重庆医科大学 2022-2023 学年第二学期

《Obstetrics and Gynecology》考试试卷(A)

考试方式：闭卷 考试时间：120 分钟

试卷适用年级及专业：2018 Foreign Student

Study ID Name Class Faculty

部分 第一部分 第二部分 第三部分 总分 审核

分值 30 分 30 分 40 分 100 分

得分

阅卷人签名

一、Single choice questions (1.5 point ×20，total 30points) 得分

1.Regarding physiological changes in pregnancy which is true【 】

A. The plasma volume increases in pregnancy but the red cell mass slight increase which
results in a fall in the haemoglobin concentration
B. Pregnant women are at risk of venous thromboembolism, but only in the third trimester
C. Platelet counts is increased in pregnancy
D. The thrombin time is increased in pregnancy
E. Increased fibrinogen is the most important mechanism to prevent postpartum
hemorrhage
2. The statement about miscarriage is incorrect【 】

A. Once diagnosed with inevitable miscarriage, complete expulsion of embryonic and

placental tissue should be achieved as soon as possible
B. Once diagnosed with incomplete abortion, timely suction or curettage should be
performed to remove residual tissue in the uterine cavity
C. Complete abortion generally does not require special treatment
D. Infectious miscarriage is mostly incomplete miscarriage combined with infection, and
the treatment principle should first remove residual tissue in the uterine cavity
E. Women with a history of habitual miscarriage should undergo necessary examinations
before pregnancy

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3. Which of the following is not the characteristics of pelvic outlet【 】
A. It is Formed by two triangular planes with a common base of ischial spine
B. The ischial tuberosities is the lowest part of the pelvis
C. The anteriortriangle is bordered by the subpubic angle at the apex
D. The posterior triangle is bordered by the sacrococcygeal
joint at its apex
E. The sacrotuberous ligaments are the sides of the posterior triangle
4. In China, the current diagnostic standard of gestational weeks for preterm birth is【 】
A. Between 24-27+6 weeks B. Between 26-27+6 weeks C. Between 28-34+6 weeks
D. Between 28-35+6 weeks E. Between 28-36+6 weeks

5. The presentation in the figure is【 】

A. Left occiput anterior (LOA)

B. Right occiput posterior (ROP)
C. Left occiput posterior (LOP)
D. Right occiput transverse (ROT)
E. Right occiput anterior (ROA)
6. Which of the following is wrong about the hydatidiform mole【 】
A. Complete hydatidiform mole has diffused edematous villi.
B. Complete hydatidiform mole has trophoblastic proliferation.
C. The karyotype of complete hydatidiform may be 46, XX or 46, XY.
D. The complete hydatidiform mole has higher risk for persistent gestational trophoblastic
neoplasia (GTN) compared with partial hydatidiform mole
E. Fetal tissue can usually be seen in complete hydatidiform mole.
7. Which of the following is an important sign of female puberty: 【 】
A. From 18 to 48 years old B. Ovarian insufficiency
C. The follicles do not secrete estrogen D. Begins to appear feminine E. Menarche
8. Female, 56 years old, menopause for 6 years, irregular vaginal bleeding for 1 week.
History of hypertension for 8 years, obesity. Gynecological examination: Mild erosion of
the cervix, the uterus is slightly large. B-mode ultrasonography showed thick and irregular
endometrial lining. To confirm the diagnosis, the most common method is: 【 】

A. Cervical biopsy B. Colposcopy C. Segmented curettage

D. Laparoscopy E. Serum tumor marker determination
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9. The most common initial symptom of intrahepatic cholestasis of pregnancy is: 【 】
A. jaundice B. nausea and vomiting C. itching
D. liver size enlargement E. vaginal bleeding
10. A pregnant woman, 28 years old, the gestational age is 39 weeks. She was diagnosed
with GDM. The blood glucose was well controlled by insulin injection. Which of the
following treatment is proper? 【 】
A. Induce labor at 39 gestational weeks B. Induce labor at 40 gestational weeks
C. Wait for onset of labor naturally D. Cesarean section at 39 gestational weeks
E. Cesarean section at 40 gestational weeks
11. How long is the time that postpartum uterus restores completely? 【 】
A. 6 weeks after delivery B. 8 weeks after delivery C.10 weeks after delivery
D. 1 weeks after delivery E. 30 days after delivery
12. Which of the following statements about pelvic examination is NOT true: 【 】

A. Empty bladder is needed for all patients before pelvic examination.

B. Pelvic examination should be performed under bladder lithotomy position.
C. There are three components to the pelvic examination, including inspection, speculum
and bimanual examination.
D. Rectal examination can be used as an alternative to a vaginal examination in children and
in adults who have never had sex.
E. Before proceeding to a vaginal examination, the patient’s verbal consent should be
obtained, and a female chaperone should be present for any intimate examination.
13. A woman, 42 years old, secondary progression of dysmenorrhea for 6 years,
accompanied with menorrhea, pelvic examination: enlarged uterus. which of the following
may be the diagnosis: 【 】

