A. Paracervical Block C. Give Spinal Block D. Pudendal Block

OB 3A FINALS RATIO 2015 (November 5, 2015)
1) A parturient is more than 5 cms dilated & feels pain at the infraumbilical area 8/10 in
severity. What is the best management?
A. Paracervical Block
B. Give Epidural Block
C. Give Spinal Block
D. Pudendal Block
Ratio:
Obstetric Anesthesia & Analgesia by Pacis, pp. 6-7
2) A parturient who is fully dilated with head at station +4 feels 9/10 pain at the vaginal area.
No qualified anesthesist is present. What is the best thing to do?
A. Observe
B. Give Spinal Block
C. Administer Pudendal Block
D. Give Saddle Block
Ratio:
William’s Obstetrics, 24th Edition, p. 508
PHYSIO OB FINALS 2015 1 | P a g e

3) To mitigate risk in case of aspiration, which should be given shortly before anesthesia
induction?
A. Antacids
B. Antibiotics
C. Analgesic
D. Antipyretics
Ratio:
Obstetric Anesthesia & Analgesia by Pacis, p. 8
4) A parturient is given combined spinal & epidural anesthesia. Seconds later, she had
seizures. What is the most likely reason for this?
A. Spinal Anesthesia
B. Epidural Anesthesia
C. Both
D. None of the above
Ratio: Obstetric Anesthesia & Analgesia by Pacis, pp. 5-6

5) Which of the following is true of intravenous sedatives?
A. Prolongation of labor
B. Safer than regional analgesia
C. Equally efficacious with regional analgesia in providing pain relief
D. Readily cross the placenta
Ratio:
6) Non-pharmacological method of pain control that helps increase beta endorphins in the
peripheral blood
A. Lamaze
B. Clinical Hypnosis
C. Acupuncture
D. Deep Breathing
Ratio:

7) Which of the following should be done to decrease morbidity from obstetric anesthesia?
A. Fasting for at least 8 hours

B. Giving of anti-emetic
C. Pre-anesthetic fluid hydration
D. All of the above
Ratio:
Obstetric Anesthesia & Analgesia by Pacis, p. 5 & 9
8) What anatomical structure separates the true pelvis from the false pelvis?
A. Linea terminalis
B. Interischial diameter
C. Intertuberous diameter
D. Greater transverse diameter of the inlet
Ratio: Bony Pelvis by Pacis, p. 1

9) The antero-posterior diameter of the pelvic inlet is best indicated by this measurement
A. Diagonal Conjugate
B. True Conjugate
C. Obstetric Conjugate
D. Shape of the Pelvic Inlet
Ratio:
Bony Pelvis by Pacis, p. 2 & 4
10) A primigravida, in early labor for a full-term fetus, in cephalic presentation had a
measurement of 11 cm from the midposition of the symphysis pubis to the promontory of
the sacrum. Is her pelvic inlet clinically adequate?
A. Yes
B. No

11) A primigravida in her second stage of labor had an occiput transverse presentation station
+1 for 3 hours. On examination, she has prominent ischial spines, convergent side walls &
straight sacrum. Where is the cephalo-pelvic disproportion?
A. Pelvic inlet
B. Pelvic midplane
C. Pelvic outlet
D. No cephalo-pelvic disproportion
Ratio:
REMEMBER:
Ischial Spines:
has to do with MIDPELVIS
Ischial Tuberosities:
has to do with PELVIC OUTLET
d
ALWAYS COMPARE the given pelvis
with the GYNECOID PELVIS
Bony Pelvis by Pacis, p. 5
12) On clinical pelvimetry, the distance between the 2 ischial tuberosities was 11 cm and the
posterior sagittal of the outler was 8 cm. Is the pelvic outlet adequate?
A. Yes
B. No

13) What represents the shortest diameter of the pelvic cavity?
A. Obstetric conjugate = 10-11 cm

B. True conjugate = 11 cm
C. Interspinous diameter =10 cm
D. Intertuberous diameter =11 cm
Ratio:
14) What type of pelvis is oval anteroposteriorly, has increased anterior & posterior segments,
straight or divergent sidewalls, long & curved pubic arch & slightly narrow subpubic
angle?
A. Gynecoid
B. Anthropoid
C. Android
D. Platypelloid
Ratio: (MUST KNOW)

