UKN INDONESIAN COLLEGE OF OBSTETRICS AND GYNECOLOGY

PART 1
1. The Blood vessels that supply the perineum came from:
a. Internal iliac artery
b. Vaginal artery
c. Superior gluteal artery
d. Internal pudendal artery
e. Internal gluteal artery
2. Choose the incorrect statement regarding to physiological changes of the urinary system
during pregnancy:
a. Examination of urine protein/creatinine ratio can be used to detect proteinuria
b. Changes in the urinary system during pregnancy can mimic nephrotic syndrome
c. Transient Diabetic insipidus can occur in the third trimester
d. Proteinuria levels >200mg/24 hours in the 3rd trimester are normal
e. The physiological respiratory alkaliosis causes a compensatory metabolic acidosis
of the renal tubular system
3. Choose the correct statement about innate immunity
a. Attack self-antigen
b. Induce humoral immunity by antibody production
c. Activated by Th2 cytokines
d. Produces memory cells
e. Recognize pathogen-associated molecular patterns
4. Please state the duty of the patient!
a. Non-maleficence
b. An implied contractual one
c. A financial one
d. Justice based
e. Autonomy based
5. What are the two phases involved in drug metabolism in the liver?
 a. Phase 1 metabolism: happens in the cytoplasm, involving conjugation with
various substances; phase 2 reaction: occur in endoplasmic reticulum, convertinf
drugs into more polar metabolites
b. Phase 1 metabolism: occur in the endoplasmic reticulum, converting drugs into
more polar metabolites; phase 2 reaction: happens in the cytoplasm involing
conjugation with various substances
c. Phase 1 metabolism: happens in the endoplasmic reticulum involving conjugation
with various substance; phase 2 reaction: occur in the cytoplasm, converting drugs
into more polar metabolites
d. Phase 1 metabolism: occur in the cytoplasm, converting drugs into less toxic
compound; phase 2 reaction: happen in the endoplasmic reticulum, involving
conjugation with various substance
e. Phase 1 metabolism: occurs in the endoplasmic reticulum converting drugs into
more polar metabolites; phase 2 reactions: happen in the cytoplasm, involving
oxidation by cytochrome P450 enzymes
6. The process of the information encoded in DNA being transferred into a strand of mRNA
is called?
a. Transcription
b. Regulation of Gene Expression
c. Translation
d. Replication
e. None of the above
7. A 22-year old G1P0A0 present in spontaneous labor at 39 weeks of gestation, fully
dilated. During the delivery, you perform episiotomy on her. Which of the following
structure is involved in a mediolateral episiotomy?
a. External anal sphincter
b. Transverse perineal muscle
c. Ischiocavernous muscle
d. Central perineal tendon
e. Levator ani
8. Regarding to DNA structure, below statements are true except?
 a. DNA consist of sugar-phosphate backbone
b. DNA contains the five-carbon sugar ribose
c. The purine base guanine is paired with cytosine
d. The two chains are linked by hydrogen bonds
e. The purines base adenine is paired with the pyrimidine base thymine
9. Choose the correct statement regarding to physiological changes of the respiratory system
in pregnancy!
a. Respiratory alkalosis
b. Increased ventilation caused by an increase in the hormone estrogen
c. Increased ventilation 40%
d. Occurrence of maternal hypoventilation
e. Lung capacity increases by 10%
10. The characteristic histopathological feature of chronic inflammation is
a. Neuronal proliferation
b. Apoptosis process dominant
c. Fibroblast proliferation
d. Predominant polymorphonuclear inflammatory cells
e. Endothelial inflammation
11. Women may feel breathlessness during pregnancy. What is the sign of a normal
physiological breathlessness during pregnancy?
a. Breathlessness is present during moderate activity
b. It caused by decrease minute ventilation
c. Followed by low oxygen saturation
d. Most common in the first trimester
e. Breathlessness is often felt during rest
12. Chromosomes In the Human body each consist of two pair of autosomes plus the sex
chromosome for a total 46. Which these statements is correct?
a. Each cell (except gametes) has 46 copies of genetic information
b. Y chromosome is larger tha X chromosomes
c. In females, there are two X chromosomes, both were active
d. Chromosomes are numbered sequentially with the smallest first
 e. In females, there are two X chromosome, one copy silent
13. Which of the following inflammatory cell types in the lesion plays the most important
role in the healing process?
