OB FEEDBACK 2ND SEM PRELIMS (S.Y.

2015-2016)
1. A 24 year old at 38 weeks AOG, in active labor. Her cervix is 5 cm dilated. this is one of the factors
that would have an effect on her labor :a. DEGREE OF CERVICAL RESISTANCE- bec she is still in
the active phase of labor

2. The above pt’s labor progress: after 5 hrs, her cervix is fully dilated, 100 percent effaced, cephalic
presentation, at station 0. At this stage, this factor will determine if the pt will deliver vaginally: D.
FETO-PELVIC PROPORTION

3. This factor causing dystocia is closely related to feto-pelvic disproportion: B. UTERINE

DYSFUNCTION

4. A 28 year old G4P3 40 weeks AOG is admitted for labor at 8 pm. Her cervix is 2 cm dilated, 60
percent effaced cephalic in presentation at station -3. After several hrs her contractions were mild to
moderate intensity and on repeat pelvic exam findings remained the same. Throughout the night she
slept with minimal complaints. Her repeat pelvic exam on 12 nn she had the same results. This is
diagnosed as: C. PROLONGED LATENT PHASE- bec she is only at 2cm. she is still at the latent
phase. CS is not done if the pt is still at 2cm dilatation

5. Treatment for above condition is: a. BEDREST

6. An 18 year old G1P0 39 weeks AOG admitted d/t active labor. Initial exam showed her cervix to be 5
cm dilated, 80 percent effaced, vertex presentation, station -2 and intact BOW. After 2 hrs, she
progressed 6 cm dilatation with the rest of the findings remaining the same. Her uterine contractions
remained regular moderate to severe intensity. After another 2 hrs her cervix is still 6cm, her
contractions slowed down a bit and became lesser. Her BOW was ruptured with clear amniotic fluid.
She was examined an hour later and her cervix was at 7-8cm with head at station 0. This is dx as: D.
FAILURE IN DESCENT- the head of the baby has not gone beyond station 0 in the deceleration
phase at first stage of labor. If the mother reached 2nd stage of labor and the head was at lower
stations but did not progress, that is diagnosed as arrest.

7. Characteristic of hypotonic uterine dysfunction: A. NO BASAL HYPERTONUS- when you look at the
tracings there is no increase in basal pressure

8. Criteria for the dx of arrest in cervical dilatation- a. COMPLETED LATENT PHASE

9. If the pt has 5 contractions in a 10 min window and the readings in the pressure difference is as
follows: 40-35-40-35-40, base line tonus is at 10, this means: ADEQUATE UTERINE
CONTRACTIONS- add all the 10 min window contraction window(40+35+40+35+40=190 montevideo
units), if >180 montevideo units, it is adequate

10. During the second stage of labor, this is also impt for dystocia not to occur: A. FETAL DESCENT
MUST OCCUR

11. After this # of hours and as long as external and fetal conditions permit, prospects of spontaneous
delivery is only 10-15 %: d. 5 HOURS
12. A concluded cause of uterine dysfunction: a. EPIDURAL ANESTHESIA

13. Prolonged sitting or squatting during 2nd stage of labor could lead to: B. PERINEAL NEUROPATHY

14. If the Diagonal Conjugate is less than 11.5: c. CONTRACTED PELVIC INLET

15. If on palpation the fetal head is found on left iliac fossa and the breech on the right iliac fossa the pt
must be checked for ff except: C. OLIGOHYDRAMNIOS

16. If 2 fingers are placed over the posterior aspect of posterior shoulder and forward pressure is applied,
what maneuver is applied for shoulder dystocia:c. REVERSE CORKSCREW MANEUVER

17. This maneuver results to cephalad rotation of the symphysis pubis and flattening of the sacrum: c.
MCROBERTS MANEUVER

18. Persistent occiput posterior and transverse arrest are results of failed and arrested: c. INTERNAL
ROTATION

19. In occiput transverse position, transverse position may persist and with further descent the head may
end up in deep transverse arrest in w/c of the ff pelvis: c. PLATYPELLOID

20. To favor flexion and engagement of the head in breech delivery one must do the ff: b. APPLY
SUPRAPUBIC PRESSURE

21. During vaginal exam you palpated anterior fontanelle, frontal suture, orbits, nasal bridge what is the
presentation: BROW PRESENTATION

