A 28 yo woman Gl 36 weeks of gestasional age went to your clinic to do routine ANC.

During

ultrasound the doctor told that she will be expecting baby boy with EFW 2500 gram, however

amniotic fluid considered to be less than normal. Then u asked the patient to drink minimal 2L of water
a day and get herself another ultrasound within 3 days to evaluate the amniotic fluid

1. Oligohydramnios is defined as which of the following 7

a. Amniotic fluid index< 5 cm

b. SOP< 2 cm

c. AFI < 90th percentile.

d. All of the above

e. None of the above

2. Amniotic fluid volume is a balance between production and resorption. What is the primary
mechanism of fluid resorption?

a. Fetal breathing

b. Fetal swallowing

c. Absorption across fetal skin

d. Absorption by fetal kidney

e. Filtration by fetal kidney

3. In a normal fetus at term what is the daily volume of fetal urine that contributes to the

amount of AFI present?

a. 200ml

b. 250ml

c. 500ml

d. 750ml

e. 1000ml
A patient came with chief complaint of spotting two hours ago. Her LMP was 3rd January 2017 and she
had not had any pregnancy test. She appears well and complaint of slight cramps on her lower
abdomen. On examination you found that she is normotensive and there is no tachycardia, her

general status appears normal. During gynecological exam her external ostium is closed, her uterus is
enlarged slightly with no active bleeding. By trans vaginal ultrasound examination you found

gestasional sac intra uterine with crown rump length appropriate for 8 weights of gestation with FHR
186bpm.

4. What is the best management for this patient?

a. Bed rest and progestogen

b. Bed rest and tocolitic

c. Long maturation

d. Bed rest only

e. Progesterone only

5. What is the following is least likely to be associated with preterm delivery?

a. Incompetent cervix

b. Hydramnios

C. Uterine fibroid

d. Abdominal pregnancy

e. Hydrops fetalis

6. Which one of the following is most likely to be contraindication for tocolysis at 28 weeks
gestation

a. Suspected abruption

b. Group B Streptococcal bacteriuria

c. Recent laparotomy for appendicitis

d. Uterine fibroid

e. Preterm premature rupture of the membrane

7. Each of the following Is a side effect of terbutallne, except for :

a. Fetal tachycardia

b. Hyperglycemia

c. Hyperkalemia

d. Hypokalemla

e. Increase pulse pressure

Mrs. A 26 years old GlP0A0 according to the her LMP is 34 weeks pregnant, came for her 1st ANC. She
admit to have 20 Kg weight gain during pregnancy with swelling ankles for the past 4 weeks. She never
too any iron or vitamin supplementation. For the physical finding 145/95 mm Hg. HRb86 x/m, RR 20x/m,
BMI 35 kg/m2. Ultrasound examination confirm twins in breech presentation. From

urinalysis were as follows color cloudy yellow spesifik Gravity 1.013, albumin 2+ RBC 0 -1, WBC 2-5,
bacteria negative

8. What is the most likely diagnosis?

a. Acute fatty necrosis

b. Chronic hypertension

c. Preeclampsia

d. Renal disease

e. Pyelonephritis

9. Given the history of this patient several more laboratory and diagnostic test were obtained. she
was stable and the fetuses have reassuring heart rate tracing. Which of the following do you expect to
see in the rest result?

a. Chest x ray to show decreased pulmonary vascular marking

b. Urine to show infection

c. Creatinine clearance to be increased above normal pregnancy level

d. Serum uric acid to be increased

e. A decreased hematocrit

Mrs B 37 yo came to you office at 32 weeks of gestation according to her last menstrual
period. She has no ultrasound examination before and didn’t get ANC routinely. The vital sign is

within normal limit. She has BMI 19 kg/m2• During physical examination the uterine fundal height is 22
cm. From ultrasound examination the fetus has biometric value that correlate with 30 weeks fetus

10. Which of the f is the next best step in managing this patient?

a. ANC routinely for the next 2 weeks

b. Evaluate maternal status and comorbidities

c. Consider deliver the baby

d. Repeat sonography for fetal growth in 2 weeks

e. Doppler velocimetry evaluation every 3 days