1. Which of the following is not diagnostic of severe preeclamsia?

a. increased serum creatinine

b. 1+ proteinuria
c. Thrombocytopenia
d. Elevated liver enzymes

2. Which artery is most often associated with vulvar hematoma?

a. uterine
b. cervical
c. femoral
d. pudendal..

3. What is the most common cause of uterine rupture?

a. previous uterine perforation
b. excessive oxytocin
c. manual manipulation
d. separation of a previous cesarean section scar

4. What is the important mechanism in the eficacy of internal aliac artery ligation?
a. ischemia
b. reduction in pulse/pressure
c. block of collateral circulation
d. all of the above

5. Which of the following is considered an abnormal 24 hours urinary protein?

a. >300 mg in 24 hours
b. 1 g in 24 hours
c. > 2 g in 24 hours
d. > 4 g in 24 hours

6. Which of the following is relatively reduced in women with preeclamsia?

a. renin
b. angiotensin II
c. aldosterone
d. all of the above

7. How is the pathophysiology of preeclamsia characterized?

a. vasodilatation
b. vasospasm
c. hemodilution
d. hypervolemia
8. Which of the following is true in pregnancy women?
a. Thromboxane is increased
b. Prostacyclin is reduced
c. Prostaglandin E2 is decreased
d. All of the above

9. Which of the following is not a major risk factor for rupture of the unscarred uterus?
a. oxytocin infusion
b. parity
c. prostaglandin E2 gel
d. age less than 15 years

10. Which of the following is considered a classical finding in uterine rupture?

a. increased vaginal bleeding
b. sharp, shooting pain
c. sudden increase in uterine contraction
d. sudden lost of fetal heart sound

11. What is the maternal febrile morbidity in a woman undergoing a trial of labor compared
to elective repeat cesarean section?
a. slightly increased
b. markedly increased
c. the same
d. decreased by one-half

12. Hemodynamically in preeclampsia, which of the following is true ?

a. myocontractility is usually impaired
b. the preload is normal or low in the absence of volume expansion
c. Hydralazine decreases cardiac output
d. As vascular resistence increases, so does cardiac output

13. How is magnesium toxicity treated?

a. calcium gluconate 1 g intravenously
b. calcium gluconate orraly
c. calcium gluconate and discontinue magnesium
d. dialysis

14. In severe preeclamsia with pulmonary edem, what immediate treatment should be given?
a. furosemide intravenously
b. digoxin
c. hydrochlorothiazide
d. fluid restriction
15. What is the most common presenting sign in women with abruptio placenta?
a. preterm labor
b. uterine tenderness
c. back pain
d. bleeding

16. Which compound is responsible for lysing fibrin?

a. thromboplastin
b. plasmin
c. prostacyclin
d. factor III

17. How can acute tubular necrosis following abrution be prevented?

a. cesarean section
b. volume replacement
c. furosemide
d. Swan-Ganz catheter.

18. What is the most common characteristic sign or symptom in women with placenta
previa?
a. abdominal fetal heart rate tracing
b. painful bleeding
c. painless bleeding
d. coagulopathy

19. How is magnesium excreated?

a. lungs
b. liver
c. kidney
d. gastrointestinal tract

20. Which of the following is not an indication of severe pregnancy-induced hypertension?

a. upper abdominal pain
b. oliguria
c. creatinine 0.6 mg/dl
d. fetal growth restriction

21. Of the following, which is not considered to be a predisposing factor tp preeclampsia?

a. family history of preeclampsia
b. multiple fetuses
c. renal transplantation
d. multiparity
22. Which of the following is the characteristic glomerular lesion of preeclampsia?
a. Endotheliosis
b. capillary leaks
c. burst cells
d. clang cell

23. in regard to preeclampsia, proteinuria is decreased as how much urinary excreation?

