OBS I

1. In the inguinal canal

a. ------
b. Gardner
c. Cooper
d. The round ligament
2. Adaptation of female body to pregnancy, except:
a. Increase in plasma volume up to 40%
b. Decrease peripheral vascular
c. Increase RBC 20%
d. Increase blood flow to
e. Increase peripheral vascular
3. Blood supply to uterus
a. Uterine and ovarian arteries
b. Uterine and left renal artery
c. Uterine and hypogastriac artery
d. Uterine and cervical artery
e. Uterine and right renal artery
4. The area of vestibule is bordered by:
a. Labia minora laterally, by frenulum labiorum pudenda posteriorly, by urethra and
clitoris anteriorly
5. Major nerve supply the clitoris:
a. Lumbar spinal nerve
b. Pudendal nerve
c. Femoral nerve
d. Ilioinguinal nerve
e. ----- gluteal nerve
6. GnRH stimulates release of:
a. ACTH
b. GH
c. LH
d. Opiate
e. TSH
7. Most significant diameter in midpelvis
a. Passing from ischial spine to coccyx
b. Pasing from ischial spine to promontorium
c. Passing from ischial spine to ischial spine
d. Passing from posterior part of pubic symphisis to promontorium
8. Normal sequence of pubertas
a. Purarche, menarche, telarche (P M T)
b. PTM
c. TPM
d. TMP
e. MPT
9. Menaeche occurs
a. 8 – 10
b. 12 – 13
c. 14 – 16
d. 17 - 18
10. Pubertal
a. Breast development
 b. Menarche
c. Pubic hair
d. Skeletal
e. Vaginal
11. Menarche usually occurs between ages of:
a. 0 & 10 years
b. 11 & 13 years
c. 14 & 16 years
d. 17 & 18 years
12. Parity 0:
a. State of having giving birth to an infant or infant weighing 500 gr/<, dead or alive
b. State of having giving birth to an infant with estimated duration of gestation of 28
completed weeks or more
c. State of having giving birth to an infant weighing 2500 gr / <, dead or alive
d. State of having giving birth to an infant with estimated duration of gestation 24
completed weeks or more
13. Birth rate is commonly expressed in terms of :
a. The number of fetal birth per 100,000 population
b. The number of live fetal birth per 1000 population
c. The number of live fetal birth per 100,000 population
d. The number of fetal birth per 1000 population
14. Probable manifestation of pregnancy :
a. Palpation of fetus
b. Mastodinia
c. Linea nigra
d. Spider teleangiektasis
e. Chadwick's sign
15. Hegar sign is:
a. Congestion of pelvic vasculatory causes bluish of purpluis discolorization of the vaginal
servix
b. An increase in vaginal discharge
c. Relaxation of the joints
d. Widening of the softened area of the isthmus, incompressibilty of the isthmus or
bimanual examination.
16. The daily dose required by pregnant women with previous pregnancy affected by neural
tube defect baby :
a. 10 mg
b. 4 mg
c. 0,4 mg
d. 400 μg
17. An increase in procoagulant activity during pregnancy helps reduce blood loss at delivery,
but in the other hand it is associated with :
a. incidens of die
b. increased risk of clinical trombosis
c. Increased risk of infection
d. incidence of PE
e. Incidence of HELLP syndrome
18. The homeostatic mechanism most important in combating pos partum hemorrhagic is:
a. Increase blood cloting factors in pregnancy
b. Intramiometrial vascular coagulation due to vasoconstriction
c. Contraction of interlacing uterine muscle bundles
 d. Markedly decreased blood pressure in the uterine venules
e. Fibrinolysis inhibition
19. These are common complaints during pregnancy that need not require further investigation,
except :
a. Phyalism
b. pica
c. skin rashed
d. nose bleeding
e. Palpitation at rest
20. Insulin secretion doubles in normal pregnancy. This is associated with :
a. Increase in glucose demand
b. Increase register to insulin due to the antagonist effect of placental hormone
c. Increase in glucose blood level
d. Decrease in glucose demand by the mother