A. Pelvic inflammatory disease B. Myoma C. Adenomyosis

D. Endometrium cancer E. Uterine malformation
14. 24 years old female, vulva itching, purulent, yellow leucorrhea. The gynecological
examination found that the vaginal mucosa was congested and the discharge was yellow and
foamy. The most likely diagnosis is: 【 】
A. Fungal vaginitis B. Gonococcal vaginitis C. Nonspecific vaginitis
D. Amebic vaginitis E. Trichomoniasis vaginitis
15. What is the initial recommendation for PCOS patients with obesity? 【 】

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A. Oral contraceptives B. Weight reduction C. Fasting D. Liposuction E. Metformin
16. Which one is regarded as a gold standard for diagnosing tubal obstruction? 【 】
A. Laparoscopy B. Hysterosalpingography (HSG) C. Ultrasound
D. Three dimensional hysterosalpingo-contrast sonography E. Hysteroscopy
17. What is the most important structure preventing uterine prolapse?【 】
A. Round ligament B. Broad ligament C. Cardinal ligament
D. Uterosacral ligament E. Pubocervical ligament
18. Which one is not the clinical feature of threatened abortion？【 】

A. Slight vaginal bleeding B. With or without lower abdominal pain

C. Cervix is closed D. The size of the uterus corresponds to the gestational age
E. Feeling faint or actual fainting
19. Which sign towards malignant pelvic mass? 【 】
A. Growing slowly B. Smooth surface C. Cystic mass
D. Ascites E. Without cachexia
20. Which of the following is not the most common cause of abdominal pain: 【 】
A. Ectopic pregnancy rupture B. Endometriosis C. Uterine leiomyoma
D. Acute pelvic inflammatory disease E. Torsion of ovarian tumor

二、Answer the questions (6 point ×5，total 30points)

得分
1. Please write down the characteristics of “in labor”。

2. Please describe “three steps” for the diagnosis of cervical cancer. If the HPV 16 (+) in
cervix of patient, what should be done next for the patient?

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3. Please describe the pathologic type of endometriosis.

4. Please describe the mechanisms of combined oral contraceptive pills.

5. Please describe the definition and the etiologies of postpartum hemorrhage.

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 得分
三. Case analysis (10 points ×4，total 40 points)
1. A 26 years old primiparous woman, 38 weeks pregnant, has regular uterine contractions
for 17 hours, a small amount of pale yellow fluid flows out of the vagina, contractions for
25 seconds/6-8 minutes, fetal heart sounds about 150 times/minute, the cervix of the uterus
is dilated 2 cm and slightly edematous, the fetal head is located 2 cm above the ischial spine,
and no obvious bone birth canal abnormalities.
(1) What is the possible diagnosis for this patient? （4 points）
(2) What should be done? (2 points)
(3) If the fetal heart rate is observed at 110 beats per minute after half an hour and there is
frequent late deceleration during CST monitoring, what new diagnosis is there and what
treatment should be taken? (4 points)

2. A 22-year-old woman, G1P0, 33 weeks’ gestation, was complaining about fluid passing
through her vagina 30min ago. She had no vaginal bleeding or abdominal pain. Her
temperature was 38.5°C. The baseline of the fetal heart rate was 165 beats/min.
(1) What is the most likely diagnosis? (4 points)
(2) The diagnosis of the vaginal fluid can be confirmed by? (4 points)
(3) what is the next management? (2 points)

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3. The 52-year-old woman presents to the outpatient department complaining of abdominal
distention and pelvic mass 10 days. The onset was 10 days ago after she had abdominal
distention, and then she took ultrasound examination which showed pelvic mass. She has
never had a routine health check-up before. Gynecological examination revealed fixed
pelvic mass (diameter: 8cm). Lab examination showed serum CA125 850U/ml.
Ultrasound examination showed: a large amount of ascites and pelvic mass with increased
blood flow signal.
(1) What is the most possible diagnosis? Why? (5 points)
(2) Please write the necessary examination. (2 points)
(3) Please write the proper treatment. (3 points)

4. A 30-year-old woman comes to see you because she feels menorrhea for 3 years, and
often feels dizzy recently. She denies any irregular bleeding and reports normal menstrual
periods for 30 days，but continue for 10-15 days every menstruation. She states that it does
not cause her any pain. The woman had not been pregnant before.
Pelvic examination: we can touch the enlarged uterus just like a 10-week pregnancy uterus.
(1) What is the most likely diagnosis of the patient and why? (6 points)
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(2) What examination should firstly be considered to make the diagnosis of this patient?
(2points)
(3) Blood test results showed no significant increase in CA125 and that the woman had a
hemoglobin of 59g/L. Pelvic MRI result is shown in the figure. Please write the proper
treatment for the patient. (2 points)