31.

Your diagnostic examination result showing normal FEP, plasma ion 95 ug/dL, TIBC 350 ug/dL,
and ferritin 50 ng/dL. What will be possible diagnosis

a. Iron deficiency anemia

b. Sideroblastic anemia

c. A thalassemia

d. Sickle cell anemia

e. Anemia of chronic disease

32. What is the cause of this condition?

a. Deletion of one or all a genes on chromosomes 16

b. Deletion of one or all a genes on chromosomes 11

c. Deletion of one or all 13 genes on chromosomes 11

d. Deletion of one or all 13 genes on chromosomes 16

e. Deletion of one or all a genes on chromosomes 18

A 17 year old G1P0 woman present at 25 weeks gestation complaining of headache for the past 36

hours. She has had regular prenatal visit going back to her 1 prenatal visit at 8 weeks gestation. A 20
weeks ultrasound redated her pregnancy by two weeks as it was 15 days earlier than her LMP

dating. She has a BP of 155/104 mmHg.

33. You review her medical record and determine that she does not have chronic hypertension. The
patient denies having RUQ pain but because of your high suspicion pf severe

preeclampsia you order a CBC, liver enzyme, renal function test, and a 24 hours urine

protein collection. Her laboratory test result reveal a normal platelet count and liver but a slightly
elevated creatinine and proteinuria f 550 mg in 24 hours. Her headache has resolved after a dose of
acetaminophen. What is the next best step in her management.

a. her a prescription for labetolol and have her follow up in clinic in 2 weeks

b. (a) plus bed rest

c. Hospitalization for further evacuation and treatment

d. Immediate delivery
e. Begin induction of labor

34. Over the next 12 hours the BP rise above 160 mmHg on several occasion, most notably to 172/
102 mmHg. 2 hours after admission and to 168/96 mmHg 9 hours after admission pain. Her headache
does not return and she had no RUQ or visual symptoms. A set of repeat laboratory test result are
unchanged and by increasing her labetolol dose to 400 mg TID, her BPs decrease to 140-150/70-90
mmHg. She is also started on Magnesium Sulfate. What change in physical or laboratory examination do
you observe that would indicate delivery ?

a. Another BP of 174/102 mmHg

b. Headache returning

c. Double vision

d. Platelets of 08

e. AST 265

A 43 vears old woman G4P3 at 37 weeks gestation presented in hospital with a ten day history of \ow
extrimities edema, with idiopatic hypertension, for 1 year. At presentation she had a blood pressure of
170/100 mmHg. Laboratory finding was normal except urinalysis (protein 2+). She was diagnosed with
superimposed severe preeclampsia. It was decided to deliver the fetus by mean of a C section by
indication of tranverse lie. Blood pressure measurement was 150/100 mmHg. She lost consciousness for
30 second five hours after operation. The laboratory studies give the following

result AST 225, ALT 140, LOH 1017, serum urea and creatinine were normal, Hb 10,6, platelet SO.ODO,
CT scan was performed on patient which revealed the left frontal lobe lacunar infarction. The patient
was transferred to ICU

35. What is the most appropriate diagnose

a. DIC

b. Acute fatty liver in pregnancy

c. HELLP syndrome

d. Severe purpuraal infection

e. Trombotic trombositopenic purpura

36. What is the best management after, for this case

a. Fresh-frozen plasma and thrombocytes concentrates

b. Anti-platelets

c. Anti-oxidant

d. Corticosteroid

e. Magnesium sulfate

37. Twelve hours observation showed urine production was 100 ml.#

a. Immediately giving diuretics bolus IV

b. Immediately giving diuretics maintained by syringe pump

c. Check albumin level, giving diuretic justified after hypoalbuminemia condition had been
distinguished

d. Renal failure due to micro thrombopathy suspected, heparin provision could be considered

e. Immediately step on fluid resuscitation

A 33 year old woman G1P0A0, came to hospital with major complaint, watery leakage. She was on her
33 weeks of gestational age. Data from medical record showed that she came previously a week ago,
complaining vaginal discharge. Vaginal swab has done.

38. In case above, what kind of examination should you performed for establishing diagnosis.

a, Vaginal examination

b. Inspeculo

c. Blood test

d. Ultrasound

e. Simple urine test

39. you found leopold 1, hard, round with ballottement ( + ). Contract1on was infrequent and weak.
What was your next plan

a. Went for labour induction

b. Immediate c-section

c. Tocolytic and corticosteroid provision

d. Performed ultrasound

e. Performed external version

woman refer from primary health care due considerably low maternal body weight. She is on her 35
weeks of gestation, height 150 cm weight 32 kg. She had previous history of severe hyperemesis. Other
medical problems were denied.

40. Ultrasound examination showed that trans-cerebellar diameter was proper to gestational age,
abdominal circumference was lower than 2.5 centile and amniotic fluid deepest pocket was 1.2 cm

What is the most likely diagnosis?

a. Growth restriction with olygohydramnion

b. Normal growth with olygohydramnion

c. Growth restriction with normal amniotic fluid

d. Normal growth with normal amniotic fluid

e. Need another examination for establishing diagnosis