularization. This FEB 2013 MED
B. Bluish/purplish discoloration of the vagina at 6 vascularization is a result of hypertrophy and BOARDS;
weeks AOG engorgement of the vessels below the growing TOPNOTCH MD)
C. Mask of pregnancy uterus.
D. Softening of the cervix
E. Ferning pattern
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
675 Definitive evidence of pregnancy, EXCEPT? Pregnancy test is a probable evidence of pergnancy HAZEL KAREN MIDTERM 2 -
A. Fetal heart action identification RAZ, MD (TOP 6 - AUG 2013
B. Fetal movement perception by examiner FEB 2013 MED
C. Recognition of embryo or fetus by UTZ BOARDS;
D. Positive pregnancy test TOPNOTCH MD)
E. FHT by doppler at 10 weeks AOG
676 Definition of a reactive NST: Reactive NST - presence of two or more fetal heart HAZEL KAREN MIDTERM 2 -
A. 2 or more accelerations rate accelerations within a 20-minute period, with RAZ, MD (TOP 6 - AUG 2013
B. Peak at 15 bpm above baseline or without fetal movement discernible by the FEB 2013 MED
C. Each acceleration lasts more than 30 seconds woman. Accelerations are defined as 15 bpm above BOARDS;
D. A and b baselines for at least 15 seconds if beyond 32 weeks TOPNOTCH MD)
E. All of the above gestation, or 10 bpm for at least 10 seconds if at or
below 32 weeks.
677 Biophysical profile of a pregnant patient was done iHowever, this would be dependent on the AOG. HAZEL KAREN MIDTERM 2 -
which revealed BPS of 8 with decreased AF, According to our lecture, if AOG <37 weeks, repeat RAZ, MD (TOP 6 - AUG 2013
AOG<37 weeks, what is the management of choice? test per protocol. If AOG>37 weeks, deliver. FEB 2013 MED
A. Repeat test per protocol BOARDS;
B. Administer steroids TOPNOTCH MD)
C. Deliver
D. No fetal indication for intervention
E. None
678 Type of deceleration wherein a drop of heart rate Late deceleration may signal uteroplacental HAZEL KAREN MIDTERM 2 -
is seen to start at the peak of contraction but would insufficiency. RAZ, MD (TOP 6 - AUG 2013
return to baseline HR after the contraction ? FEB 2013 MED
A. Early deceleration BOARDS;
B. Head compression TOPNOTCH MD)
C. Late deceleration
D. Variable deceleration
E. Cord compression
679 An 18 year old female came to the ER presenting This is a case of incomplete abortion wherein there HAZEL KAREN MIDTERM 2 -
with vaginal bleeding. She stated to observe is already passage of parts of the fetus. The cervical RAZ, MD (TOP 6 - AUG 2013
passage of meaty material form the vagina. What os is open, bag of waters ruptured. FEB 2013 MED
would be the management of choice for this BOARDS;
patient? TOPNOTCH MD)
A. tocolysis
B. Completion curettage
C. bed rest
D. IV antibiotics
E. prostaglandins
680 type of version used for delivery of the second Podalic version is an obstetric procedure wherein HAZEL KAREN MIDTERM 2 -
twin? the fetus is turned within the womb such that one RAZ, MD (TOP 6 - AUG 2013