a. > 100 mg/24 hr
b. >200 mg/24hr
c. > 300 mg/24 hr
d. >500 mg/24 hr

24. Which of the following is true concerning blood volume in eclampsia?

a. similar to the nonpregnant state
b. similar to the normal pregnant state
c. lower than the nonpregnant state
d. increased compared with the normal pregnant state

25. When is eclampsia least likely to occur?

a. antepartum
b. intrapartum
c. immediately postpartum
d. after 48 hr postpartum

26. How is pathophysiology of preeclampsia characterized?

a. vasodilatation
b. vasospasm
c. hemodellution
d. hypervolemia

27. Which of the following is associated with severe preeclampsia?

a. HLA DR Ig G
b. Molecular variant of angiotensinogen gene
c. Factor V leiden mutation
d. Rennin gene RELP

28. What is the significance of maternal thrombocytopenia in a patient with preeclampsia ?

a. is a fetal indication for caesarean section
b. indicates severe diseases
c. requires therapy with platelets
d. is a contraindication to scalp pH determination
29. With eclampsia, which of the following is NOT true?
a. cerebral edema is present
b. electroencephalogram abnormalities are frequent
c. petechial hemorrhage is common
d. cerebral blood flow is normal
30. Which of the following is true of placental blood flow?
a. increased by furosemide
b. decreased by apresoline
c. increased by thiazide diuretics
d. increased in patients with preeclampsia

31. Which of the following is characteristic of midtrimester bleeding?

a. little consequence
b. related to early effacement and tearing of small vessels
c. 25 percent of the time a previa or an abrution will be found
d. Requires hospitalization.

32. Which of the following is most commonly associated with placental abrution?
a. trauma
b. short umbilical cord
c. folic acid deficiency
d. hypertension

33. What is the most common method for diagnosis of placenta previa?
a. abdominal x-ray
b. arteriography
c. ultrasound
d. computed tomographic scanning

34. Which of the following is the most common cause of post partum hemorrhage mandating
hysterectomy ?
a. previa
b. atony
c. irreparable tears
d. placenta accrete

35. Assuming blood loss is 1000 mL , how is late postpartum hemorrhage defined?
a. 1 hr
b. 2 hr
c. 8 hr
d. 24 hr

36. What are the two most common cause of hemorrhage?

a. uterine atony and retained placenta
b. retained placenta and lacerations
c. lacerations and uterine atony
d. chorioamnionitis and retained placenta.
 37. What is the most common cause of uterine rupture?
a. previous uterine perforation
b. excessive oxytocin
c. manual manipulation
d. separation of a previous cesarean section scar

38. What is the important mechanism in the efecacy of internal aliac artery ligation?
a. ischemia
b. reduction in pulse/pressure
c. block of collateral circulation
d. all of the above

39. Where is the ureter found with respect to the location of the ligature in internal iliac
artery ligation?
a. superiorly
b. inferiorly
c. medially
d. laterally

40. Which compound is responsible for lysing fibrin

a. thromboplastin
b. plasmin
c. prostacyclin
d. factor III

41. Rates of successful pregnancy following three spontaneous losses (habitual abortion) are:
a. Very poor
b. Slightly worse than those in the baseline population
c. No different from those in the baseline populatin
d. Just under 50%
e. Good unless cervical incompetence is diagnosed

42. A 26 year old patient has had three conscecutive spontaneous abortions early in the second
trimester. As part of an evaluatin for this problem. The least useful test would be
a. Histerosalpinogram
b. Chromosomal analysis of the couple
c. Endometrial biopsy in the luteal phase
d. Postcoital test
e. Test of thyroid function
43.The risk of having a baby with Down syndrome for a 30-year old woman increases
a. If the father of the baby is age-40
b. If her pregnancy has been achieved by induction of ovulation by menotropins (e.g.
Follistin, Gonal F)
c. If she has had a previous baby with Turner Syndrom (45X)
d. If she has had a previous baby
e. If she has had three first-trimester spontaneous abortus
44.In terms of birth defect potential, the safest of the following drugs is:
a. Alcohol
b. Isotretionin
c. Tetracycline
d. Progesterones
e. Phenitoin (Dilantin)

