1- A woman 35 years old /G4 P3 presents with couvelaire uterus in C/S. When is hysterectomy indicated?

A-presence of hematoma in the broad ligament

B-presence of hematoma in mesosalpinx
C- atony retractable to treatment
D- presence of blood in abdominal cavity

2-In the second stage of labor ,you notice a persistent fetal heart rate bradycardia of 110 bpm. What is
your management?
A- left lateral position, nasal oxygen, 1000 cc serum, fetal monitoring
B- detecting fetal blood PH
C-after 40 min intervention is needed
D- It is a normal event in this stage . No further step is needed.

3-BPP of a 34-week pregnancy is 4. What step should be taken?

A-L/S should be determined . If it is below 2, the BPP should be repeated
B-immediate pregnancy termination
C-BPP should be repeated if it is below 6 , pregnancy termination
D- BPP should be repeated 48 hours later and management is designed according to that score

4- NST of a G2 / GA=37 wks/ cephalic presentation/ with a history of 2 IUFDs shows a 2-min deceleration.
What is the best management ?
A- daily BPP and observation
B- C/S
C- repeat of NST 24 hours later
D-vaginal exam with continuous fetal monitoring

5- A pregnant woman’s BPP shows a non-reactive NST, one inspiration in 3 min of 30 sec duration, 2 body
movements, one Flex and Ext of limbs, AF of one vertical packet of 3 cm. What is your management?
A- pregnancy asphyxia and pregnancy termination
B- repeating the test one week later w/o the possibility of fetal asphyxia
C- repeating the test with the possibility of fetal asphyxia
D- the possibility of asphyxia, repeat of the test on the spot and if abnormal, termination of pregnancy

6-A term pregnancy- dil=3cm- eff=50%-satation=-2 soft cervix in mid position has a Bishop score of:
A-5
B-7
C-9
D-10

7- G4-P1-Ab2 / GA:38wks/full dil &eff/frank breech/ station=1 /WB=intact /FHR=100 BPM / x-ray shows
flexion of the head. What is the best management?
A-Frank breech extraction
B-C/S
C-modified Prague maneuver
D- observation for non assisted breech delivery
8-Which is wrong about misoprostol?
A- It is a synthetic PG E1
B-It is used for peptic ulcer
C- It is used for contraception
D- Its dose is 100 mcg intra cervical for labor induction

9-Which is wrong in shoulder dystocia?

A-Most of shoulder dystocia cases can not be diagnosed or predicted
B- Shoulder dystocia can be diagnosed with high accuracy using modern imaging studies
C-ultrasound is not reliable
D- C/S is recommended in diabetic mothers with babies more than 4500 gr and in non diabetic mothers
with babies more than 5000 gr

10- A 40 years old woman / G3/P2 /GA=35 wks/ BP=210/110 is in seizure. What is the best way to control
her seizure?
A-Phenytoin loading dose of 1000 mg/h IV
B- Diazepam and creatinin measurement
C- amobarbital sodium 250 mg IV
D- MgSO4 4-6 gr as loading dose

11-which is the most common reason of DIC in Obstetrics?

A-IUFD
B-abruption
C-AF emboli
D- septic shock

12-A woman suffers intractable heavy vaginal bleeding after C/S. Laparatomy is performed. Retrovesical
hematoma is evacuated and the site of bleeding is sutured. The bleeding does not stop. What is the second
stage in management?
A-total hysterectomy
B-bilateral uterine and ovarian arteries ligation
C-bilateral hypogastric arteries ligation
D-bilateral hypogastric and ovarian arteries ligation

13-How PG f2-alfa is administered for uterine atony?

A-20 mg IM for max 3 doses by 15-90 min intervals
B-500 mcg IV for max 4 doses IM by 30 min intervals
C-1000 mcg IM single dose
D-250 mcg IM for max 8 doses by 15-90 min intervals

14-In a 14 year old anemic girl with prolonged uterine spotting what should be done?
A- assurance, follow up and ferrus sulfate
B- Low dose OCP q6h for 7 days
C- Low dose OCP 21 days for 3-6 cycles
D- conjugate estrogen 2.5 mg PO q6h for 7 days

15-What trisomy in the form of placental mosaicism causes IUGR?