a. Plasma cells
b. Epithelioid cells
c. Neutrophils
d. Macrophages
e. Eosinophiles
14. Which organs are primarily responsible for drug clearance in the body?
a. Liver and kidney
b. Pancreas and spleen
c. Heath and lungs
d. Stomach and intestines
e. Brain and spinal cord
15. Choose the correct statement about adaptive immunity!
a. T helper activates cellular immunity by releasing Th1 cytokines
b. B cells can present antigen through MHC class I molecule
c. T lymphocytes develop at bone marrow
d. Use dendritic cell to induce B cells activation
e. Recognize the antigen through pathogen recognition receptor
16. Malignant cervical neoplasia demonstrates
a. Relatively well differentiated cervical cells
b. Local destructive invasion of the surrounding cervical tissue
c. No metastasis outside surrounding cervical tissue
d. Bias distinction between benign and malignant appearance
e. No local destructive infiltration to surrounding cervical tissue
17. Which of the following is not multifactorial inheritance?
a. Diabetes mellitus
b. Cystic fibrosis
c. Congenital heart disease
d. Major neural tube defect (spina bifida and anencephaly)
 e. Cleft lip and palate
18. Which of the following gives rise to the chorionic structures that responsible for oxygen
and nutrients transport from the mother to the fetus?
a. Extra villous trophoblast
b. Endovascular trophoblast
c. Villous trophoblast
d. Interstitial trophoblast
e. Anchoring villi
19. The defect in placentation process (or deep placentation process) may lead to the
development of Great Obstetrics Syndromes which includes, except:
a. Abrutio placenta
b. Preeclamsia
c. Preterm labor
d. Macrosomia
e. Fetal growth restriction
20. What is the definition of pharmacokinetics?
a. Pharmacokinetics focuses on the analysis of adverse reactions and side effect
caused by drugs
b. Pharmacokinetics is the study of drug interactions with various receptors in the
body
c. Pharmacokinetics refers to the study of how drugs are metabolized by liver
d. Pharmacokinetics is the mathematical description of the rate and extent of drug
uptake, distribution, and elimination in the body
e. Pharmacokinetics refers to the study of the chemical properties and composition
of drugs
21. Which of the following is not a necessary component of the informed consent process?
a. Written authorization
b. Documentation of consent
c. Explanation by physician
d. Expressed patient preference
e. Patient understanding
22. A 23-year-old G1P0A0 reffered by midwife with an information that the labor was
prolonged. She was having labor pain for 8 hours but there was no visible progress of
labor. Her cervical examination reveals a dilatation of 3 cm, 50% effacement, 0 station
(hodge 3), and vertex presentation. The part of the maternal perlbis that used as landmark
to assess the fetal head lowering is:
a. Lesser sciatic foramen
b. Ischial spine
c. Sacral promontory
d. Ischial tuberosity
e. Margo inferior symphysis pubis
23. What is main reason to position the mother on her left side during maternal resuscitation?
a. In the left lateral recumbent position, there is an increase in the peripheral
vascular resistance
b. In the supine position there is an increase in venous return to the heart
c. Supine hypotensive syndrome can occur in the supine position
d. There was an increase in blood pressure in the left lateral recumbent position
e. There is a drecrease in stroke volume in the left lateral recumbent position
24. Which of the following muscle forms the labia majora?
a. Superficial transverse perineal muscle
b. Deep transverse perineal muscle
c. The external anal sphincter
d. Bulbospongiosus
e. Pubococcygek muscle
25. Choose the correct statement regarding to physiological changes of the cardiovascular
system in pregnancy!
a. Increased blood pressure in the 1st and 2nd trimester
b. Smaller heart silhouette
c. There was a loud diastolic murmur
d. Shift of the heart to the right
e. Increased cardiac output 40%
26. What is the ethical consideration for issues in pregnancy?
 a. The balance between risk and benefits is more important for the woman than
fetus
b. The doctor uses specialist knowledge without any experience and clinical
judgement
c. A pregnant woman’s right to informed refusal must be respected fully
d. The patient’s views and understanding of their condition is not essential for
making
e. The potential benefit to the fetus should be overstated in an effort to ensure
maternal participation
27. What is the condition with karyotype 69, XXX or 69 XXY & extra chromosomes from
the father that could lead to hydatidiform mole?