15) Clinical pelvimetry of a patient in labor revealed that the sacral promontory could not be
reached at 11.5cm, sidewalls straight, ischial spines not prominent, sacrum well-curved,
sacro-sciatic notch wide & shallow & subpubic angle 85%. What is your assessment of the
pelvis?
A. Clinically adequate
B. Contracted
Ratio:
ALWAYS REMEMBER TO
COMPARE IT TO THE
GYNECOID PELVIS
Gynecoid Pelvis: Suited for

DELIVERY of most fetuses
16) Internal examination of a nulliparous woman in active labor revealed the most dependent
portion of the head to be at station 0. What does this mean?
A. The head is engaged

B. The inlet is adequate
C. The midplane is contracted
D. A&B
Ratio: Bony Pelvis by Pacis, pp. 7-8

17) Which of the following pelvic diameter measurements is normal?
A. Greatest transverse diameter of the inlet 12 cm

B. Anteroposterior diameter of the midplane 11 cm
C. Interspinous diameter 10 cm
D. Posterior sagittal diameter of the outlet 4.5 cm
Ratio:
MUST KNOW
Pelvic Inlet:
Pelvic Midplane:
Pelvic Outlet:
Bony Pelvis by Pacis, pp. 5-6
Identify the phase of parturition in the following (MUST KNOW PICTURE)
A. Stimulation
B. Quiescence
C. Involution
D. Activation

18) A 22 y/o G2P1 (1001) consulting at the outpatient department at 18 weeks gestation for
congenital anomaly scan by ultrasound
Answer: B
19) A 27 y/o G1P0 37 weeks gestation mentions during her prenatal visit that she felt the baby
“dropped” and descended, causing pressure in her inguinal area
Answer: A
Ratio:
Physiology of Labor by Pacis, p. 2
20) A 39 y/o G4P3 (3003) 38 weeks gestation is currently fully dilated cervix & is actively
pushing with each contraction
Answer: D
Identify the stage/phase of labor of the following (MUST KNOW)
A. First stage, latent phase

B. First stage, active phase
C. First stage, deceleration phase
D. Second stage
E. Third stage

21) A 32 y/o G3P2 (2002) who has delivered a live term infant, and is currently showing signs of
placental separation
Answer: E
22) A 19 y/o G1P0 39 weeks, cervix 2 cm dilated, 70% effaced, cephalic, station -1, intact bag of
water; uterine contractions every 10-12 minutes, mild to moderate
Answer: A
23) A 23 y/o G3P2 (2002) 37 weeks, cervix 6 cm dilated, 90% effaced, cephalic, station -1,
ruptured bag of water; uterine contractions every 5-6 minutes, moderate
Answer: B
24) Which of the following is/are true of Braxton Hicks Contractions?
A. Earliest sign of labor

B. Pathologic if seen in phase 1 parturition
C. Benign myometrial contractions
D. All of the above
E. A & B only
Ratio:
25) Mrs Chloe came back with her ultrasound result as follows: Single live intrauterine
pregnancy, 24 weeks AOG, appropriate for gestational age. Good somatic activity.
Adequate amniotic fluid. No adnexal mass. Cervix 1 cm long. Which of the following is the
best advice for her?
A. Her pregnancy is okay. Come back for next check-up after 4 weeks
B. She is at risk for preterm labor
C. She is in preterm labor
D. She has an incompetent cervix

Ratio:
Not in Preterm Labor

because she did not satisfy
the Criteria for True Labor
Conduct of Normal Labor & Delivery by Pacis, p. 11-12
26) What is second stage of labor?
A. Regular uterine contractions to 4 cms cervical dilatation

B. 4 cms cervical dilatation to full cervical dilatation
C. Full cervical dilatation to delivery of the fetus
D. Delivery of the fetus to delivery of the placenta
Ratio: Conduct of Normal Labor & Delivery by Pacis, p. 9

27) Which of the following describes the Duncan mechanism of placental separation?
A. Retroplacental hematoma forms & pushes the center

B. Blood collects between the membranes & the uterine wall & escapes from the vagina
C. Glistening amnion, covering the placental surface, presents at the vulva
D. Retroplacental hematoma follows the placenta
Ratio:
28) How is postpartum hemorrhage prevented in the phase 4 of parturition?
A. Maintain myometrium in a state of rigid & persistent contraction & retraction

