Professional Documents
Culture Documents
1. Among the following ligaments, the one that gives major support to the uterus is the:
a. broad ligament
b. cardinal ligament
c. infundibulopelvic ligament
d. round ligament
2. A 16 y.o. nulligravid was brought to the ER due to a straddle injury. On inspection, the
right vulva was converted to a 5 x 6 cm bluish tender mass. The most probable vessel that
is involved in this is the:
a. cervicovaginal branch of the uterine artery
b. vestibular artery
c. pudendal artery
d. inferior vesical artery
3. One of the major blood supplies of the pelvic organs is derived from:
a. The uterine arteries, which branch directly from the hypogastric arteries
b. the ovarian arteries, which branch directly from the internal iliac arteries
c. the external iliac arteries, which branch directly from the common iliac arteries
d. the cervico-vaginal branches of the uterine arteries
4. A patient with myoma uteri presents with pyelonephritis resulting from ureteral obstruction.
The most likely location of the myoma is
a. subserous
b. intramural
c. intraligamentary
d. submucous
6. A patient who regularly has a 34-day ovulatory cycle asks for opinion as to when she is
most likely to conceive. Her ovulation most probably occurs on day:
a. 16
b. 18
c. 20
d. 22
7. Rationale for giving high dose estrogen to stop bleeding in treating patients with severe
menorrhagia secondary to anovulation:
a. increases platelet aggregation
b. increased spiral artery recoil
c. promotes synthesis of prostaglandin
d. promotes rapid endometrial growth
8. Which of the following is part of the ovarian phase of the menstrual cycle?
a. menstrual phase
b. secretory phase
c. luteal phase
d. proliferative phase
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
10. This refers to the violaceous discoloration of the vagina because of increased vascularity
starting on the 6th week of pregnancy:
a. Hegar’s sign
b. Goodell’s sign
c. Chadwick’s sign
d. Spalding’s sign
11. Why is cardiac output in late pregnancy higher in the lateral recumbent rather than in the
supine position?
a. the gravid uterus impedes cardiac venous return in the supine position
b. the uterine vessels become distended in the supine position
c. hormonal effects are greater in the lateral recumbent position
d. hormonal effects are greater in the lateral recumbent position
12. For which reason is the pregnant woman with asthma more likely to develop hypoxia?
a. increased residual volume
b. decreased functional residual capacity
c. decreased tidal volume
d. increased inspiratory capacity
15. The nausea and vomiting commonly experienced by many women during the first
trimester of pregnancy is an adaptation to the increased level of:
a. estrogen
b. progesterone
c. luteinizing hormone
d. chorionic gonadotropin
17. The minimum daily requirement for ferrous (iron) to meet increased iron requirements
during pregnancy:
a. 25 mg
b. 26 mg
c. 27 mg
d. 28 mg
18. A healthy pregnant woman asks you for clearance to travel by plane. You tell her that:
a. air travel can be harmful to pregnancy
b. she can travel anytime
c. she can safely travel up to 36 weeks AOG
d. she can travel after the 1st trimester
19. The fetal heart tones can be best heard in this area if the following were the Leopold’s
findings:
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
20. Ms. X, a fashion model, is very figure-conscious. She inquires about weight gain during
pregnancy and how soon she can get back into shape postpartum. What information will
you tell her?
a. the average weight gain during pregnancy is 14 kg, and is easily shed off during
the puerpuerium
b. recommended weight gain during pregnancy depends on pre-pregnancy weight
c. weight gain should be about 2.7 kg/month, and should commence as early as the
first trimester
d. regardless of the route of delivery, she can start exercising 4 weeks postpartum
21. A 25 y.o. primigravid, 9 weeks AOG, sought consult with you for the first time for prenatal
check up. Which among the labs will you request for?
a. 100 g OGTT
b. TORCH titers
c. Complete blood count
d. complete Hepatitis B profile
23. Hepatitis B virus screening of pregnant women prior to delivery will identify new infants
who:
a. have passive immunity to the hepatitis B virus
b. need hepatitis B virus vaccination
c. need hepatitis B immunoglobulin injection
d. are carriers of hepatitis B virus
24. In a mother positive for Hepatitis B antigen who plans to breastfeed her baby, you tell her
that:
a. breastfeeding is contraindicated. Just give milk formula
b. breastfeeding is not contraindicated
c. breastfeeding is allowed once baby has been immunized
d. breastfeeding may be done as long as mother is not highly infective
26. Smoking during pregnancy has been linked with the following except:
a. placental abruption
b. placenta previa
c. fetal death
d. fetal macrosomia
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
27. Mrs. X is unsure of her last normal menstrual period since she has irregular menstrual
cycle. On abdominal examination, you noted that the fundus is palpable at the level of the
umbilicus. What is your estimated age of gestation?