A-13
B-16
C-18
D-21

16-Which is not a sign of twin to twin transfusion?

A-difference in weights more than 10%
B-hydramnios in one fetus and oligohydramnios in the other
C- difference in Hb more than 5 gr/dl
D-monochorion with placental vascular anastomosis

17- What should be done for a woman 31 week gestation with twin pregnancy and one fetus dead?
A-prophylactic heparin for DIC prevention
B- C/S
C- observation
D- tocolytics

18-What is your management of a 36 year old woman who is pregnant after primary infertity. She is
referring to you for spotting and hypogastric pain, beta HCG is 1500 mu/l and ultrasound of uterus and
ovaries are normal.
A-laparatomy
B-laparascopy
C-repeat of vaginal sonography several days later
D-progesterone measurement

19. Which of the following ovarian tumor is most prone to undergo torsion during pregnancy?
A. Serous cystadenoma.
B. Mucinous cystadenoma
C. Dermoid cyst
D. Theca lutein cyst

20. A 28-year-old primigravid woman at term comes to the labor and delivery ward with
a gush of fluid and regular contractions. Her prenatal course was remarkable for her
being Rh negative and antibody negative. Her husband is Rh positive. Over the following
10 hours, she progresses in labor and delivers a 3600-g boy via a normal spontaneous
vaginal delivery. The placenta does not deliver spontaneously, and a manual removal is
required. To determine the correct amount of RhoGAM (anti-D immune globulin) that
should be given, which of the following is the most appropriate laboratory test to send?
A. Complete blood count
B. Kleihauer-Betke
C. Liver function tests
D. Prothrombin time
E. Serum potassium

21.A 25-year-old nulliparous woman at 35 weeks' gestation comes to the labor and delivery ward
complaining of contractions, a headache, and flashes of light in front of her eyes. Her pregnancy has been
uncomplicated except for an episode of first trimester bleeding that completely resolved. She has no
medical problems. Her temperature is 37 C (98.6 F), blood pressure is 160/110 mm Hg, pulse is 88/minute,
and respirations are 12/minute. Examination shows that her cervix is 2 centimeters dilated and 75%
effaced, and that she is contracting every 2 minutes. The fetal heart tracing is in the 140s and reactive.
Urinalysis shows 3+ proteinuria. Laboratory values are as follows: leukocytes 9,400/mm3, hematocrit 35%,
platelets 101,000/mm3. Aspartate aminotransferase (AST) is 200 U/L, and ALT 300 U/L. Which of the
following is the most appropriate next step in management?
a.Administer oxytocin
b.Discharge the patient
c.Encourage ambulation
d.Start magnesium sulfate
e.Start terbutaline

22. A 21-year-old primigravid woman at 39 weeks' gestation comes to the labor and delivery ward with
painful contractions every three minutes. Her prenatal course was unremarkable. Examination shows her
cervix to be 3 centimeters dilated and 90% effaced. The fetal heart rate tracing is in the 150s and reactive.
5 hours later cervical examination reveals that the patient is 9 centimeters dilated and at -1 station. The
fetal heart rate tracing shows moderate variable decelerations with each contraction and decreased
variability. Fetal scalp sampling is performed that yields fetal scalp pHs of 7.04, 7.05, and 7.06. Which of
the following is the most appropriate next step in management?
a.Expectant management
b.Episiotomy
c.Forceps-assisted vaginal delivery
d.Vacuum-assisted vaginal delivery
e. Cesarean delivery

23.The pseudomyxoma peritonei occurs as a complication of the following ovarian tumor:

a) Serous cystadenoma
b) Mucinous cystadenoma
c) Dysgerminoma
d) Gonadoblastoma

24.The risk of Asherman syndrome is the highest if Dilatation and Curettage (D & C) is done for the
following condition:
a) Medical termination of pregancy
b) Missed abortion
c) Dysfunctional uterine bleeding
d) Post partum haemorrhage