A. Internal podalic version or both feet present through FEB 2013 MED
B. External cephalic version the cervix during childbirth. It is used most often in BOARDS;
C. Internal cephalic version cases where the fetus lies transversely or in TOPNOTCH MD)
D. External podalic version another abnormal position in the womb.
E. None
681 A 25 yo, G3P4 comes to your office for a routine Answer: B. Molar pregnancy (pp. 19, High-Yield OB- MICHELLE JAY MIDTERM 1 -
prenatal check-up, complaining of vaginal bleeding. Gyne, 2nd edition) FRANCISCO, MD AUG 2013
Patient is 16 weeks AOG based on LMP. Upon PE, Notes: Molar pregnancy is the only time (TOP 9 - FEB
her uterus is at the level of the umbilicus and no preeclampsia is diagnosed prior to 20 weeks. 2013 MED
FHTs can be heard. BP is 150/90 mmHg with no * note that the uterine size is larger than the BOARDS;
prior history of hypertension. Urinalysis showed gestational age. TOPNOTCH MD)
2+ proteinuria on dipstick. Which of the following *SIMILAR TO PREVIOUS BOARD EXAM
condition should you rule out first? CONCEPT/PRINCIPLE
A. IUFD
B. Molar pregnancy
C. Preeclampsia
D. Gestational hypertension
682 What is the normal position of the uterus? Answer: A. Anteverted and anteflexed (must MICHELLE JAY MIDTERM 1 -
A. Anteverted and anteflexed know) FRANCISCO, MD AUG 2013
B. Anteverted and retroflexed (TOP 9 - FEB
C. Retroverted and anteflexed 2013 MED
D. Retroverted and retroflexed BOARDS;
TOPNOTCH MD)
683 What provides the major support of the uterus and Answer: D. Mackenrodt ligament (pp. 4, OB-Gyne, MICHELLE JAY MIDTERM 1 -
the cervix? Topnotch handouts) FRANCISCO, MD AUG 2013
A. Round ligament Notes: Cardinal ligament synonyms – transverse (TOP 9 - FEB
B. Uterosacral ligament cervical ligament or Mackenrodt ligament 2013 MED
C. Transverse sacral ligament *There is no such thing as transverse sacral BOARDS;
D. Mackenrodt ligament ligament. TOPNOTCH MD)
684 Proper recording and evaluation of the periodic Answer: D. Uteroplacental insufficiency (pp. 21, MICHELLE JAY MIDTERM 1 -
changes of the fetal heart rate (FHR) are needed OB-Gyne, Topnotch Handouts) FRANCISCO, MD AUG 2013
for proper intrapartum assessment. What is the * Kinds of deceleration were asked 4-5x during the (TOP 9 - FEB
probable etiology if there is gradual decrease in the Feb 2013 Boards. 2013 MED
FHR below the baseline with onset to nadir of at BOARDS;
least >30 secs? TOPNOTCH MD)
A. Normal
B. Head compression
C. Umbilical cord compression
D. Uteroplacental insufficiency
685 Which sequence of cardinal movements of labor Answer : B. Descent, Internal rotation, Flexion, MICHELLE JAY MIDTERM 1 -
best applies to a fetus delivered via face Restitution (pp. 27, OB-Gyne, Topnotch Handouts) FRANCISCO, MD AUG 2013
presentation? (TOP 9 - FEB
A. Descent , Engagement, Internal Rotation, Lateral 2013 MED
Flexion BOARDS;
B. Descent, Internal rotation, Flexion, Restitution TOPNOTCH MD)
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
C. Engagement, Descent, Flexion, Internal Rotation
D. Engagement, Descent, Extension, External
Rotation