22. Cephalic replacement by reversing cardinal movts in shoulder dystocia is: C. ZAVANELLI
MANEUVER

23. If the occiput is higher than the level of sinciput, what is the presentation: BROW

24. In partial breech delivery which of the ff maneuver is helpful in delivering the legs of the fetus:
PINARDS MANEUVER

25. Changing the relationship of bisacromial diameter within the pelvis is accomplished by applying: c.
ENTER MANEUVER

26. To dislodge the shoulder by gravitational force: d. GASKIN

27. Which of the ff is incorrect with regards to amniotic fluid: c. IT IS GENERATED FROM FETAL
PLASMA

28. By term the fetus produces this amt per day: 500-700 ML/DAY

29. Production and absorption of amniotic fluid is balanced by several means and one of them is
absorption thru the skin.when does it begin: c. 20 WEEKS

30. Where is the primary source of elimination of AF: FETAL SWALLOW

31. AF is impt at birth and this time, AF is at this amt: 1000ML

32. If the amt of AF is decreased the pt is said to have oligohydramnios. It is defined to be having this amt
of AF: LESS THAN 200ML

33. In order to say that AF is within normal amt, utz findings must reveal the largest pocket fluid to be: 1cm
34. It is routinely done to examine the placenta after delivery. This finding in the placenta is assoc with
oligohydramnios: c. PLACENTA NODOSUM

35. Most plausible cause for oligohydramnios: d. RENAL AGENESIS

36. Hydramnios is a concern. It is most often linked to: a. GIT MALFORMATION

37. In cases of hydramnios, which of the ff condition is most likely to happen first during delivery: CORD
PROLAPSED

38. In order to diagnose hydramnios based on utz, the deepest pocket of fluid must be: 8 CM

39. Among women whose labor has been induced,this condition is common: CHORIOAMNIONITIS

40. This bishop score indicates cervix is unfavorable and ripening of the cervix is need for induction: a. 4

41. A 29 year old G1P0 42 weeks AOG has the following pelvic exam result: Cervix is 1-2 cm dilated, 80%
effaced, soft in consistency, posteriorly located, cephalic presentation, station -2. Your bishop score
will be? B. 7

42. Because of the above result, you can conclude the following?
C. SHE HAS A LOW BISHOP SCORE AND THE RATE OF SUCCESSFUL INDUCTION DECREASES

43. Contraindications to prostaglandin use will be?

B. ASTHMA

44. While inducing labor, your patient develops prolonged uterine contraction lasting for more than 2
minutes. This was followed by late decelerations after each contraction. This side effect is called?
C. UTERINE HYPERSTIMULATION

45. This mechanical method of cervical dilatation has long been used successfully when employed prior
pregnancy termination or abortion?
C. LAMINARIA INSERTION

46. Discontinuation of oxytocin rapidly decreases frequency of uterine contraction because?

B. THE MEAN HALF-LIFE OF OXYTOCIN IS APPROXIMATELY ONLY 5 MINUTES

47. Oxytocin dosage at or above this level, the likelihood to progression to vaginal delivery decreases
A. 36 MU/MIN

48. To avoid this effect of oxytocin when used for a considerable length of time, it is recommended to use
a more concentrated oxytocin solution
D. WATER INTOXICATION

49. After delivery, clearing of residual fluid thorugh the pulmonary circulation and through the pulmonary
lymphatic is delayed. This can occur in the normal newborn
B. TRANSIENT TACHYPNEA

50. The newborn usually has increased frequency and magnitude of breathing movements before and
after birth because of
C. OXYGEN DEPRIVATION AND CARBON DIOXIDE ACCUMULATION

51. At around this time, normal mature newborns pressure volume changes and are very similar with the
adult by the
B. 5TH BREATH

52. To prevent the lungs from collapsing, the following must occur
B. SURFACTANT MUST LOWER ALVEOLAR SURFACE TENSION

53. Characteristics of secondary apnea which differentiates it from primary apnea would be?
A. NEONATES WILL NOT RESPOND TO STIMULATION WITH SECONDARY APNEA