45. Which of the following statements about twinning is true?

a. The frequencies of monozygosity and dizygosity are the same
b. Division after formation of the embyonic disk results in conjoined twins
c. The incidence of monozygotic twinning varies with race
d. A dichorionic twin pregnancy always denotes dizygosity
e. Twinning causes no appreciable increase in maternal morbidity and mortality
over singleton pregnancy

46. The placenta of twins may be

a. Dichorionic and monoamniotic in dizigotic (DZ) twins
b. Dichorionic and monoamniotic in monozygotic (MZ) twins
c. Monochorionic and monoamniotic in DZ twins
d. Dichorionic and diamniotic in MZ twins

47. Fetal blood is returned to the umbilical arteries and the placenta through the
a. Hypogastric arteries
b. Ductus venosus
c. Portal vein
d. Inferior vena cava
e. Foramen ovale

48. The smallest anteroposterior diameter of the pelvic inlet is called the
a. Interspinosus diameter
b. True conjugate
c. Diagonal conjugate
d. Obstetric conjugate

49. A pelvic characterized by an anteroposterior diameter of the inlet greater than the
transverse diameter is classified as
a. Gynecoid
b. Android
c. Anthropod
d. Platypeloid
50. An abnormal attitude is illustrated by
a. Breech presentation
b. Face presentation
c. Transverse position
d. Occiput posterior
e. Occiput anterior
A 29-year-old G1P0 presents to the obstetrician’s office at 42 weeks gestation. On physical
exam, her cervix is 50/1/-1. The patient declines induction because she wants to go into labor
spontaneously. She agrees to undergo antepartum testing to evaluate fetal well-being.

51. Which of the following modalities used to assess fetal health has the highest false-
negative rate when administered weekly?
a. Contraction stress test
b. Non stress test
c. Biophysical profile
d. Modified biophysical profile
e. Nipple stimulation test

52. The patient returns to the office still undelivered at 43 weeks gestation. She agrees to
undergo induction. Her cervix remains unchanged from the previous week. All of the
following are options for cervical ripening except
a. Laminaria
b. Cervidil
c. Misoprostol
d. Prepedil
e. Pitocin

53. Which of the following statements concerning abdominal pregnancy is correct?

a. Gastrointestinal symptoms are quite severe.
b. Fetal survival is approximately 50%
c. Aggresive attempts should be made to remove the placenta at the time of initial
surgery
d. It may result in infectious morbidity prior to the diagnosis
e. It is usually the result of a primary abdominal implantation

54. Which of the following statements concerning placenta previa is true?

a. Its incidence decrease with maternal age
b. its incidence is unaffected by parity
c. The initial hemorrhage is usually painless and rarely fatal
d. management no longer includes a double setup
e. Vaginal examination should be done immediately on suspiction of placenta previa

55. A patient at 17 weeks gestation is diagnosed as having an intrauterine fetal demise. She
returns to your office 5 weeks later and has not had a misscarriage, although she has had
some occasional spotting. This patient is at increased risk for
a. Septic abortion
b. Recurrent abortion
c. Consumptive coagulopathy with hypofibrinogemia
d. Future infertility
e. Ectopic pregnancys
Items 56-58
A 38-year-old G3P1011 comes to see you for her first prenatal visit at 10 weeks gestational age.
She had a previous term vaginal delivery without any complications. You detect fetal heart tones
at this visit, and her uterine size is consistent with dates. You also draw her prenatal labs at this
visit and tell her to follow up in 4 weeks for a return OB visit.