B. Promote closure of the cervical opening to prevent blood loss
C. Manual extraction of the placenta
D. All of the above
E. A & C only
Ratio:

29) Phase 4 of parturition lasts for
A. An hour after delivery of the baby

B. An hour after the delivery of the placenta
C. 2 weeks after labor & delivery
D. 4-6 weeks after labor & delivery
Ratio:
Puerperium by Pacis, p. 1
William’s Obstetrics, 24th Edition, p. 668
30) Which group of agents is theorized to initiate phase 3 of parturition?
A. Uterotonics
B. Sex steroids
C. Betamimetics
D. Calcium channel blockers
Ratio: Physiology of Labor by Pacis, p. 17

31) Which of the following is a primary regulator of oxytocin receptor expression?
A. Calcium
B. Progesterone
C. Prostaglandin dehydrogenase
D. Corticotropin-releasing hormone
Ratio:
32) On ultrasound, the baby was noted to have an absent frontal calvarium. Which of the
following abnormalities of parturition has been associated with this finding?
A. Preterm labor
B. Prolonged gestation
C. Uterine tachysystole
D. All of the above
Ratio:

33) A G1P0 at term complains of hypogastric pain & bloody show. The cervix is 5 cms dilated.
Which of the following are plausible causes of the complaint of the patient?
A. Myometrial hypoxia
B. Uterine peritoneum stretching
C. Compressed vein ganglia in the cervix
D. A & B only
E. B & C only
Ratio:
34) Which of the following is/are true about the longitudinal lie?
A. It is present in about 50% of labors at term

B. It is unstable & can convert to transverse or oblique lie
C. The long axis of the fetus lies parallel to that of the mother
D. All of the above
Ratio:
Conduct of Normal Labor & Delivery by Pacis, p. 1

35) A 20 year-old primigravida on her 38th week of gestation is in labor, with a 7 cm dilated,
almost fully effaced cervix, ruptured bag of waters, cephalic, with the anterior fontanel
lowermost in the birth canal. What is this type of presentation?
A. Face
B. Sinciput
C. Brow
D. Vertex
Ratio:
36) Predisposing factors to transverse lie include the following, EXCEPT
A. Nulliparity
B. Placenta previa
C. Hydramnios
D. Uterine anomalies
Ratio:

37) How is the third Leopold’s maneuver performed?
A. The tips of the fingers of both hands are placed on each side of the lower maternal
abdomen and deep pressure is exerted
B. By grasping the thumb & fingers of one hand the lower portion of the maternal abdomen
C. With the tips of the first three fingers of each hand, deep pressure is made in the direction
of the axis of the pelvic inlet
D. All of the above
Ratio:

38) With full flexion, what fetal head diameter navigates the planes of the pelvis?
A. Occipitofrontal
B. Suboccipitobregmatic
C. Mentooccipital
D. Biparietal
Ratio:
39) A 26 year old primigravida in labor was admitted with a 5 cm dilated, 80% effaced cervix,
BOW (+), cephalic, station -1. After 5 hours, the cervix became 10 cm dilated and the bag of
waters (BOW) ruptured spontaneously, with the head now at station 0. Three hours later,
the head was still at station 0. Which part of labor here was prolonged?
A. The latent phase

B. The phase of maximum slope
C. The deceleration phase
D. The second stage of labor
Ratio:

40) Which of the cardinal movements of labor is responsible for the smaller presenting
diameter of the fetal head?
A. Engagement
B. Descent
C. Flexion
D. Internal Rotation
Ratio:
41) When engagement has occurred, which of the following has been accomplished?
A. The biparietal plane has passed the inlet

B. The most dependent portion of the fetal head is at the level of the inlet
C. The fetal head is just entering the true pelvis
D. The cephalic prominence cannot be determined on Leopold’s 4th maneuver
42) After external rotation, what is the next step to deliver the anterior shoulder?
A. Pull the baby up

B. Pull the baby sideways
C. Pull the baby down
D. Pull the baby up diagonally
Ratio:
Conduct of Normal Labor &

Delivery by Pacis, p. 14

43) When the sagittal suture is closer to the symphysis pubis, what is the condition?
A. Anterior asynclitism
B. Posterior asynclitism
C. No asynclitism
Ratio:
44) This type of episiotomy is associated with higher rates of anal sphincter & rectal injury
A. Median
B. Mediolateral
C. Both
Ratio:

45) One hand over the posterior perineum over the fetal chin to extend the fetal head and
another hand over the occiput with pressure downward to flex the head is
A. Modified Ritgen’s
B. Vacuum extraction
C. Modified Crede’s
D. Brandt Andrews
46) Auscultation of the FHT is done _______ a uterine contraction
A. At the onset of
B. During the peak
C. After
Ratio:

47) When the fetal head is encircled by the vulvar ring, this is called
A. Ritgen’s
B. Crowning
C. Engagement
Ratio:
48) The earliest sign of placental separation is
A. Lengthening of the cord

B. Gush of blood from the vagina
C. Calkin’s Sign
D. Uterus rises in the abdomen
Ratio:
Conduct of Normal Labor & Delivery by Pacis, pp. 14-15
49) Prolonged second stage of labor in nulliparas occurs when the
A. It exceeds 3 hours with epidural anesthesia

B. If it is more than 2 hours without anesthesia
C. Both
D. Neither
Ratio:
Conduct of Normal Labor & Delivery by Pacis, p. 12 Obstetric Anesthesia & Analgesia
by Pacis, p. 12

50) Lacerations extending to the rectal mucosa is
A. First degree
B. Second degree
C. Third degree
D. Fourth degree
Ratio:
51) After delivery of the fetus, the umbilical cord is clamped & cut. The next step to do while
holding the clamped cord is
A. Perform vigorous traction of the cord to pull the placenta

B. Pressure is applied to the body of the uterus cephalad
C. Uterus is pushed downward with the abdominal hand
Ratio:

52) Upon inspection of the perineum after delivery of the infant and placenta, a laceration was
noted from the skin & vaginal mucosa & perineal muscle with involvement of the anal
sphincter. This type is what type of laceration?
A. First degree laceration

B. Second degree laceration
C. Third degree laceration
D. Fourth degree laceration
Ratio:
53) A 32 year old G2P1 (1001) term, cephalic is admitted at the delivery room at 4 cm, 60%
effaced, station -2, with intact bag of waters. The following is/are component/s of active
management of labor for this patient
A. Pelvic examination is done every 2 hours

B. Amniotomy is performed if cervical dilatation is not progressing 1 cm/hour
C. Oxytocin infusion is given if there is inadequate uterine contractions
D. All of the above
Ratio:
William’s Obstetrics, 24th
Edition, p. 452

54. This refers to the time following delivery during which maternal changes return to
nonpregnant state:
A. Puerperium
B. Postpartum
C. Peripartum
D. Fifth Stage of Labor
RATIO:
55. The uterus returns to pregravid size by:

A. 3 weeks after delivery
B. 5 weeks after delivery
C. 8 weeks after delivery
D. 10 weeks after delivery
56. A primipara delivered 2 weeks ago is complaining of intermittent

crampyhypogastric pain. What is NOT considered in the immediate management?
A. Initiate empiric antimicrobial therapy for endometritis
B. Reassure the patient that the uterus tends to remain tonically contracted
C. Offer analgesic therapy
RATIO:
 Empiric antimicrobial therapy for endometritis was not considered in this case
because endometritis postpartum is part of a normal reparative process.

 After pains in primiparas – uterus tends to remain tonically contracted.
 Mild analgesics can be given for after pains.
57. A puerpara on her 2nd week postpartum is complaining of white-yellow vaginal

discharge. What is your impression?
A. Lochia rubra
B. Lochia serosa
C. Lochia alba
RATIO:
58. Which of the following becomes the source of the new endometrium during the
puerperium?
A. Decidua basalis
B. Decidua functionalis
C. Decidua spongiosa
D. Decidua compacta
RATIO:

59. A woman on her 3rd postpartum week comes complaining of persistent vaginal
bleeding of minimal amount. On bimanual examination, the fundus is softish and
noted halfway between the umbilicus and symphysis. Ultrasound showed thickened
heterogenous endometrium. Which is the MOST likely cause of this condition?
A. Chlamydial infection
B. Retained placental fragments
C. Incompletely remodeled uteroplacental arteries
RATIO:
 Retained placental fragments – results to abnormal involution of the placental site
that may cause bleeding.
 Chlamydia infection – postpartum metritis.
 Incompletely remodeled uteroplacental arteries – noninvoluted vessels that are
filled with thrombosis and lack an endothelial lining.
60. According to the American College of Obstetricians and Gynecologists, secondary

postpartum hemorrhage is defined:
A. bleeding 6 hours to 12 hours after delivery
B. bleeding 24 hours to 12 weeks after delivery
C. develops 14 weeks after the delivery
D. develops 16 weeks after the delivery