e. Decresed in insulin receptor during pregnancy
21. What kind of vaccine are considered safe in pregnancy?
a. Varicella
b. Hepatitis B
c. Rubella
d. Measles
22. The prognose of 2nd stage, except
a. Descent of the presenting part
b. Flexion of the presenting part
c. Rotation of the presenting part
d. Frequency and duration of uterine contraction
23. The plasenta:
f. Allows mainly small molecules and a few blood cells to pass
24. Which of the following statement regarding the plasenta is true?
b. The placenta fulfilled the function of lung, kidney, and intestine for the fetus
25. Organogenesis begins from:
a. 4 – 8 weeks after conception
b. 2 – 8 weeks after conception
c. 4 – 8 weeks after LMP
d. 2 – 8 weeks after LMP
e. 2 – 8 weeks after implantation
26. Smallest circumferrentia:
a. Suboccipito bregmatica
27. The expected date of delivery:
c. Counting 40 weeks from first day of LMP
28. Accurate estimated date of delivery:
a. Breast tenderness and morning sickness began
b. Uterus size
c. Counting 280 days from 1st positive PP test
d. Asking patient when she first feel pregnant
e. Fetal biometry by USG prior to 20 weeks gestation
29. Fundal height, from the top of simphysis pubis to top of fundus. It is measured:
e. In centimeters, approximating the weeks of gestation between 18 and 34 weeks
30. Mechanism transport via the placenta by which the mother become sensitive to fetal red
cells antigens such as the Rh antigens:
a. Simple diffusion
b. Facilitated diffusion
 c. Active transport
d. Pinocytosis
e. Leakage
31. Mechanism transport of amino acid from
a. Simple diffusion
b. Facilitated diffusion
c. Active transport
d. Pinocytosis
e. Leakage
32. Main class of immunoglobulin found in human milk is
a. Ig G
b. IgA
c. Ig E
d. IgM
33. The element in breast milk have prophylactic value against infection, except
a. Imunoglobulin
b. Leucocyte
c. Lysosomes
d. ---- factor
e. Lactose
34. Pathogens caused mastitis
a. Streptococcus aureus
b. Streptococcus virideus
c. Streptococcus beta haemolyticus
d. E. coli
35. DJJ pada
36. A
37. Decrease during pregnancy
a. Blood level
b. Cardiac output
c. Peripheral vascular resistance
d. Blood flow distribution
e. Blood pressure
38. ECG excepts
a. Systolic ejection murmur
b. Continuous murmur or bruit at left sternal edge
c. 15 - 20° shift to left in electrical axis
d. ST segment depression or T wave flattened
e. Changes in amplitude and deviation of QRS complex
39. Cardiovascular position during pregnancy
a. Blood volume
b. Cardiac output
c. Stroke volume
d. Blood flow distribution
e. Blood pressure
40. The following lung volumes are decreased during pregnancy, except:
a. Tidal volume,
b. Residual volume
c. Inspiratory reserve
d. Expiratory reserve
41. Calcium intake during later months of pregnancy and during lactation reaches:
 a. 1 gr/d
b. 1,5 gr/d
c. 2 gr/d
d. 2,5 gr/d
42. Active management of 3rd stage, except:
a. Oxitocyn
b. Control cord progression
c. Immediated cord clamp
43. Pregnant woman with iron deficiency anemia needs therapeutics dose:
a. 30 ml/L
b. 60 – 120 mg/L
c. 150 – 200 mg/L
d. 250 – 300 mg/L
44. Of the following, the most worrisome sign or symptom of potentially serious pathology in
late pregnancy:
a. Swollen ankles
b. Constipation
c. Visual changes
d. Nocturia
e. Heartburn
45. The best method to safety and reliability
a. USG
b. Leopold’s maneuver
c. Auscultation
d. X-ray
e. CT scan
46. The average blood loss during normal deliveries when measured appears to be above:
a. 700 ml
b. 500 ml
c. 250 ml
d. 110 l
e. 50 ml

A 40 year grande multigravide was referred by midwife because of severe bleeding after delivery.
Px: On arrival showed her blood pressure was 90/66, HR 112 bpm, RR 28 tpm.

