1. Pain during the first stage of labor is mediated through: D.

Footling Breech Presentation

A. 7th and 8th thoracic nerves
B. 9th and 10th thoracic nerves 11. A conclusive diagnosis of rupture membranes is made:
C. 10th , 11th, 12th thoracic nerves & 1st lumbar nerve A. By testing the pH of the vaginal fluid
D. 1st, 2nd, and 3rd lumbar nerves B. When amnionic fluid is seen pooling in the posterior fornix
C. By using the indicator nitrazine test
Ms. Paraso, 18 year-old, G1P0, 39-40 weeks AOG, was brought to the Delivery D. Detection of alpha-fetoprotein in the vaginal vault
Suite because of labor pains. On admission, BP=110/80; FH=34cm; FHT= 145
bpm. Internal examination: Cervix 3cm, 60% effaced; intact BOW, station -2; 12. Lacerations that include the skin and mucous membrane, the fascia and the
cephalic presentation. Uterine contractions were occurring at every 5-6 minutes muscles of the perineal body are classified as:
interval, 30 seconds duration; mild to moderate contractions. A. Third-degree laceration –anal sphincter
B. Second-degree laceration
2. The patient in this case is already in what phase of labor? C. First-degree laceration
A. latent case D. Fourth-degree laceration- rectal musosa
B. acceleration phase
C. phase of maximum slope 13. A 25-year-old G3P2 (2002) was referred to the hospital for prolonged second
D. deceleration test stage of labor. What condition will not favor outlet forceps
extraction?
3. The following pelvimetry suggest midpelvic contraction, except: A. The cervix is fully dilated
A. spines are prominent B. There is no cephalopelvic disproportion
B. pelvic sidewalls converge C. The most dependent portion is at the level of the ischial spines
C. sacral promontory can be reached at 8.0 cm D. the sagittal suture of the fetal head is in the AP diameter
D. sacrosciatic notch is narrow
14. A 29-year-old primigravid was admitted for labor pains. The cervix remained
4. Which of the following statements is not a characteristic of cephalhematoma? 9 cms. dilated for 3 hours and the fetal head was at station O in
A. This is usually caused by injury to the periosteum of the skull right occiput posterior position. The correct management is:
during labor and delivery A. Forceps extraction
B. Hemorrhage can occur over one or both parietal bones B. Low segment cesarean section
C. The periosteal limitations with definite palpable edges will not C. Internal podalic version
differentiate the cephalhematoma from caput succedaneum D. Cesarean hysterectomy
D. Cephalhematoma may not appear for hours after delivery, often
growing larger and disappearing only after several weeks 15. Of the hematologic changes associated with preeclampsia, the following is the
most common:
5. Fetal Heart Rate Patterns suggesting true fetal distress is/are: A. hemolysis
A. Zero beat-to-beat variability B. thrombocytopenia
B. Severe decelerations C. decreased plasma clotting factors
C. Persistent baseline rate changes D. increase plasma clotting factors
D. All of the above
16. The most important information that the obstetrician has for a successful
6. Which of the following statements regarding drug use in pregnancy is true? management of pregnancy complicated by hypertension is:
A. Drugs cross the placenta in varying degrees depending on lipid A. knowledge of the gestational age of the fetus
solubility, molecular size, maternal metabolism, protein binding B. knowledge of the weight of the fetus
and storage. C. knowledge of the fetal biophysical score
B. Drugs associated with cardiac malformations will exert their D. knowledge of the maternal-fetal Doppler blood flow studies
effect when ingested after the eighth week from fertilization.
C. The fetus is safe from drug and substance effects during the fetal 17. During puerperium the uterus descends into the cavity of the true pelvis
period. within:
D. As a general rule, drugs are safe until proven otherwise. A. one (1) week C. two (2) weeks
B. ten (10) days D. four (4) weeks
7. A fetus in transverse lie becomes a fetus in oblique lie when the long axis forms C.
a/an: 18. If a woman does not nurse, her menses usually return within:
A. Right angle A. 4-6 weeks C. 8-10 weeks
B. Obtuse angle B. 6-8 weeks D. 3 months
C. Acute angle
D. All of the above 19. Antimicrobial regimens for pelvic infection following cesarean delivery
proven to have the greatest efficacy which is widely studied:
8. Choose the correct statement regarding the female reproductive organs: A. Ampicillin-Gentamicin
A. The cardinal ligament of the uterus connects the cervix to the B. extended spectrum PCN
posterior surface of the pubis C. extended spectrum Aps
B. The uterine artery crosses over the ureter in its course D. Quipenem and cilatasis
C. The ovarian veins (right and left) drain into the inferior vena
cava. 20. An acute febrile illness with severe multi-system derangement characterized
D. Lymphatic drainage of the uterus and the upper ¾ of the vagina by fever, headache, mental confusion, macular erythematous rash, subcut, edema,
are directed towards the pelvic nodes only that from the lower ¼ nausea, vomiting and watery diarrhea and marked hemoconcentration:
of the vagina is directed into the superficial inguinal nodes. A. toxic shock syndrome
B. Group AB-hemolytic strep infection
9. The shortest distance between the promontory of the sacrum and the symphysis C. Pelvic abscess
pubis: D. Septic pelvis thrombophlebitis
A. Obstetric conjugate
B. Diagonal conjugate 21. The best method of diagnosing uterine atony is by:
C. True conjugate A. observation of vaginal bleeding
D. None of the above B. cervical and vaginal inspection
C. palpation of the uterus
10. If the thighs are flexed on the abdomen and the legs upon the thighs, this is a: D. careful BP and RR observations
A. Incomplete Breech Presentation
B. Complete Breech Presentation 22. In the immediate puerperium, in a setting of excessive of vaginal bleeding, the
C. Frank Breech Presentation guide to instituting blood transfusion therapy is:
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A. the amount of blood lost D. after the 2nd trimester
B. the pulse rate
C. the diastolic blood pressure 34. The effect of myoma on pregnancy includes:
D. the systolic blood pressure A. Abruptio is common on placentas implanted over or in contact
with a myoma
23. Inversion of the uterus is almost always subsequent upon: B. Growth of myomas increases with gestational age
A. difficult forceps delivery C. It is an absolute indication for CS delivery
B. abruptio placenta D. Fetal malposition and preterm labor are not commonly seen
C. multiple pregnancy
D. traction of the umbilical cord before the separation 35. In Ovarian masses, complicating pregnancy:
A. The most common ovarian tumors are cystic
24. Fetal growth is divided into the following 3 consecutive cell growth phases: B. Solid ovarian masses are most likely benign
A. Hyperplasia, Hypertrophy, Hyperplasia and Hypertrophy C. Cysts of less than 5 cm should be removed
B. Hypertrophy, Hyperplasia and Hypertrophy, Hyperplasia D. Cyst rupture is the most frequent and serious complication
C. Hyperplasia, Hypertrophy and Hyperplasia, Hypertrophy
D. None of the above 36. Uterine rupture in trauma:
A. Rupture of the uterus is common with blunt trauma
25. The following screening and identification of fetal growth restriction should be B. Clinical findings may be identical to placental abruption
done: C. Usually associated with indirect impact to the uterus
A. Uterine fundal height D. All of the above
B. Ultrasonic measurements
C. Doppler Velocimetry 37. The most common skin symptom during pregnancy:
D. All of the above A. burning sensation
B. pruritus
26. This placental disorder is associated with certain maternal diseases such as C. pain
hypertension wherein there is reduction in functioning placenta, D. cold sensation
which may lead to enarteritic thickening and obliteration termed
hemorrhagic endovasculitis (HEV): 38. Major risk for maternal mortality during pregnancy:
A. placenta accreta A. atrial septal defect
B. abruptio placenta B. ventricular septal defect
C. vasa previa C. patent ductus arteriosus
D. placental infarction D. pulmonary hypertension