61. A woman delivered 10 days ago came back complaining of moderate vaginal
bleeding. On PE: stable vital signs; IE cervix firm closed, corpus slightly enlarged, no
adnexal mass nor tenderness. Ultrasound revealed thin endometrium. What is the
BEST management in this patient?
A. Give antibiotics
B. Perform suction curettage
C. Perform curettage
D. Uterotonics: methylergonovine
RATIO:
 Uterotonics: methylergonovine is recommended because it stimulates uterine
contractions and can reduce blood loss.
 Antibiotics – used only if uterine infection is suspected.
 Suction curettage – if large clots are seen in the uterine cavity with sonography.
 Curettage – carried out only if appreciable bleeding persists or recurs after medical
management.
62. A woman delivered 2 weeks ago consulted complaining of moderate vaginal

bleeding. On PE: stable vital signs; IE cervix is 1 cm open, corpus enlarged to 2
months size, no adnexal mass nor tenderness. Ultrasound revealed thickened
endometrium probably retained placental tissues. What is the BEST management in
this patient?
A. Give antibiotics
B. Perform suction curettage
C. Perform curettage
D. Uterotonics: oxytocin
RATIO:
 Curettage – carried out only if appreciable bleeding persists or recurs after medical
management.
 Antibiotics – used only if uterine infection is suspected.
 Suction curettage – if large clots are seen in the uterine cavity with sonography.
 Uterotonics: oxytocin is used if the patient is stable and sonographic examination
shows an empty cavity.
63. What are the obstetrical factors that can cause urinary incontinence?
A. length of 2nd stage of labor
B. infant head circumference
C. birthweight
D. AOTA
RATIO:

64. Which of the following hematological changes in the puerperium is abnormal?
A. WBC count sometimes reaches 30,000/uL
B. relative lymphophenia
C. absolute eosinophenia
D. Thrombocytopenia
RATIO:
65. TRUE about weight loss in the puerperium:

A. loss of 2 to 3 kg due to uterine evacuation and blood loss
B. loss of 5 to 6 kg due to uterine evacuation and blood loss
C. loss of about 4 to 5 kg through dieresis
D. loss of about 5 to 6 kg through dieresis
RATIO:
66. Marked separation of rectus abdominis is called:

A. diastasis recti
B. lineanigra
C. striaegravidarum

RATIO:
67. Compared with mature milk, colostrums is richer with this/these component/s,
which protects the newborn against enteric pathogens.
A. Mineral and amino acids
B. Essential fatty acids
C. Immunoglobulin A
D. AOTA
RATIO:

68. A 25 y/o G1P1, on her 2nd postpartum day, is very anxious because she’s still not
lactating. She complained that her breasts are engorged and tender. Her last attempt
to nurse her baby is right after delivery. What is the BEST advice to give her?
A. Encourage her to regularly breastfeed and/or pump breasts
B. Reassure her that some women may not lactate immediately
C. Prescribe her with formula or infant milk
D. AOTA
E. A and B only
Ratio:

69. Women who do not breastfeed may expect their menstruation ______ after
A. 6-8 weeks
B. 10-12 weeks
C. 6-8 months
D. 10-12 months
RATIO:
70. A G3P3 delivered 2 months ago consulted for family planning. She has been
exclusively breastfeeding for 2 months. What contraception can be given to her at this
time?
A. Progestin-only contraceptives
B. Combined oral contraceptive pills
C. Calendar method
Ratio:
caramelmachiato trans. Puepuerium P.4

71. Postpartum blues is likely theresult of several factor/s:
A. Emotional letdown following excitement and fears during pregnancy
B. Fatigue from loss of sleep during labor and postpartum
C. Anxiety over ability to provide appropriate care for new baby
D. AOTA
RATIO:
72. Advantages of EARLY ambulation include/s:

A. Less bladder complications
B. Improved bowel function
C. Increased thromboembolic events
D. AOTA
E. A and B only
RATIO:

73. A G1P1, who recently underwent Cesarean section, is on her 3rd unremarkable
post-op day. According to the American College of Obstetricians and Gynecologists,
when is the BEST TIME to discharge her from the hospital?
A. 12 hours
B. 24 hours
C. 48 hours
D. 96 hours
RATIO:
74. Which of the following vascular supply of the endometrium is responsive to

hormonal influence?
A. Spiral
B. Arcuate
C. Radial
D. Straight
RATIO:
WILLIAMS OBSTETRICS 24th Edition, P.28
The spiral arteries supply the functionalis layer. These vessels respond – especially by
vasoconstriction and dilatation – to a number of hormones and thus serve as an
important role in menstruation. Also called, the straight arteries, the basal arteries
extend only into the basalis layer and are not responsive to hormonal changes.
75. This is homologous to the male gubernaculums testis:

A. Round ligament
B. Uterosacral ligaments
C. Mackenrodt ligaments
D. Broad Ligaments
RATIO:
WILLIAMS OBSTETRICS 24th Edition
The round ligament corresponds embryologically to the male gubernaculums testis
(Acién, 2011). It originates somewhat below and anterior to the origin of the fallopian
tubes. Clinically, this orientation can aid in fallopian tube identification during
puerperal sterilization. This is important if pelvic adhesions limit tubal mobility and
thus, limit fimbria visualization prior to tubal ligation.

76. Of the 2 million oocytes in the human ovary present at birth, approximately how
many are present at puberty?
A. 200,000
B. 300,000
C. 400,000
D. 500,000
RATIO:
77. Which of the following is the endometrial layer that is shed with every menstrual
cycle?
A. Basalis
B. Decidual
C. Functionalis layer
D. Luteinized layer
RATIO:

78. The recommended dose of folic acid is ___________ per day, taken preconceptionally
to prevent or decrease the incidence of neural tube defects.
A. 400 ug
B. 300 ug
C. 200 ug
D. 100 ug
RATIO:
79. The respiratory tract change/s in pregnancy is/are:

A. the diaphragm rises about 4 cm
B. thoracic circumference increases by 6 cm
C. subcostal angle becomes narrow
D. A and B
E. B and C
RATIO:

80. Which of the following is/are seen in pregnancy:
A. gallbladder contractility is increased
B. increase in the liver size
C. the appendix is displaced upward and lateral
D. shortened gastric emptying time
RATIO:
WILLIAMS OBSTETRICS, 24th Edition
The appendix, for instance, is usually displaced upward and somewhat laterally as the
uterus enlarges. At times, it may reach the right flank.
81. In a normal term pregnancy, if the weight of the baby is 3000 gms, what is the
weight of the placenta in grams?
A. 300
B. 500
C. 700
D. 900
Ratio: Placental Growth & Maturation by Pacis, p. 1
3000g x 1/6 = 500g
82. When oxygen is needed by the fetus, where will it pass?

A. Umbilical arteries
B. Umbilical vein
C. spiral veins
D. uterine vein
RATIO:
Umbilical arteries – deoxygenated blood
Umbilical vein – oxygenated blood

83. Human chorionic gonadotropin takes over progesterone secretion from the corpus
luteum by the:
A. 8th day after ovulation
B. 6th day after ovulation
C. 5th day after ovulation
D. 4th day after ovulation
RATIO: From Lecture

Corpus luteum continues progesterone production in response to embryonic human
chorionic gonadotropin, which binds to the same receptor as LH after the 8th day of
ovulation. Plussamplexito I think from prelims 
84. Human chorionic gonadotropin is mainly synthesized in:
A. Cytotrophoblast
B. Syncitiotrophoblast
C. Decidual cells
D. Amniotic epithelium
RATIO:
85. This finding, seen by 4 to 5 weeks of gestation, is the first sonographic evidence of
pregnancy.
A. cardiac activity
B. intradecidual sign
C. gestational sac
D. crown rump length
RATIO:

86. A woman presents for check up on October 30, 2015. Her last menstrual period
was July 10, 2015. What is the expected date of delivery?
A. February 17, 2016
B. March 17, 2016
C. April 17, 2016
D. May 17, 2016
RATIO:
87. What is the complete obstetrical score if a woman’s obstetrical history includes 1
child born alive at term, a set of twins born prematurely with one of them stillborn, no
miscarriages nor ectopic pregnancies?
A. G2P2 (1203)
B. G2P3 (1203)
C. G2P2 (1202)
D. G2P2 (1203)
RATIO: Answer: G2P2 (1202)

