OBSTETRICS 10.
A 28-year old Gravida 2 Para 2 diagnosed case of
Preliminary Examinations
AY 2015 – 2016, First Semester
1. What is the period from the 20 weeks age of
gestation to 28 days post-partum?
PERINATAL PERIOD
2. What is the product of fertilization after the 4th
week called?
EMBRYO
3. A 24-year old woman delivered at 37 weeks of
gestation to a baby boy with an APGAR score of
3, weighing 1680 grams who died after 4 hours.
What are the terms that will apply to this case?
TERM, SMALL-FOR-GESTATIONAL AGE
4. The baby in number 3 is a:
EARLY NEONATAL DEATH
5. The mother in number 3 developed high-grade
fever on the 4th day post-partum and was found to
have endometritis and pelvic thrombophlebitis and
died of septicemia on the 8th day post-partum. The
death of this woman is considered as:
DIRECT MATERNAL DEATH
6. The number of still births PLUS the number of
neonatal deaths per 1000 live births is:
PERINATAL MORTALITY RATE
7. What is the number 1 cause of maternal death
worldwide:
HEMORRHAGE
8. What is the most significant cause of neonatal
morbidity:
LOW BIRTH WEIGHT
9. Which of the following increase with decrease in
birth weight?
ALL OF THE ABOVE: RESPIRATORY
DISTRESS, SEPTICEMIA, ENTEROCOLITIS
RHD with MS/MR was admitted at 38 weeks with
advanced labor. She had assisted vaginal delivery
under epidural anesthesia but died soon after
heart failure. What will be the classification of this
maternal death?
INDIRECT MATERNAL DEATH
11. At times, this organ is excluded from the pelvic
organs:
VAGINA
12. Which of the following structures is covered partly
by adventitia?
VAGINA
13. Which of the following structures join the uterus
antero-superiorly?
FALLOPIAN TUBES
14. Placed on each side at the lower part of the vagina
is which structure?
SKENE’S GLANDS
15. The uterus is anchored by several ligaments and
this keeps it in place and ante-flexed. Which
ligament is this?
ROUND LIGAMENT
16. In doing hysterectomy, which of the following
ligaments would you be careful as not to cut and
ligate the ureter?
TRANSVERSE LIGAMENT
17. Which of the following statements is correct
regarding the uterus?
THE INTERNAL OS DIVIDES THE UTERUS
INTO THE CORPUS AND THE CERVIX.
18. This structure may be injured with severe
consequence when damaged by surgery.
URETER
19. Which of the following structures lies at the floor of
the fossa ovarica when doing oophorectomy?
OBTURATOR NERVE
20. The ovary drains into which of the following
nodes?
PARA-AORTIC NODES
21. When does recruitment occur in the monthly
menstrual cycle?
DEMISE OF THE CORPUS LUTEUM WITH THE
RISE IN THE FSH LEVELS
22. In the absence of pregnancy, the human corpus
luteum regresses after how many days post-
ovulation?
9-11 DAYS
23. Which of the following is the first sign of ovulation 36. At what day of the menstrual cycle is the epithelial
that is histologically evident? surface of the endometrium is restored and
GLYCOGEN ACCUMULATION ON THE BASAL vascularization is in progress?
PORTION OF THE GLANDULAR EPITHELIUM DAY 5
AND PSEUDOSTRATIFICATION
37. The pre-ovulatory endometrium is characterized
24. What phase of the menstrual cycle is by:
characterized by low inhibin levels? PROLIFERATION OF GLANDULAR, STROMAL,
EARLY FOLLICULAR PHASE AND VASCULAR ENDOTHELIAL CELLS

25. Which hormone is required for the late stage 38. Serrated, dilated glands with intraluminal
development of the antral follicles? secretions are lined by short columnar cells. This
FOLLICLE STIMULATING HORMONE describes what phase of the menstrual cycle?
LATE SECRETORY PHASE
26. Which stage of folliculogenesis is marked by its
increased sensitivity to FSH, ability to produce 39. What is the level of inhibin A during the
high concentration of estrogen, as well as its ability development of a mature corpus luteum?
to modulate gonadotropin secretion? 100 PG/ML
SELECTION
40. This endometrial layer contacts the avascular
27. Which of the following describes the endometrium extraembryonic fetal membrane internally:
of late proliferative phase? DECIDUA CAPSULARIS
ENDOMETRIAL THICKNESS FROM BOTH
GLANDULAR HYPERPLASIA AND 41. This decidua is directly beneath the blastocyst
INCREASED STROMAL GROUND implantation and this is modified by trophoblast
SUBSTANCE WHICH IS EDEMA AND invasion:
PROTEINACEOUS MATERIAL DECIDUA BASALIS

28. Luteinization of granulosa and theca cells with 42. Fragmented endometrium with condensed stroma
increased production of progesterone is and glands with secretory vacuoles describe what
stimulated by? phase of the menstrual cycle:
LH SURGE MENSTRUAL PHASE