a. 16 weeks
b. 18 weeks
c. 20 weeks
d. 24 weeks
30. Who among the following women has an abnormal pattern of labor?
a. 32/G3P2 (2002) who started her labor 10 hours ago, her cervix is 2 cm dilated, 50
% effaced
b. 25/G1P0 who entered the active phase of labor at 4 cm dilatation 6 hours ago, her
cervix is 7 cm dilated
c. 28/G4P3 (3003) delivered 20 minutes after full cervical dilatation
d. 34/G5P4 (4004) with rate of cervical dilatation of 2 cm/h
31. A 20 y.o. primigravid came in labor with age of gestation 38 weeks. Internal exam
showed the cervix to be 7 cm dilated, BOW ruptured, station -1. After an hour, the cervix
became fully dilated with the fetal head still at station -1. At this point, your impression is:
a. dysfunctional labor, failure of descent
b. dysfunctional labor, arrest of descent
c. prolonged deceleration phase
d. protracted active phase
32. In a multigravid, the minimum rate of cervical dilatation in the active phase of labor is:
a. 0.5 cm/h
b. 1.2 cm/h
c. 1.5 cm/h
d. 2.0 cm/h
34. Which of the following is the correct sequence of the cardinal movements of labor?
a. engagement, flexion, extension, internal rotation, external rotation, descent,
expulsion
b. flexion, internal rotation, engagement, extension, external rotation, descent, flexion
c. descent, engagement, internal rotation, flexion, external rotation, extension,
expulsion
d. engagement, descent, flexion, internal rotation, extension, external rotation,
expulsion
35. The young primigravid patient at full cervical dilatation is instructed to bear down several
times before delivery of the fetus. Edema was noted over the most dependent portion of
the fetal head. The mother is advised that this is:
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
a. cephalic prominence
b. cephalhematoma
c. caput succedaneum
d. molding
37. You are tasked to deliver a mother whom you have been monitoring since admission.
After spontaneous delivery of the baby and clamping/cutting of the cord, you note sudden
gush of blood. The next best step would be:
a. give oxytocin drip to decrease blood loss
b. wait for other signs of placental separation
c. start pulling on the cord to assist placental delivery
d. do manual extraction of the placenta
38. The placenta should be delivered within what period of time following delivery?
a. 1-2 minutes
b. 3-10 minutes
c. 12 – 15 minutes
d. 15 – 20 minutes
39. A 28 y.o. G3P2 (2002) was brought to the Delivery Room. Internal examination showed a
fully dilated cervix with the head at station +2. On auscultation, the fetal heart tone was
noted to be 100 beats per minute associated with uterine contractions but with recovery.
The most probable cause of deceleration is:
a. fetal head compression
b. uteroplacental insufficiency
c. umbilical cord compression
d. maternal exhaustion
40. The following are important in determining a patient’s cervical ripeness except:
a. cervical dilatation
b. station of presenting part
c. condition of bag of waters
d. position of the cervix
41. The latent phase of labor of a 19 y.o. primigravid already exceeded 20 hours. The
preferred treatment for this case is:
a. therapeutic rest
b. oxytocin drip
c. cesarean delivery
d. expectant
43. A 24 y.o. primigravid at 37 weeks age of gestation consulted the Emergency Room with a
blood pressure of 150/90. Urine albumin was +1. The fundic height is 26 cm with an
estimated fetal weight of 1 kg. The cervix was noted to be 2 cm dilated with intact bag of
waters. The admitting diagnosis is:
a. gestational hypertension
b. pre-eclampsia, mild
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
c. pre-eclampsia, severe
d. chronic hypertension with superimposed pre-eclampsia
44. Therapeutic levels of magnesium sulfate are maintained at this level to prevent eclamptic
seizures:
a. 4-7 meq/L
b. 8-10 meq/L
c. 10-12 meq/L
d. more than 12 meq/L
45. The patient at the Intensive Maternal Unit was given a loading dose of magnesium
sulfate. As the intern-on-duty, you will monitor the following before administering the next
dose except:
a. patellar reflex
b. urine output
c. respiratory rate
d. muscle strength
46. A 28 y.o. G1P0 admitted at 32 weeks age of gestation with a blood pressure of 190/120,
jaundiced, with hematuria, gum bleeding and petechiae all over. The most likely
diagnosis is:
a. severe pre-eclampsia
b. acute fatty liver of pregnancy
c. HELLP Syndrome
e. fulminant hepatitis
47. When managing a 14 y.o. who is pregnant, the physician should recognize that the
adolescent is at risk for:
a. glucose intolerance
b. fetal chromosomal abnormalities
c. incompetent cervix
d. iron deficiency anemia
49. A 27 y.o. G1P0, on her 16th week of pregnancy consults for prenatal check up. Both
parents are diabetic. You will advise her to do a:
a. 100 gram oral glucose tolerance test immediately
b. 50 gram glucose challenge test immediately
c. 100 gram oral glucose tolerance test at 24-28 weeks AOG
d. 50 gram glucose challenge test at 24-28 weeks
51. A 36 y.o. G3P2 (2002) had a 50 gram GCT result of 155 mg/dl. What is to be done next?
a. nothing
b. a 100 g OGTT
c. refer to an endocrinologist for management of GDM
d. order for urine ketones
52. A 33 y.o. primigravid on her 38th week of gestation was brought to the Emergency Room
by her husband for a sudden gush of fluid from the vagina. On pelvic examination, the
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
umbilical cord was noted to be coming out of the vagina. Important management at this
point:
a. place the patient in trendelenburg position
b. apply downward pressure on the presenting part
c. await spontaneous vaginal delivery
d. ask the patient to start bearing down
53. After a successful cesarean section delivery for breech, the G1P1 mother asked her OB-
GYN if she has a chance to have vaginal delivery next time she gets pregnant. Which of
the following conditions may make vaginal delivery possible?
a. mother has contracted pelvis
b. previous scar is a low segment cesarean
c. malpresented fetus
d. abnormal placentation-previa
54. A 40 y.o. G7P6 (6006) was admitted for labor pains. After 3 hours, she delivered her
twins vaginally. Ten minutes after the delivery of the second twin, there was profuse
vaginal bleeding, BP was 80/50, HR was 110/min. The most probable cause of the
bleeding is
a. cervical laceration
b. placenta accreta
c. uterine atony
d. retained products of conception
56. A 25 y.o. primigravid consulted at the Emergency Room on her 36 th weeks age of
gestation with abdominal pain and decreased fetal movement. On palpation, there was
note of titanic uterine contractions. Internal examination revealed the cervix to be 3 cm
dilated, fully effaced. The next best thing to do is:
a. amniotomy
b. tocolysis
c. emergency cesarean section
d. augment labor
57. The most expedient procedure in a G2P1 with ruptured ampullary pregnancy with
unstable vital signs is:
a. salpingectomy
b. salpingostomy
c. salpingotomy
d. fimbrial expression of the ectopic gestation
58. A 41 y.o. G4P3 (3003) was admitted at 40 weeks AOG with an ultrasound result of
placenta previa (placenta anterior and totally covering the os). Her three previous
pregnancies were terminated by low segment cesarean section with no complications.
What should you anticipate with this delivery?
a. profuse vaginal bleeding if you wait 3 more days
b. uterine atony
c. bleeding sinuses at the lower uterine segment
d. placenta accreta
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
60. Which of the following organisms is associated with high fever in the first 24 hours after
childbirth?
a. group A Streptococcus
b. Bacteroides bivius
c. Peptostreptococcus
d. Bacteroides fragilis
62. A 19 y.o. primigravid came in at the ER with vaginal bleeding. Her amenorrhea is 12
weeks. On pelvic exam, the cervix is open and the corpus 8 weeks size.
Your diagnosis is:
a. incomplete abortion
b. completed abortion
c. threatened abortion
d. septic abortion
64. A 19 y.o. pregnant cousin asks you regarding a medication which is classified as
category C. You tell her that it means that the drug has:
a. no fetal risks in human studies
b. no fetal risks in human studies
c. fetal risks outweigh benefits
d. adverse effects in animal studies but no human data
66. Risk factors that are classified as high risk for ectopic pregnancy include the following
except:
a. tubal corrective surgery
b. tubal sterilization
c. previous ectopic pregnancy
d. previous pelvic or abdominal surgery
67. A 55 y.o. G5P5 (5005) consulted for fish-wash like vaginal discharge and on-and-off
vaginal bleeding. Pelvic exam showed the cervix to be converted to a 6 x 5 cm nodular,
fungating mass extending to the R lateral fornix, the right parametria nodular but free
while the left was smooth and pliable. Based on the information given, this patient can be
clinically staged as
a. IIB
b. IIIA
c. IIIB
d. IVA
68. A 53 y.o. G1P1 (1001) underwent exploratory laparotomy for an ovarian new growth.
Intraoperative findings showed the right ovary to be converted to a 10 cm predominantly
cystic mass with excrescences on its outer capsule and densely adherent to the fundal
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
portion of the uterus. The left ovary was grossly normal. All other abdominopelvic organs
were grossly normal. Based on the information given, the Intraoperative stage of this
patient is
a. IA
b. IB
c. IC
d. IIA
69. Histopath of a a 47 y.o. nulligravid who underwent PFC, THBSO, BLND was read as
follows:
Endometrial adenocarcinoma, endometrioid type, well-differentiated with less than 50
% myometrial invasion.