56. Two weeks later, the results of the patient’s prenatal labs come back. Her blood type is
A-, with an antibody titer of 1:4. What is the most appopriate next step in the
management of this patient?
a. Schedule an amniocentesis for amniotic fluid bilirubin at 16 weeks
b. Repeat the titer in 4 weeks
c. Repeat the titer at 28 weeks
d. Schedule PUBS to determine fetal hematocrit at 20 weeks
e. Schedule PUBS as soon as possible to determine fetal blood type

57. All of the following are scenarios in which it would have been appropriate to
administered Rhogam to this patient in the past except
a. After spontaneus first trimester abortion
b. After treatment for ectopic pregnancy
c. Within 3 days of delivering an Rh-fetus
d. At the time of amniocentesis
e. At the time of external cephalic version

58. A 33 year old has an infection in pregnancy. Which of the following is a reinfection, and
therefore not a risk to the fetus?
a. Group B coxsackivirus
b. Rubella virus
c. Chickenpox virus
d. Shingles
e. Herpesvirus hominus type 2

59. Viremia and the presence of rubella virus in the throat of infected persons bear which of
the following relationship to the onset of the rubella rash?
a. They procede the rash by 5 to7 days
b. They procede the rash by 1 to 2 days
c. They occur coincidentally with the rash
d. They occur 1 to 2 days after the rash
e. They bear no consistent relationship to the onset of the rash

60. Hypertonic dysfunctional labor generally can be expected to

a. Be associated with rapid cervical dilation
b. Cause little pain
c. Occur in the active ohase of labor
d. React favorably to oxytocin stimulation
e. Respond to sedation
61. A forceps rotation of 30 from left occiput anterior (OA) to OA with extraction of the
fetus from +2 station would be described as which type of delivery?
a. Outlet forceps
b. Low forceps
c.Mid forceps
d. High forceps

A 25 year old G1P0 patient at 41 weeks presents to labor and delivery complaining of gross
rupture of membranes and painful uterine contractions every 2 to3 min. On digital exam, her
cervix is C/3 with fetal feet palpable through the cervix. The fetus’s estimated weight is about 6
lb, and the fetal heart rate tracing is reactive.

62. What is the best method to achieve delivery?

a. Deliver the fetus vaginally by breech extraction
b. Deliver the baby vaginally after external cephalic version
c. Perform an emergent cesarean section
d. Perform an internal podalic version

63. What type of breech presentation is described above?

a. Frank
b. Incomplete single footling
c. Complete
d. Double footling

64. The most common skin disease or condition to affect the vulva is :
(A) lichen planus
(B) psoriasis
(C) seborrheic dermatitis
(D) contact dermatitis
(E) hidradenitis suppurativa

65. Which of the following is most likely to cause vulvar pruritus?

(A) vaginal trachomaniasis
(B) leukemia
(C) personal hygiene products
(D) secondary syphilis
(E) hidradenitis suppurativa

66. The most common cause of vaginal adenosis is :

(A) in utero exposure to thalidomide
(B) in utero exposure to diethylstilbestrol (DES)
(C) in utero exposure to progesterone
(D) chronic tampon use
(E) elevated hormone levels during late pregnancy
67. The most likely cause of abnormal genital bleeding in a 13-years-old girl is :
(A) uterine cancer
(B) ectopic pregnancy
(C) anovulation
(D) systemic bleeding diatheses
(E) threatened abortion

68. A 47-years-old woman complains of postcoital bleeding, nearly as heavy as menses. The
most likely origin of her bleeding would be cervical :
(A) polyps
(B) ectropion
(C) carcinoma
(D) nabothian cysts
(E) infection

69. Adenomyosis may be associated with which of the following clinical or histologic changes?
(A) stromal hyperthrophy
(B) an irregular uterus
(C) atrophy of the overlying endometrium
(D)deformation of the basal endometrium into folds that dip into the
myometrium
(E) myometrial hypertrophy

70. The most common indication for treatment of uterine leiolyomata in a 42-years-old
woman is :
(A) interference with reproductive function
(B) rapid enlargement
(C) pain
(D) excessive uterine bleeding
(E) impingement on another organ