27. Amniotomy in abruptio: 39. The most accurate and safest method to diagnose heart disease in pregnancy is:
A. hasten delivery A. electrocardiogram
B. reduce entry of thromboplastin into maternal circulation B. chest x-ray
C. character of the fluid increases the suspicion of abruptio C. two-dimensional echocardiogram
D. all of the above choices D. coronary angiogram
Mrs. Williams delivered to a live term baby boy, with no complications noted. On
28. Which of the following is NOT associated with an increased abortion rate?
the boy's second year of life, he was noted that he does not answer when his name
A. advanced paternal age
is called, and does not react if other children are shouting in front of him. Maternal
B. Class A1 Diabetes Mellitus
history revealed maternal fever and a three-day generalized maculopapular rash.
C. Advanced maternal age
D. Pregnancy within 3 months of a live birth
40. The most common cause(s) of the deafness in children is/are:
A. Maternal influenza
29. Which of the following uterine abnormalities has the greatest likelihood of
B. Maternal Rubella
spontaneous abortions?
C. Maternal cytomegalovirus
A. Asherman's syndrome
D. B and C are correct
B. Bicarnuate uterus
C. Leimyomata Bella, a 23 year-old commercial sex worker, went to the Social Hygiene clinic for
D. Uterine septa her regular check-up. On examination, she was noted to have variable rash on the
palms and soles of both feet.
30. Which of the following signs/symptoms most strongly implies a ruptured
ectopic pregnancy with sizable intraperitoneal hemorrhage? 41. The following are characteristics of primary chancre of syphilis:
A. shoulder pain on inspiration A. characterized by a painless firm ulcer with raised edges and a
B. Heavy vaginal bleeding granulation base
C. nausea and vomiting B. persists for 2 to 6 weeks and heals spontaneously
D. abdominal mass, unilateral C. often accompanied by nontender, enlarged inguinal lymph nodes
D. all the above are correct
31. This is characteristic of complete H-mole:
A. usually triploid 69XXY, XYY
Gloria, a 27-year-old G1P0, on her 20 th week gestation, was known to be HIV
B. composed of a mixture of N-sized chorionic villi mixed with
positive one year prior to this pregnancy.
large hydropic ones
C. is 46XX or YY coming from father 90% of the time
42. Prevention of vertical (mother to infant) transmission of HIV infection is/are
D. fetus is usually present
the following:
A. Cesarean delivery
32. Patient is considered at high risk of developing persistent gestational
B. Antiretroviral therapy and vaginal delivery
trophoblastic disease when the following risk factor/s is/are present:
C. Antiretroviral therapy and cesarean section
A. theca luteum cyst of 5 cm.
D. Antiretroviral therapy
B. age less than 40
C. hCG level> 100,000
A 29 years old female, married, G1P0 AOG 16 weeks, complained of
D. uterine enlargement of 3 months AOG
vague abdominal wall pain for 3 days, with slight fever and urgency. She took
Paracetamol 500 mg and there was temporary relieved of symptoms.
33. Pre-operative evaluation of cervical incompetence is best done:
A few minutes prior to consultation, she noticed blood tinged urine.
A. before 14 weeks
Husband is an overseas worker (Seaman).
B. after 14 weeks and not later than 20 weeks
C. after 20 weeks
 3
43. What is the probable clinical impression on consultation?
A. acute pyelonephritis uncomplicated
B. acute urethritis syndrome
C. acute cystitis, hemorrhagic
D. acute pyelonephritis complicated