Gravida: 2 (How many times patient conceived a.k.anabuntis)
Parita: 2 (How many times the patient gave birth a.k.ananganak)
Term - 1
Preterm – 2
Abortus - 0
Alive – 2
88. Yellowish-brown discoloration of deciduous teeth is associated with intake of this

drug?
A. Chloramphenicol
B. Tetracycline
C. Sulfonamides
D. Metronidazole

RATIO:
89. Grey baby syndrome is caused by:

A. Doxycycline
B. Chloramphenicol
C. Metronidazole
D. Ciprofloxacin
RATIO:
90. A woman with severe cystic acne lesions has been taking Isotretinoin for 6
months. She and her husband want to have children already. What is the BEST advise
to the couple?
A. Discontinue isotretinoin and plan pregnancy 1-2 months after
B. She can get pregnant anytime
C. Isotretinoin is not associated with high pregnancy loss
D. Switch to a topical preparation and plan pregnancy
RATIO:
91. Which of the following immunoglobulins can pass through the placenta?
A. IgG
B. IgA
C. IgD
D. IgE
E. IgM

RATIO:
92. Organogenesis takes place:

A. from fertilization to the 1st 8 weeks of life
B. from 9th to 12th week of life
C. from 13 to 24 weeks
D. beyond 24 weeks
RATIO:
93. The surface tension reducing component of lung surfactant is:

A. Phosphatidyl glycerol
B. Dipalmitoylphosphatidyl choline (DPPC)
C. Phosphatidyl ethanolamine
D. Phosphatidyl choline
RATIO:

94. In a contraction stress test (CST), contractions are induced with:
A. Dilute oxytocin IV infusion
B. Nipple stimulation
C. rubbing uterus
D. A and B
E. B and C
95. A Gravida 3 Para 2 (2002) at 41 weeks AOG was admitted for induction of labor.
On IE, cervix was soft, closed intact bag of waters, cephalic floating. Contraction stress
test was done which revealed the tracing below. Interpret the result:
A. Positive
B. Negative
C. Equivocal

96. On ultrasound of a patient with bilateral renal agenesis, the amniotic fluid volume
by the 4 quadrant technique will likely be:
A. Normal
B. Decreased
C. Increased
D. Unchanged
Ratio:
Bilateral Renal agenesis
- Remember mostly of the amniotic fluid volume in the late phase is composed of
fetal urine. With the absence of the fetal kidneys, there would be no production
of urine from the fetus thus leading to a decrease in the amniotic fluid volume
4 Quadrant Technique
- This technique is used to measure the AFI (Amniotic Fluid Volume)
Causes of Low Amniotic Fluid
- Leaking or rupture of membranes  PROM
- Placental Problems
- Renal defects Bilateral Renal Agenesis
- Maternal complications  DM, Hypertension, Dehydration, Pre-eclampsia,
Chronic hypoxia
97. Type of fetal heart rate deceleration of above tracing:

A. Early
B. Variable
C. Late
D. Prolonged

98. The MOST common cause of fetal tachycardia is:
A. Maternal fever
B. Fetal compromise
C. Cardiac arrhythmias
D. Sympathetic medications

99. Doppler velocimetry has proven to be of benefit in which of the following
conditions?
A. Fetal hypoxia
B. Fetal distress
C. Growth restriction
D. Pre-eclampsia
DOPPLER VELOCIMETRY
• Used to determine the volume and rate of blood flow through maternal and fetal vessels
• Systolic–diastolic ratio (S/D ratio)- Compares maximum (peak) systolic flow with end-diastolic
flow, thereby evaluating downstream impedance to flow
ABNORMAL:
• If the S/D ratio is above the 95th percentile for gestational age.
• In extreme cases of growth restriction, end-diastolic flow may become absent or even reversed
100. Which of the following is NOT a component of standard ultrasound examination

in the third trimester?
A. Fetal number
B. Presentation
C. cardiac activity
D. measurement of nuchal translucency
Fetal Nuchal Translucency

• the maximum thickness of subcutaneous translucent area between
• the skin and soft tissue overlying the fetal spine at the back of the neck

• between 11-14 weeks (First trimester)
101. Which of the following is a complication of amniocentesis?