686 How many weeks post-partum does the uterus Answer: D. 4 weeks (pp.32, OB-Gyne, Topnotch MICHELLE JAY MIDTERM 1 -
regresses or involutes to its non-pregnant size? Handouts) FRANCISCO, MD AUG 2013
A. 2-3 days SIMILAR TO PREVIOUS BOARD EXAM (TOP 9 - FEB
B. 2 weeks CONCEPT/PRINCIPLE 2013 MED
C. 3 weeks BOARDS;
D. 4 weeks TOPNOTCH MD)
687 Benign GTD can be classified as complete and Answer: Incomplete means one haploid egg is MICHELLE JAY MIDTERM 1 -
incomplete mole. An incomplete mole has 3 sets of fertilized by 2 haploid eggs, so the outcome is FRANCISCO, MD AUG 2013
chromosomes due to which of the following diploid (TOP 9 - FEB
reasons? 2013 MED
A. A haploid egg is fertilized by 2 normal sperms BOARDS;
B. A haploid egg is fertilized by a diploid sperm TOPNOTCH MD)
C. A diploid egg is fertilized by a haploid sperm
D. All of these
688 What is the most frequent site of eccyesis? Answer: A. Ampulla (pp.35, OB-Gyne, Topnotch MICHELLE JAY MIDTERM 1 -
A. Ampulla Handouts) FRANCISCO, MD AUG 2013
B. Isthmus Notes: Eccyesis is another term for ectopic (TOP 9 - FEB
C. Interstitial pregnancy. 2013 MED
D. Supero-posterior part of uterus BOARDS;
TOPNOTCH MD)
689 A 26 yo, G1P1 (1001) complains of amenorrhea. Answer: C. Sheehan’s syndrome MICHELLE JAY MIDTERM 1 -
She had hypotensive episodes during her delivery Notes: Sheehan’s syndrome – destruction f pituitary FRANCISCO, MD AUG 2013
7 months ago and was transfused 10 units of fresh gland as a result of severe bleeding. (TOP 9 - FEB
whole blood. She was not able to breastfeed 2013 MED
because her breasts started to sag. She also lost BOARDS;
weight, became anorexic and weak. What explains TOPNOTCH MD)
the amenorrhea in this patient?
A. Simmond’s syndrome
B. Lactational amenorrhea
C. Sheehan’s syndrome
D. Anorexia nervosa
690 A 4 yo girl was brought to the clinic for slight Answer: B. A benign self-limiting condition that MICHELLE JAY MIDTERM 1 -
enlargement of the left breast with no other does not require treatment FRANCISCO, MD AUG 2013
associated signs and symptoms since two years (TOP 9 - FEB
ago. You will tell the parents that premature 2013 MED
thelarche is: BOARDS;
A. A condition that needs surgical removal of the TOPNOTCH MD)
ovaries
B. A benign self-limiting condition that does not
require treatment
C. A serious condition leading to central precocious
puberty
D. A condition that requires treatment with
hypothalamic suppressive therapy
691 A 40 yr-old G4P3 woman comes to the E.R. Answer: E MICHELLE JAY MIDTERM 1 -
complaining of vaginal bleeding, pelvic pain, flank Differentials include PID, miscarriage, DUB, cervical FRANCISCO, MD AUG 2013
pain, foul-smelling discharge and disorientation. lesions (including cervical CA), UTI leading to (TOP 9 - FEB
Her past medical history is significant for 3 NSVDs pyelonephritis. CBC & complete metabolic panel are 2013 MED
and 1 miscarriage. In addition, she did have a impt.because patient already has disorientation. BOARDS;
history of abnormal Papsmears approx.3 years TOPNOTCH MD)
earlier. What initial lab work-up must be done?