29. In ovulation, the nucleus of the secondary oocyte 43. The period of regression in the menstrual cycle is:
begins the second meiotic division that progresses MENSTRUAL PHASE
and is arrested at?
METAPHASE 44. It is the key to both endometrial and extracellular
matrix breakdown and repair of the functionalis
30. At what day of the menstrual cycle will the single layer:
follicle rupture and form the corpus luteum? LEUKOCYTE INFILTRATION
BETWEEN 5-7 DAYS
45. A 22-year old Gravida 1 Para 1 with a regular 28-
31. When is estrogen found to be lowest in the ovarian day cycle is not on any contraceptive. Her LMP is
menstrual phase? on July 3. If she is now pregnant, her product of
EARLY FOLLICULAR PHASE conception at this stage will be a:
MORULA
32. Which of the following is dependent on
gonadotropin? 46. At this above stage, the product of conception is
ANTRAL FOLLICLE found to be:
ENTERING THE UTERINE CAVITY
33. It is the source of endometrial regeneration after
each menstruation: 47. Between days 5 to day 7, the product of
DECIDUA BASALIS conception has the following features:
THE ZONA PELLUCIDA HAS DISAPPEARED.
34. At day 27 of the endometrial cycle, which layer of
the endometrium is deprived of blood supply due 48. In this type of placentation, there is a great
to the coiling of the arteries which lead to necrosis challenge to the immune system to avoid rejection
and sloughing of this layer? of the fetus.
FUNCTIONALIS LAYER HEMOCHORIAL PLACENTATION
35. Which is the most important factor in endometrial
recovery after each menstruation?
FOLLICULAR PHASE ESTROGEN
PRODUCTION
49. In human placentation, the following statement is
TRUE:
THE MATERNAL BLOOD BATHES THE OUT
SYNCYTIOTROPHOBLASTS TO ALLOW
EXCHANGE OF GASES AND NUTRIENTS WITH
THE FETAL CAPILLARY BLOOD WITHIN THE
CONNECTIVE TISSUE AT THE VILLOUS CORE.
50. The chorionic villi at the embryonic pole will
become the:
DECIDUA BASALIS
51. The chorionic villi that allows extraordinary
communication between the mother and the fetus
thus leading to maternal immunologic acceptance
of the conceptus is:
CHORION LAEVE
52. If your patient is 6 – 7 days pregnant, you expect
the following to be true:
IT NOW HAS 8 EMBRYO PRODUCING CELLS.
53. The following must be secreted to allow embryo
hatching which is critical to a successful
pregnancy:
LEUKEMIA INHIBITING FACTOR AND
COLONY STIMULATING FACTOR 1 ARE ALSO
SECRETED BY THE RECEPTIVE
ENDOMETRIUM TO ALLOW TROPHOBLAST
INVASION.
54. Uterine receptivity is limited to these days:
DAY 20 – 24
55. Knowing that the blastocyst implantation is divided
into phases: apposition, adhesion, and invasion,
which CAM expressed is considered the marker of
receptivity of blastocyst attachment?
B3 AND B41 INTEGRINS
56. The unique glycopeptide plays a critical role in
migration and attachment of trophoblasts to
maternal decidua:
FETAL-SPECIFIC FIBRONECTIN
57. For the invasiveness of the implanting blastocyst:
MMP-9
58. During the morula stage this is the first to
differentiate and is the beginning of the formation
of the human placenta:
TROPHOECTODERM
59. Eight (8) days post fertilization or after initial
implantation this trophoblast will be the primary
secretory component within the placenta:
CYTOTROPHOBLAST
60. After complete implantation this trophoblast
becomes the chorionic villi acting as the primary
transporter of oxygen and nutrients between the
fetus and the mother:
VILLOUS TROPHOBLAST
61. To ensure the optimal growth of the gestation, the
placenta takes over which of the following
functions?
ALL OF THE ABOVE (SECRETION OF
HORMONES, REGULATION OF ENERGY,
MODIFICATION OF THE MATERNAL IMMUNE
RESPONSE)
62. What is the main source of progesterone synthesis
in the placenta?
MATERNAL LDL CHOLESTEROL
63. What hormone is responsible for successful
implantation and maintenance of pregnancy?
PROGESTERONE
64. Which of the following hormones is/are
responsible for immunity, the T lymphocyte
mediated tissue rejection and confer immunologic
privilege to the developing conceptus?
ALL OF THE ABOVE
65. Prevention of smooth muscle contraction and
maintenance of uterine quiescence so that
premature labor does not occur is a function of
which hormone?
PROGESTERONE
66. Placental estrogen synthesis is markedly
decreased in which of the following conditions:
INTRA UTERINE FETAL DEATH
67. A 24 year old gravid 1 para 0 was admitted on her
7th week of gestation for severe right lower
quadrant pain. An 8cm complex right adnexal
mass was seen on trans-vaginal ultrasound. At
laparotomy, it turned out a gangrenous twisted
right ovarian mass. Right oophorectomy was done
and cut section of the ovary removed showed
smooth internal surface filled with blood clots and
corpus luteum. What is the possible complication
of this patient?
ABORTION
68. Which of the following statements regarding HCG
is/are true?
HCG STIMULATES PRODUCTION OF
PROGESTERONE BY CORPUS LUTEUM IN
EARLY PREGNANCY
69. Which of the following hormones is most
responsible for the provision of enough nutrition for
the developing fetus and reaches the highest level
at term among placental hormones?
HUMAN PLACENTAL LACTOGEN
70. Placental growth hormone gradually raises the
maternal growth hormone in the maternal
circulation starting at what age of gestation?
20 WEEKS
71. If your patient, a 20 year old gravida 1 para 0, has 83. This protein found in the syncytiotrophoblast is
regular 28 day cycles and her LMP is January 30, responsible for the sequestration of heavy metals
2015, when is her expected day of confinement? like zinc, copper, cadmium or lead:
NOVEMBER 6, 2015 METALLOTHIONEIN 1