Chronic endocervicitis with squamous metaplasia
Negative for tumor: peritoneal fluid, all harvested lymph nodes.
Positive lymphovascular space invasion.
No diagnostic abnormality recognized, both ovaries and fallopian tubes
What is the stage of the patient?
a. Stage IB
b. Stage IC
c. Stage IIB
d. Stage IIIC
71. In an epithelial carcinoma of the ovary, the tumor marker that is most likely to be elevated
is:
a. alpha fetoprotein
b. lactic dehydrogenase
c. CA 125
d. B-hcg
72. The most common genital tract malignancy in Filipino women based on the 2005
Philippine Cancer Facts and Estimates is:
a. vulvar cancer
b. cervical cancer
c. endometrial cancer
d. ovarian cancer
74. A 27 y.o. primigravid consults at the ER for vaginal spotting of one week duration. She
has an amenorrhea of 10 weeks. On pelvic exam, you note the uterus to be boggy and
enlarged to 20 weeks age of gestation. Ultrasound showed an endometrial mass with
snowstorm pattern. Best management for this case would be:
a. subtotal hysterectomy
b. total hysterectomy
c. suction curettage
e. dilatation and curettage
75. According to the American Cancer Society Guidelines for Cervical Cancer Screening,
screening using Pap smear should be started
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
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a. age 12
b. age 18
c. age 21
d. once the woman is sexually active
76. In low resource settings like the Philippines, this has become an acceptable method of
cervical cancer screening:
a. Schiller’s test
b. Toluidine blue test
c. 4-quadrant cervical biopsy
d. visual inspection with acetic acid
78. Speculum exam of a 27 y.o. complaining of leucorrhea showed copious frothy greenish
vaginal discharge with strawberry-like mucosa. This is most likely due to:
a. candidiasis
b. trichomoniasis
c. gonococcal infection
d. bacterial vaginosis
79. In a patient with mucopurulent cervicitis, the patient is also given doxycycline to take care
of:
a. Neisseria gonorrhea
b. Ureaplasma urealyticum
c. Chlamydia trachomatis
d. Gardnerella vaginalis
81. A 20 y.o. commercial sex worker came to you because of multiple, pruritic warty masses
at the vulva. The largest measured 2 x 3 cm. Causative agent of these warts:
a. pox virus
b. bacterial
c. treponemes
d. human papilloma virus
83. A 48 y.o. G3P3 (3003) consulted at the Out Patient Clinic for menometrorrhagia since 5
months ago. Pelvic exam showed a corpus irregularly enlarged to 16 weeks size.
Ultrasound showed multiple myoma uteri. Best treatment option for this patient would be:
a. THBSO
b. myomectomy
c. GnRH agonist
d. progestin supplementation
84. A 35 y.o. G3P3 (3003) consults at the Emergency Room for severe abdominal pain.
Pelvic examination reveals a vague mass at the left adnexal area. But a thorough
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
85. A 36 y.o. G1P1 (1001) consulted for menorrhagia of one year duration. Internal
examination showed a globular uterus symmetrically enlarged to 14 weeks size.
Sonographic impression was consistent with adenomyosis. Definitive management
consists of:
a. continuous low-dose oral contraceptive pills
b. GnRH agonists
c. DMPA injections
d. total hysterectomy
86. A 6 y.o. child underwent exploratory laparotomy for an ovarian cyst. The most common
finding is:
a. serous cystadenoma
b. dysgerminoma
c. dermoid cyst
d. physiologic ovarian cyst
89. The use of combined oral contraceptives will protect a woman from
a. ovarian cancer
b. breast cancer
c. cervical cancer
d. liver cancer
90. A 21 y.o. G2P2 (2002) is interested to learn the use of rhythm method. She reports that
for the past year, her longest cycle was 38 days while the shortest was 24 days.
Abstinence should be observed during the following days of her cycle:
a. day 17 to 23
b. day 8 to 21
c. day 6 to 27
d. day 15 to 20
92. A 25 y.o. primipara is desirous of family planning. She is 2 months postpartum and
claims to have been partially breastfeeding. The best method would be:
a. progestin-only pills
b. combined OCP
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OBSTETRICS & GYNECOLOGY
Physician’s Licensure Examination
June 4, 2009; 1:00 – 5:00
c. lactation amenorrhea
d. bilateral tubal ligation
97. Which of the following is most effective in reducing postmenopausal bone loss?
a. weight-bearing exercise
b. calcium supplementation
c. estrogen therapy
d. vitamin D supplementation
99. Among the different causes of infertility, the treatment of this has the greatest success
rate:
a. ovulatory dysfunction
b. tubal dysfunction
c. male factor
d. uterine pathology
-END-
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