71. A woman complains of postvoid dribbling of urine when she stands, painful inter-
course, and dysuria. She has no other symptoms. She is most likely to have :
(A) a urinary fistula
(B) detrusor instability
(C) female prostatism
(D) genuine urinary stress incontinence
(E) a urethral diverticulum
72. Kegel excercises were designed to :
(A) strengthen the abdominal muscles after childbirth
(B) increase the blood flow to the perineum to speed the healing of an episio-
tomy
(C) improve the tone of the muscles surrounding the bladder base and proxi-
mal bladder neck
(D) prevent denervation of pelvic muscles after childbirth
(E) decrease the muscle atrophy associated with aging
73. A 52-years-old postmenopausal woman complains of urinary frequency, urgency,
and urge incontinence. She is otherwise healthy. You recommend behavioral treat-
ment that includes :
(A) relaxation techniques
(B) anticholinergic medication
(C) voiding every hour during the daytime
(D) bladder retraining
(E) incontinence pad testing

74. The most common cause of rectovaginal fistula is :

(A) obstetrical delivery
(B) irradiation to the pelvis
(C) carcinoma
(D) hemorrhoidectomy
(E) Crohn’s disease
75. If a rectovaginal fistula is identified, initial treatment should include :
(A) diverting colostomy
(B) bowel resection
(C) rectal pull-through operation
(D) vaginal repair of the fistula
(E) systemic steroids and antibiotics

76. Fecal incontinence may be related to :

(A) interplay between the pubococcygeus muscle and rectum
(B) innervation of the pelvic floor and the anal sphincters
(C) normal colonic transit time
(D) nulliparity
(E) urinary retention

77. When performing a vaginal hysterectomy for any indication, prevention of fu-
ture enterocele or vaginal vault prolapse is aided by :
(A) reattachment of the round ligaments to the vaginal cuff
(B) closing the vaginal mucosa
(C) reattachment of the cardinal and uterosacral ligaments to the vaginal cuff
(D) complete a purse string suture closure of the cul-de-sac peritoneum
(E) placing a vaginal pack for 24 hours postoperatively

78. Childhood neoplastic ovarian masses most commonly originate from :

(A) gonadal epithelium
(B) gonadal stroma
(C) germ cells
(D) sex cords
(E) metastatic disease
79. The most common pelvic mass associated with amenorrhea in reproductive-age
woman is a :
(A) follicular cyst
(B) corpus luteum cyst
(C) benign cystic teratoma
(D) leiomyoma
(E) pregnancy

80. A large cystic ovarian tumor is detected during routine prenatal examination. The
most common complication of such a tumor during the first trimester of pregnan-
cy is :
(A) torsion
(B) rupture
(C) intracystic hemorrhage
(D) solid degeneration
(E) luteinization

81. The most common pelvic mass in a postmenopausal woman is a(n) :

(A) follicular cyst
(B) corpus luteum cyst
(C) germ cell tumor
(D) leiomyoma
(E) endometrioma

82. Most neoplastic ovarian masses in postmenopausal women originate from :

(A) ovarian epithelium
(B) ovarian stroma
(C) ovarian germ cells
(D) ovarian sex cords
(E) metastatic disease

83. Signet ring cells are characteristic findings in which tumor of the ovary?
(A) Brenner tumor
(B) Krukenberg’s tumor
(C) dermoid cyst
(D) endometrioid carcinoma
(E) dysgerminoma

84. Vulvar intraepithelial neoplasia (VIN) has also been called :

(A) carcinoma in situ
(B) erythroplasia of Queyrat
(C) Bowen’s disease
(D) Paget’s disease
(E) all of the above
85. Paget’s disease is associated with :
(A) epidermoid immaturity
(B) a high incidence of other primary carcinomas
(C) sharply demarcated borders
(D) brown melanin pigment
(E) unifocal spread