A. Complete metabolic panel
B. Complete blood count
C. B-BHCG levels
D. Urinalysis
E. All of the above
692 Potential sites for ureteral injury during abdominal Answer: A MICHELLE JAY MIDTERM 1 -
hysterectomy with bilateral salpigo-oophorectomy In general, ureters do not travel near the round FRANCISCO, MD AUG 2013
include all of the following except: ligament, in a pelvis with normal anatomy. (TOP 9 - FEB
A. Transaction of the round ligament 2013 MED
B. Transaction of uterine arteries BOARDS;
C. Transaction of cardinal ligaments TOPNOTCH MD)
D. Transition of infundibulopelivc ligaments
E. None
693 A 60 yr-old womans visits your clinic with Answer: B MICHELLE JAY MIDTERM 1 -
complaints of pelvic pressure and abdominal Histology suggests the CA is confined to the ovary FRANCISCO, MD AUG 2013
fullness. Her LMP was 3 yrs ago. BPE and IVP are but the 5-yr survival rate is only 80%. (TOP 9 - FEB
normal. Staging explore lap is performed. You fin 2013 MED
stage 1a ovarian CA. What is the best intervention BOARDS;
in this case? TOPNOTCH MD)
A. Start patient on chemotherapy immediately
B. Perform TAH-BSO only
C. Perform TAH-BSO and infracolic omentectomy
D. Cytoreductive debulking will suffice
694 A 19 yr-old primigravida at 32 weeks’ gestation Answer: E MICHELLE JAY MIDTERM 1 -
comes to the office for a routine prenatal visit. Her Antidote for magnesium toxicity is IV calcium FRANCISCO, MD AUG 2013
BP is 150/95 mmHg. Her previous BPs have been gluconate. (TOP 9 - FEB
120/7- mmHg range. 2 hours later: While receiving 2013 MED
IV MgSO4 therapy, her RR have decreased from 20- BOARDS;
5 rpm. Findings are consistent with TOPNOTCH MD)
A. Gestational HTN
B. Mild preeclampsia
C. Severe preeclampsia
Ite QUESTION EXPLANATION AUTHOR TOPNOTCH
m # EXAM
D. Eclampsia
E. Magnesium toxicity

695 A primigravida at 16 weeks by LMP has a fundal Answer: A MICHELLE JAY MIDTERM 1 -
height at umbilicus. She has abnormality elevated The combination of fundus larger than dates and FRANCISCO, MD AUG 2013
levels of MS-AFP and B-hCG. You: abnormally elevated levels of MS-AFP and B-hCG (TOP 9 - FEB
A. schedule a sonogram to rule out multiple suggests multiple gestation. 2013 MED
gestation BOARDS;
B. are confident it’s Down’s syndrome TOPNOTCH MD)
C. diagnose patient as having molar pregnancy
D. admit patient and watch out for variable
decelerations
696 A 43 yr-old woman comes to the office complaining Answer: C MICHELLE JAY MIDTERM 1 -
of involuntary urine loss. Loss of urine occurs Overflow incontinence occurs uniquely when FRANCISCO, MD AUG 2013
continuously day and night along with pelvic intravesical pressure from an overdistended (TOP 9 - FEB
pressure. Residual volume is 450 ml. hypotonic bladder exceeds urethral pressure. 2013 MED
a. Genuine incontinence BOARDS;
b. Bypass incontinence TOPNOTCH MD)
c. Overflow incontinence
d. Motor urge incontinence
697 How many weeks after abortion does ovulation MICHELLE JAY MIDTERM 1 -
usually occur? FRANCISCO, MD AUG 2013
A. 2 to 3 weeks (TOP 9 - FEB
B. 4 to 5 2013 MED
C. 5 to 6 BOARDS;
D. 6 to 7 TOPNOTCH MD)
698 Duration of pregnancy is most correctly measured MICHELLE JAY MIDTERM 1 -
clinically by which of the following units? FRANCISCO, MD AUG 2013
A. Number of weeks, rounded to the nearest whole (TOP 9 - FEB
week since the first day of LMP 2013 MED
B. Completed weeks since first day of LMP BOARDS;
C. Completed weeks since estimated date of TOPNOTCH MD)
conception
D. Numbers of weeks rounded to the nearest whole
week since the estimated date of conception
699 In which presentation is the fetal head partially MICHELLE JAY MIDTERM 1 -
flexed and a large anterior fontanel presenting? FRANCISCO, MD AUG 2013
A. Vertex (TOP 9 - FEB
B. Face 2013 MED
C. Brow BOARDS;
D. Sinciput TOPNOTCH MD)
700 Which of the following is not an indication of Answer: C. Creatinine > 1.2 mg/dl. MICHELLE JAY MIDTERM 1 -
severe pregnancy-induced hypertension? FRANCISCO, MD AUG 2013
A. Upper abdominal pain (TOP 9 - FEB
B. Oliguria 2013 MED
C. Creatinine 0.6 mg/dl BOARDS;
D. Fetal growth restriction TOPNOTCH MD)