44. The following is true about cholestasis of pregnancy:

A. Occurs in the third trimester but can occur earlier
B. The initial and most characteristic symptom is pruritus which is
most severe during the day
C. Jaundice develops in a majority of patients
D. Amelioration of symptoms is not achieved with delivery

45. Which of the following maternal metabolic adaptations does not occur in
normal pregnancy?
A. Decreased insulin secretion
B. Increased resistance to insulin action
C. Relative fasting hypoglycemia
D. Increased plasma lipids

46. Which of the following laboratory tests will help the clinician diagnose
hyperthyroidism in pregnancy?
A. TSH
B. Free T4
C. Free T3
D. All of the above

47. Which among these measures of pulmonary function is expected to increase

during pregnancy?
A. Residual volume
B. Expiratory reserve volume
C. Functional residual capacity
D. Minute ventilation

48. True statement as regards asthma and pregnancy:

A. With mild asthma, carbon dioxide retention in the blood is
expected.
B. Asthma has predictable worsening during pregnancy
C. Monitoring of efficacy of treatment is by symptoms alone.
D. Maternal alkalosis may cause fetal hypoxemia even before
maternal oxygenation is compromised

49. Anemia in pregnant woman is defined as hemoglobin value:

A. less than 12 g/L
B. less than 14 g/L
C. less than 10 g/L
D. less than 8 g/L

50. The total iron in normal pregnancy is about:

A. 200 mg
B. 300 mg
C. 800 mg
D. 1000 mg