86. Which of the following types of vulvar cancer occurs most commonly ?
(A) Paget’s
(B) epidermoid
(C) melanoma
(D) adenocarcinoma
(E) basal cell

87. A blue swelling on the vulva is most likely to be :

(A) a melanoma
(B) a varicosity
(C) endometriosis
(D) a cyst of the canal of Nuck
(E) a hemangioma

88. The most common complication of radical vulvectomy is :

(A) debilitating edema of the lower extremities
(B) pulmonary embolism
(C) necrotizing fasciitis
(D) breakdown of the surgical wound
(E) urinary and rectal incontinence

89. Which of the following tumors of the vulva has the best prognosis?
(A) stage I verrucous carcinoma
(B) melanoma
(C) stage I squamous cell cancer of vulva
(D) basal cell carcinoma
(E) rhabdomyosarcoma

90. Which of the following malignancies tends to metastasize to the vagina most fre-
quently?
(A) ovarian
(B) endometrial
(C) bowel
(D) bladder
(E) melanomas
91. A 72-yrs-old woman has carcinoma of the vagina that has reached the lateral pel-
vic wall. The stage is :
(A) 0
(B) I
(C) II
(D) III
(E) IV

92. The most likely histology of vaginal carcinoma in this woman is :

(A) melanoma
(B) verrucous
(C) clear cell
(D) adenocarcinoma
(E) squamous cell

93. The factor most indicative of invasive cancer on colposcopic examination is :

(A) white epithelium
(B) leukoplakia
(C) abnormal blood vessels
(D) punctation
(E) mosaic pattern

94. The most common uterine neoplasm is :

(A) sarcoma
(B) adenocarcinoma
(C) choriocarcinoma
(D) adenomyosis
(E) leiomyoma

95. The most common uterine malignancy is :

(A) endometrial adenocarcinoma
(B) endometrial sarcoma
(C) leiomyosarcoma
(D) malignant mixed mullerian tumor
(E) endometrial stromal tumor

96. Endometrial adenocarcinoma is mot often preceded by :

(A) cystic hyperplasia
(B) endometrial hyperplasia
(C) endometrial hyperplasia with cytologic atypia
(D) Arias-Stella phenomenon
(E) microcystic glandular hyperplasia
97. Endometrial carcinoma is most common in which of the following age groups?
(A) 10 to 25 yrs
(B) 25 to 30 yrs
(C) 30 to 40 yrs
(D) 40 to 50 yrs
(E) >60 yrs

98. Most endometrial cancers are diagnosed as stage :

(A) I
(B) II
(C) III
(D) IV
(E) recurrent

99. Which of the following types of gynecologic cancer results in the greatest number
of deaths?
(A) ovarian
(B) uterine
(C) cervical
(D) vaginal
(E) vulvar

100. Which of the following symptoms most commonly accompanies early ovarian
carcinoma?
(A) pelvic pain
(B) bloating
(C) dysuria
(D) constipation
(E) none
 KUNCI JAWABAN

1. B
2. D
3. D
4. B
5. D
6. D
7. B
8. D
9. D
10. B
11. D
12. B
13. C
14. A
15. A
16. B
17. B
18. C
19. C
20. C
21. D
22. A
23. C
24. A
25. D
26. B
27. C
28. B
29. A
30. B
31. C
32. D
33. C
34. D
35. D
36. C
37. D
38. B
39. C
40. B
41. B
42. D
43. E
44. D
45. B
46. D
47. A
48. D
49. C
50. B
51. B
52. E
53. D
54. C
55. C
56. B
57. C
58. D
59. A
60. E
61. B
62. C
63. D
64. D
65. C
66. B
67. C
68. C
69. E
70. D
71. E
72. C
73. D
74. A
75. D
76. B
77. C
78. C
79. E
80. A
81. D
82. A
83. B
84. E
85. A
86. B
87. B
88. D
89. D
90. B
91. D
92. E
93. C
94. E
95. A
96. C
97. E
98. A
99. A
100. E