54. The following basic measures are important for well being of the newborn, except?
B. GASTRIC ASPIRATION

55. With stimulation, this is true regarding a healthy newborn?

A. BREATHE WITHIN A FEW SECONDS OF BIRTH

56. If however, the newborn starts gasping, develops apnea and has a heart rate of <100 bpm beyond 30
seconds after birth; we must do the following
B. ASSIST THE VENTILATION OF THE NEWBORN AT 30-60 BPM

57. If the newborn does not show adequate response, the following conditions must be entertained?
D. ALL OF THE ABOVE

58. The correct pressure for the alveolar to expand without causing barotrauma for term infants?
A. 30-40 CM

59. If the heart rate of the newborn remains at 60 bpm despite adequate ventilation for 30 seconds, this
must be done
C. START CHEST COMPRESSIONS AT 3:1 COMPRESSION TO VENTILATION RATIO

60. Usual number of feeding for newborn is?

C. 8-12X DAILY AT 15 MINUTES PER EPISODE

61. If the newborn at birth has a heart rate of 110 bpm, irregular, slow respirations, some flexion of the
extremities, the APGAR score would be?
B. 6

62. This is the only type of cerebral palsy that can result from Acute Peripartum Ischemia
D. SPASTIC QUADRIPLEGIA

63. A 33-year-old multigravida was carried in the ER by her husband from a rushing taxi, he tells you that
his wife just delivered at home about 2 hours ago attended by a hilot. You noticed that the patient is
tachycardic, tachypneic, hypotensive with mental alteration. What is the possible estimated blood loss
associated with this hemodynamic effect?
B. 2000ML

64. Upon further examination of the patient in the above question, you see that there is a large mass
coming out at the vagina. What will your initial management be for this patient?
A. CALL FOR HELP
65. Which of the following risk factors may lead to trauma secondary to extended tear during CS?
B. INTERNAL PODALIC VERSION OF THE SECOND TWIN

66. A primigravid after a prolonged second stage of labor delivered via normal spontaneous vaginal
delivery. During the third stage of labor, the patient suddenly bled profusely with atonic uterus. Estimated
blood loss was 1 500ml. What will be the expected hemodynamic effect on the patient’s estimated blood
loss?
C. HEART RATE, PULSE PRESSURE DECREASED, FEAR, RESTLESSNESS

67. A multigravida underwent spontaneous vaginal delivery attended by a midwife. However, the
placental detachment failed to occur within 20 minutes, so a strong cord traction was done to deliver the
placenta. Afterwhich, the patient bled profusely and was transferred to your institution. Upon bimanual
examination, the fundus is not palpable at the hypogastric and can feel the uterine base crossing the
cervix and passing through the vaginal canal. You are thinking of uterine inversion. Based on your
examination, how will you classify the degree of the inversion?
B. SECOND STAGE

68. For the woman acutely bleeding, at what hematocrit should rapid blood transfusion begin?
B. 25

69.Type of compression suture wherein combined longitudinal and transverse sutures are place as a
series of ________ at the submucosa
C. The answer was not mentioned

70.Which of the following procedure for postpartum hemorrhage will serve to diminish pulsatile flow to the
pelvis?
A.INTERNAL ILIAC ARTERY LIGATION

71. In doing systematic pelvic devascularization for the management of uterine atony causing severe
postpartum hemorrhage, one will start with?
D. UTERINE ARTERY LIGATION

72. What is the recommended maximum dose of 15-

postpartum hemorrhage?
C. 8 DOSES

73. Upon delivery of the fetus, the placenta normally follows. What is the average length of time that the
placenta must be spontaneously expelled out?
B. 15 MINUTES

74. There are several complications that can arise from third stage of labor. Among the following
complications, which do you think is the most common?
B. UTERINE ATONY

75. Placental expulsion follows as a result of the following phenomena EXCEPT one:
D. APPLICATION OF FUNDAL PRESSURE (A. Spontaneous uterine contractions; B. Decreased
pressure from the developing retroplacental hematoma; C. Increased in maternal intraabdominal
pressure)

76. When everything had been done and settled, how long will you observe the patient closely?
A. BEFORE TRANSFERRING HER TO THE ROOM HALF HOUR POSTPARTUM (Dra. Belmonte will
re-check the answer)