47. Which of the following represent the first sign of hypovolemic shock:
a. Decreased systolic pressure
b. Decreased diastolic pressure
c. Increased pulse rate
d. Increased respiratory rate
48. The most common cause of hypovolemic shock in obstetric is:
a. Antepartum bleeding
b. Intra partum bleeding
c. Post partum bleeding
d. Post abortion bleeding
49. Which of the following treatment do you have to give the patient of the first ----
a. Giving electrolytes solution
b. Giving colloid solution
c. Giving blood replacement
d. Giving O2
50. The following is the parameter to assess that hypovolemic shock state is getting better,
except:
a. Increased blood pressure
b. Increased respiration rate
c. Decreased pulse rate
d. Increased urinary output

Essay
1. Management aktif skala III
2. Asuhan persalinan normal menurut evidence

GIN I
1. The most likely cause of abnormal genital bleeding in 22 year old woman.
2. Diagnose BV is based on:
3. Theraphy BX
4. Strawberry cervix
5. Diagnose of cervicitis
6. Regulation of menstrual blood loss is controlled by 3 mechanism, except:
a. Vasodilatation of a. Spiralis
b. Fibrinolytic activity
c. Estrogen level
d. Endometrial regeneration
7. Fertilization take place in:
8. Implantation begin --- day after fertilization.
9. HLA, what for?
10. Clitoris = penis.
11. Local caused menorrhagi, except:
a. Fibroid
b. Endometriosis
c. Thyroid disfunction
d. Endometrial hyperplasi
12. When perform Pap’s smear, the important thing is:
d. Stratocolumnar junction
13. 1st line drug to menorrhagia, except:
a. Prostaglandin sintetase inhibitor
b. Combine Estrogen-Progesterone
c. Danzole
d. Anti fibrinolytis
14. Surgical treatment menorrhagia, except:
a. Dilatation and curettage
b. Ablation
c. Hysterectomy
d. Thermal baloon
15. Predominant type bacteria in vagina: Lactobacillus
16. Ovarian vessels are found in which of the following ligament:
a. Broad
b. Round
c. Uterosacral
d. infundibulopelvicum
17. At which of the following location does the uterine artery most commonly cross over the
ureter?
a. 2 cm lateral cevix
18. -
19. -
20. -
21. Estimated number of oocyt at puberty:
a. 50.000 – 100.000
b. 200.000 – 400.000
22. Gartner duct cyst is remnant of:
a. Mesonephric
b. paramesonephric
23. 1st thing t soak instrument: ----- 5%
24. Process of soking dirty instrument:
a. Desinfection
b. Decontamination
c. Antiseptic
d. Infection prevention
25. Boiling object to kill nearly all microorganism called:
a. Sterilization
b. DTT
c. Aseptic
d. decontamination
26. How long do you have to boil the instrument?
a. 10 minutes
b. 20 minutes
c. 30 minutes
d. 40 minutes
27. Following process belongs to infection prevention, excepts:
a. Taking antibiotics
28. High level disinfected gloves, suitable for:
a. Minilap
b. Vasectomy
c. Inserting/remove implant
d. Inserting/remove iud
29. Drugs alternative for trichomoniasis:
a. Ampicilline
b. Ciprofloxacine
c. Spectinomycine
d. None of the above
30. Most common vaginal complaints:
a. Vaginal epithel neoplasia
b. Herpes
c. HPV
d. Vaginitis
e. Traumatic vulvitis
31. The most likely cause of abnormal bleeding in 13 year old girl is:
a. Uterine Ca
b. Ectopic pregnancy
c. Anovulation
d. Systemic bleeding diathesis
 e. Threatened abortion
32. A 15 year old patient had menstrual bleeding during 2 – 4 weeks since menarche 1 yar ago.
The bleeding are both heavy and light. -----------
a. Obtain pregnancy test
b. ---- endometrial biopsy
c. Obtain pelvic ---
d. Initiate oral contraceptives
e. Initiate oral cycloprogestin theraphy
33. The recommended teraphy for vulvavaginal candidiasis in pregnant women:
34. -
35. -
36. -
37. The following findings are helpful in diagnostic of ---, except:
38. One or 3 extremely painful ulcer and accompanied by tender inguinal lymphadenopathy is
more likely to be:
a. Chancroid
b. Herpes
c. Syphilis
d. HPV
39. Group vesicles mixed with small ulcer particularly with a history of such lesion are:
a. Chancroid
b. Herpes
c. Syphilis
d. HPV
40. A genital ulcer with a ----, indurated ---- and a smooth ---- is characteristic of:
a. Chancroid
b. Herpes
c. Syphilis
d. HPV
41. The following theraphy is appropriate for treating hypercalemia, except:
a. 10 ml of 10% Ca gluconas
b. One ampule each of sodium bicarbonate and D50 with or without insulin
c. Kayexalate
d. Sodium bicarbonate 25 ml
42. Infections are major source of morbidity in the post operative periode. Risk factor infections
morbidity include, except:
a. Hypoalbumin condition
b. Prior surgical technique
c. Contamination of the surgical field from infected tissue or from spillage of large
bowel content
d. Immunocompromised host