25.The risk of endometrial carcinoma is the highest with the following histological pattem of endometrial
hyperplasia:
a) Simple hyperplasia without atypia
b) Simple hyperplasia with atypia
c) Complex hyperplasia without atypia
d) Complex hyperplasia with atypia

26.PAP smear shows Ca in situ-what is the best next logical procedure

a) Conisation
b) Colposcopy & biopsy
e) Hysterectomy
d) HPV viral D.N.A. testing
27.Which of the following is the least likely physiological change in pregnancy
a) Increase in intravascular volume
b) Increase in cardiac output
c) Increase in stroke volume
d) Increase in peripheral vascular resistance

28.Red degeneration most commonly occurs in

a) 1 st trimester
b) 2nd trimester
e) 3rd trimester
d) Puerperium

29.Late hyperglycemia in pregnancy is associated with

a) Macrosomia
b) IUGR
c) Postmaturity
d) Congenital malformation

30.The most common congenital anomaly in baby born to Insulin Dependant Diabetes Mellitus (IDDM)
mother is :
a) Neural tube defect
b) Cardiovascular anomalies
c) G.l.T anomalies
d) Pulmonary anomalies

31.The investigation of choice in a 55 year old postmenopausal woman who has presented with
postmenopausal bleeding is:
A. Pap smear
B. Fractional curettage
C. Transvaginal ultrasound
D. Ca 125 estimation.

32.Misoprostol has been found to be effective in all of the following except:

A. Missed abortion
B. lnduction of labour
C. Menorrhagia
D. Prevention of post-partum hemorrhage (PPH)

33.Risk of preterm delivery is increased if cervical length is:

A. 2.5 cm
B. 3.0 cm
C. 3.5 cm
D. 4.0 cm

34.All are the causes of intrauterine growth retardation except:

A. Anemia
B. Pregnancy induced hypertension
C. Maternal heart disease
D. Gestational diabetes

35.In a case of Dysgerminoma of ovary one of the following tumor markers is likely to be raised.
A. Serum HCG
B. Serum alphafetoprotein
C. Serum lactate dehydrogenase
D. Serum inhibin.

36.The most common pure germ cell tumor of the ovary is:
A. Choriocarcinoma
B. Dysgerminoma
C. Embryonal cell tumor
D. Malignant Teratoma

37.Which of the following strongly suggest the diagnosis of preterm labor?

A. cervical dilatation > 1cm
B. cervical effacement > 80%
C. contractions (4 in 20 min ) with progressive cervical dilatation
D. all of the above.

38. Which of the following is associated with an increased incidence of placental abruption ?
A.young age .
B. alcohol abuse.
C. oligohydramnios.
D. multifetal gestation

39. Imperfect development of the nitabuch layer during placental development that results in placental
villi penetrating through the myometrium is termed which of the following ?
A. placenta increta
 B. placenta accrete
C. placenta percreta
D. placenta diacreta

40.All are the causes of intrauterine growth retardation except:

A. Anemia
B. Pregnancy induced hypertension
C. Maternal heart disease
D. Gestational diabetes

41. A 29-year-old woman comes to the emergency department because of abdominal

distension and shortness of breath. Approximately 1 week ago, she underwent fertility
treatment with ovulation induction and oocyte retrieval. She has a history of polycystic
ovarian syndrome but no other medical problems. She had laparoscopy 1 year ago as part
of a fertility evaluation. She has no known drug allergies. Her temperature is 37 C (98.6
F), blood pressure is 80/40 mm Hg, pulse is 130/min, and respirations are 28/min.
Physical examination is remarkable for crackles at the lung bases bilaterally and a
distended, nontender abdomen with a fluid wave. Ultrasound demonstrates bilaterally
enlarged ovaries (each >10 cm) and free fluid in the abdomen. Urine hCG is negative.
Which of the following is the most likely diagnosis?
A. Ectopic pregnancy
B. Hemorrhagic ovarian cyst
C. Ovarian hyperstimulation syndrome
D. Ovarian torsion
E. Tubo-ovarian abscess