72. When is the best time to order an ultrasound to 84. Gender ratio is approximately 106 males: 100
your patient: females. This is explained by:
BETWEEN MARCH 30, 2015 TO APRIL 24, 2015 COUPLES WITH LARGE AGE DISCREPANCY

85. Effects of pregnancy are not fully reversed until:

73. Another patient with the same LMP as above, 8 WEEKS AFTER DELIVERY
comes to you. She is 30 year old gravida 3 para 0
(0110). With your knowledge of fetal growth and 86. The uterus is out of the pelvis in how many weeks?
development, when is the best time to request for 12 WEEKS
another ultrasound to your patient:
BETWEEN JUNE 13, 2015 TO JULY 24, 2015 87. What would be the maternal response to
starvation?
74. The product of conception is termed as an embryo HYPOLIPEDEMIA
when:
WHEN IT HAS DEVELOPED ITS CHORIONIC 88. With regards to cardiovascular changes during
VILLI IN THE EARLY STAGE OF pregnancy, this statement is correct:
PREPLACENTAL DEVELOPMENT THE PULSE RATE REMAINS NORMAL AT
TERM.
75. At the end of 4 weeks after ovulation, the embryo
is expected to have the following development: 89. The following are changes in the respiratory
THE AMNION BEGINS TO ACHIEVE THE BODY system EXCEPT:
STALK TO BECOME THE UMBILICAL CORD FUNCTIONAL RESIDUAL CAPACITY

76. Your patient, who is at the end of her first trimester 90. These are changes in the GIT during pregnancy
asks you how you can describe the development EXCEPT:
of her baby now: INCREASED ESOPHAGEAL SPHINCTER
THE SKIN AND NAILS HAVE DEVELOPED TONE

77. At this age of gestation of the fetus, the canalicular 91. During the 1st trimester, the weight gain must not
period of lung development is nearly completed: exceed this amount:
AT 24 WEEKS AOG 2 LBS

78. This fontanel is formed at the intersection of the 92. A pregnant woman needs how many calories per
sagittal and the lambdoid sutures and it is day?
important for the diagnosis of the presentation 2200 CALORIES PER DAY
position:
THE LESSER FONTANELLE 93. Who among these candidates does not need pre-
conceptual counseling?
79. This is the greatest transverse diameter of the fetal A WOMAN WHO HAD AN ABORTION
head that must pass through the different planes
of the pelvic canal: 94. The most optimal time to seek counsel in planning
THE BIPARIETAL DIAMETER to get pregnant is:
3-6 MONTHS PRIOR TO INTENDED
80. Greatest circumference of fetal head: PREGNANCY
OCCIPITOFRONTAL DIAMETER
95. In the carrier screening for genetic diseases, which
81. Substances from the mother to the fetus are of the following is not included?
transferred through the maternal interface making EPILEPSY
sure there is no direct communication between
fetal blood and maternal blood. This is responsible 96. Alcoholic intake has an adverse effect if you take
for the active and passive control and facilitates this amount of alcohol:
transfer of substances to the fetus: >10 GRAMS
SYNCYTIOTROPHOBLAST
97. Which of the following is not an adverse effect of
82. This HMW substance crosses the placenta in large excessive alcohol intake?
amounts by endocytosis via trophoblast Fc STILLBIRTH
receptors:
IgG
98. The number of cigarettes you smoke per day
determines the adverse effect if you smoke this
much:
10 STICKS

99. The recommended folic acid intake per day is:

400 MCG

100. A woman with this BMI increases the risk

for neonatal death and preterm delivery:
>30 BMI