77. These are several causes of primary postpartum hemorrhage, among which of the following causes is
the _________?
B. PLACENTAL SITE HEMORRHAGE
78. In the vaginal exam, diagnosis of traumatic hemorrhage, one of the following manifestations is a
characteristic?
D. PLACENTA IS DELIVERED

79. When giving blood on a postpartum hemorrhage patient, your main therapeutic goal is to maintain
hemoglobin at this level.
B. GREATER THAN 8

80. Most often, the cause of death in postpartum hemorrhage is?

C. SHOCK

81. A placenta is abnormal when a small accessory lobe develops in a membrane and has a vascular
connections. This is called
D. SUCCENTURIATE PLACENTA

82. A placenta described as having a fetal surface that presents as a central depression surrounded by
thickened grayish white ring is called
D. CIRCUMVALLATE PLACENTA

83. A placenta described having all the fetal membranes covered by functioning villi and the placenta
develops a thin membranous structure. This is called
C. MEMBRANOUS PLACENTA

84. The umbilical cord is said to be excessively long if it measures more than
D. 77CM

85. Short umbilical cord is said to be associated with adverse perinatal outcomes
D. FETAL DEATH

86. When the umbilical vessels separate from the cord substance before their insertion into the placenta.
This is called
A. FURCATE INSERTION

87. If you request for microscopic exam in cord infection and report said there is the presence of
multinucleated giant cell. This is pathognomonic of this infection
C. CYTOMEGALOVIRUS

88. A 32 year old G5P1A3 is 42 weeks pregnant. She is being induced of having regular, strong, uterine
contractions and is now 7cm dilated. All of a sudden, she complains of severe abdominal pain and goes
into shock. You suspect uterine rupture. If indeed she rupture her uterus, the most likely area of rupture
and direction of the rupture is
C. IMMEDIATE VICINITY OF THE CERVIX WITH A TEAR USUALLY TRANSVERSE OR OBLIQUE.

89. In cases of chronic placental separation, which begins early in pregnancy. This can lead to
B. OLIGOHYDRAMNIOS

90. This disease complicating pregnancy is usually associated with abruptio placenta
B. GESTATIONAL HPN WITH SUPERIMPOSE PREECLAMPSIA

91. This type of previa may deliver normally

C. LOW LYING PLACENTA

92. Abruption placenta is most common in this gestational age

C. 38-39 WEEKS AOG
93. This associated factor may increase the risk of placenta previa
A. CIGARETTE SMOKING

94. This cause of third trimester bleeding is closely related to placenta accreta
C. PLACENTA PREVIA

95. This cause of third trimester bleeding leading to severe blood loss is almost always associated with
DIC
B. ABRUPTIO PLACENTA

96. What embryonal abnormalities are commonly associated with a sac with absent structures
C. TRIPLOIDY

97. Which of the following is contraindicated with cerclage placement?

C. RUPTURE OF MEMBRANES

98. A 24 year old presents with 8 weeks amenorrhea and vaginal spotting. She claims that she
menstruates regularly. Pregnancy test was done with a positive result. Pelvic exam: cervix is closed,
uterus is slightly enlarged, no adnexal mass, no tenderness. Ultrasound revealed thickened endometrium.
What will be you next step for this patient?
B. REQUEST FOR SERUM B-HCG

99. An 18 year old patient G1P0 presents with 12 weeks amenorrhea and vaginal bleeding. There is
slight tenderness on the hypogastric area. On speculum exam, you noticed a tissue through an open
cervix. Pregnancy test was positive. What will your next step be?
C. DO VAGINAL ULTRASOUND

100. A patient with a pregnancy of 18 weeks gestation with leakage of amniotic fluid suddenly develops
fever, hypogastric pain, and foul smelling discharge. On physical exam, FHT of 167bpm, 38.7C, positive
pooling of amniotic fluids, cervix is noted to be 2cm dilated, small parts appreciated, uterus is enlarged
16-18 week size. No adnexal mass noted. What is the appropriate management for this patient?
A. START AUGMENTING LABOR AND EXPULSION

OB FEEDBACK 2ND SEM PRELIMS (S.Y. 2015-2016)