A. fetal growth restriction
B. infection
C. oligohydramnios
D. pulmonary hypoplasia
Complications if Amniocentesis: transient vaginal spotting or amnionic fluid leakage and chorioamnionitis
102. Which of the following conditions will MOST require alpha-fetoprotein screening?
A. Diabetes mellitus
B. History of neural tube defect in the family
C. History of Trisomy 21 in the family
D. Multiple pregnancy
DIAGNOSTIC TESTS
Diagnostic tests are offered to the following:
• Women with abnormally elevated serum AFP levels
• with certain RISK FACTORS and NORMAL AFP levels
Risk factors include:

• A personal history of NTD
• A first-degree relative with NTD
• Insulin-dependent diabetes
• First-trimester exposure to medication associated with increased NTD risk
103. 2nd stage of labor

104. Phase of maximum slope
105. Latent phase


A. Paracervical Block C. Give Spinal Block D. Pudendal Block

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OB 3A FINALS RATIO 2015 (November 5, 2015)

Obstetric Anesthesia & Analgesia by Pacis, pp. 6-7

William’s Obstetrics, 24th Edition, p. 508

PHYSIO OB FINALS 2015 1 | P a g e

Obstetric Anesthesia & Analgesia by Pacis, p. 8

Ratio: Obstetric Anesthesia & Analgesia by Pacis, pp. 5-6

PHYSIO OB FINALS 2015 2 | P a g e

Obstetric Anesthesia & Analgesia by Pacis, p. 2

Obstetric Anesthesia & Analgesia by Pacis, p. 2

PHYSIO OB FINALS 2015 3 | P a g e

A. Fasting for at least 8 hours

Obstetric Anesthesia & Analgesia by Pacis, p. 5 & 9

Ratio: Bony Pelvis by Pacis, p. 1

PHYSIO OB FINALS 2015 4 | P a g e

Bony Pelvis by Pacis, p. 2 & 4

Ratio: Bony Pelvis by Pacis, p. 5

PHYSIO OB FINALS 2015 5 | P a g e

Bony Pelvis by Pacis, p. 5

Ratio: Bony Pelvis by Pacis, p. 6

PHYSIO OB FINALS 2015 6 | P a g e

A. Obstetric conjugate = 10-11 cm

Bony Pelvis by Pacis, p. 5

Ratio: (MUST KNOW)

Bony Pelvis by Pacis, p. 7

PHYSIO OB FINALS 2015 7 | P a g e

Gynecoid Pelvis: Suited for

Bony Pelvis by Pacis, p. 7

A. The head is engaged

Ratio: Bony Pelvis by Pacis, pp. 7-8

PHYSIO OB FINALS 2015 8 | P a g e

A. Greatest transverse diameter of the inlet 12 cm

Bony Pelvis by Pacis, pp. 5-6

Identify the phase of parturition in the following (MUST KNOW PICTURE)

PHYSIO OB FINALS 2015 9 | P a g e

Physiology of Labor by Pacis, p. 2

Identify the stage/phase of labor of the following (MUST KNOW)

A. First stage, latent phase

PHYSIO OB FINALS 2015 10 | P a g e

24) Which of the following is/are true of Braxton Hicks Contractions?

A. Earliest sign of labor

Physiology of Labor by Pacis, p. 1

PHYSIO OB FINALS 2015 11 | P a g e

Not in Preterm Labor

Conduct of Normal Labor & Delivery by Pacis, p. 11-12

26) What is second stage of labor?

A. Regular uterine contractions to 4 cms cervical dilatation

Ratio: Conduct of Normal Labor & Delivery by Pacis, p. 9

PHYSIO OB FINALS 2015 12 | P a g e

A. Retroplacental hematoma forms & pushes the center

Physiology of Labor by Pacis, p. 8

28) How is postpartum hemorrhage prevented in the phase 4 of parturition?

A. Maintain myometrium in a state of rigid & persistent contraction & retraction

Physiology of Labor by Pacis, p. 9

PHYSIO OB FINALS 2015 13 | P a g e

A. An hour after delivery of the baby

William’s Obstetrics, 24th Edition, p. 668

30) Which group of agents is theorized to initiate phase 3 of parturition?

Ratio: Physiology of Labor by Pacis, p. 17

PHYSIO OB FINALS 2015 14 | P a g e

Physiology of Labor by Pacis, p. 15

Physiology of Labor by Pacis, p. 17

PHYSIO OB FINALS 2015 15 | P a g e

Physiology of Labor by Pacis, p. 4