A 19 years old girl was admitted to hospital because of high temperature and somnolent condition.
Physical examination showed decreased blood pressure, rapid pulse rate, tenderness over the
abdominal wall and foul smelling vaginal discharge.

43. Clinical diagnosis of such a patient is most likely:

a. Hypovolemic shock
b. Cardiogenic shock
c. Endotatic shock
d. Anafilactic shock
44. Which of the following condition is the most common cause of the type of shock:
a. Puerperal infection
b. Post cesarian infection
c. Unsafe abortion
d. Ruptured uterus
45. The most common causative agent producing such type of shock:
a. Streptococcus
b. Staphylococcus
c. Gram (-) bacteria
d. Gram (+) bacteria
46. Changes occurring during septic shock include the following, except:
a. Decreased blood pH
b. Increased blood lactate
c. Decreased anaerob metabolism
d. DIC
47. Sign and symptom of early stage of septic shock include all of the following, except:
a. Hyperventilation
b. Hypotension
c. Elevated blood lactate
d. Respiratory acidosis
48. Antibiotics prophylaxis regiments that usually given during hysterectomy:
a. 1 gr Cefotaxime iv
b. 1 gr Ampicilline iv
c. 500 mg Ceftriaxone iv
d. 250 mg Ceftriaxone iv
49. Bicarbonates should not be given in treating acidosis unless there is severe cardiac
complication or serum pH lower than:
a. 7,1
b. 7,2
c. 7,3
d. 7,4
50. Bradicardia, ventricular fibrillation and cardiac arrest can appear in hypercalemia greater
than:
a. 6 meq/L
b. 7 meq/L
c. 8 meq/L
d. 5 meq/L

Essay:
1. A multigravide woman complaints of vaginal bleeding, tumour like 12 weeks size, and
unregular dan heavy haid. Patient looks pale. Cervix and adnexa are unremarkable.
Sebutkan anamnesa tambahan, pemeriksaan fisik tambahan, diagnosa, dan pemeriksaan
laboratorium tambahan.

2. A nullipara complaints of pain in lower abdomen in the last 10 days. She also has fever. She
has leukorrhea and complaint of pain when urinate. Patient admitted that she had had sex.
Sebutkan anamnesa tamabhan, diagnosa, diagnosa banding, pemeriksaan penunjang.