a. Trisomy 13
b. Trisomy 21
c. Polyploidy
d. Diandry polyploidy
e. Trisomy 18
28. Choose the correct statement regarding to physiological changes of the urinary system in
pregnancy?
a. Increased serum urea level in 3rd trimester
b. Increased RPF (Renal plasma flow) in 3rd trimester
c. Decreased serum creatinine, especially in 3rd trimester
d. Uterine enlargement often causes left urinary tract obstruction
e. Decreased GFR (Glomerular Filtration Rate) along pregnancy
29. Which of the following is not professional responsibilities in obstetric-gynaecologic
medical education and training?
a. Ethical Responsibilities of Learners Assisting in Research
b. Ethical Responsibilities Toward Patients in Educational Settings
c. In consideration of society’s interest in the education of physicians, all patients
should be considered “teaching patients”
d. Duties and responsibilities of doctor
e. Ethical Responsibilities of Teachers to Learners
30. The malignancy endometrium has endometrial hyperplasia as proposed precursor lesion,
in which:
a. Does not necessarily remain confined to the uterus at presentation
b. Atypical complex hyperplasia features either architectural or cytological
abnormalities
c. Metaplasia of epithelium is as common as metaplasia occurring in the cervix
d. Abnormal vaginal bleeding is common symptom in postmenopausal women
e. Estrogen as in the absence of progesterone is minor to proliferation of the
epithelium
31. The woman underwent a caesarean section to give birth in this operation, incisions and
sutures are also made on the lower abdominal wall. What changes are most likely to
occur in this woman's surgical wound tissue one week postoperatively?
a. Granulation tissue is visible
b. Vascular changes
c. There are many blood clots
d. Keloids form
e. Fluid exudation
32. Which of the following statements is not true regarding epigenetic?
a. May involve noncoding RNA
b. The process may involve Histone modification
c. A methyl group (-CH3) is added to a cytosine, converting it to 5-methylcytosine
d. The principal epigenetic modification of DNA is methylation
e. Modifications of DNA and chromatin that affects the underlying DNA sequence
33. Which of the following is not correct regarding reproductive hormone?
a. Hypophysis secretion is in pulsatile fashion
b. Reproductive hormones mainly produce by the ovary
c. GRH induces production of LH and FSH
d. LH receptors can be found in granulosa cells
e. FSH receptors can be found in granulosa cells
34. During drug distribution, which of the following accurately describes the two phases of
distribution?
 a. The first phase involves rapid distribution to the muscles, brain, and skin, while
the second phase involves slower distribution to the liver, kidney, viscera and fat
b. In the first phase, drugs are rapidly distributed to the liver, kidney, and brain,
followed by a slower distribution to muscles, viscera, skin, and fat in the second
phase
c. The first phase involves rapid distribution to muscles, viscera, skin, and fat, while
the second phase involves slower distribution to the liver, kidney, and brain
d. Initially, drugs are quickly distributed to the liver, kidney, and viscera in the first
phase, and subsequently, there is slow distribution to brain, muscles, skin, and fat
in the second phase
e. The first phase encompasses slow distribution to the skin, fat, and viscera, while
the second phase involves slower distribution to the liver, kidney, and brain
35. The following statements are true regarding to GnRH:
a. It enters posterior lobe of pituitary
b. The secretion is stimulated by dopamine
c. It has membrane receptor
d. It's a steroid hormone
e. It directly enters from tractus tubero infundibular
36. Choose the incorrect statement about immunity!
a. Autoimmune disease is a kind of immune pathology
b. Protect the body from harmful objects
c. Allergic reaction is a part of normal immune response
d. Should be able to differentiate between foreign and self-antigens
e. Immune response should be regulated
37. The maintenance of normal tissue architecture, whether normal or neoplastic is dependent
upon the balance of
a. cellular proliferation and cell death
b. cellular proliferation and mitotic
c. cellular mitotic and necrotic
d. cellular angiogenesis and proliferation
e. cellular necrotic and cell death
38. Pelvic muscles consist of
a. Pubococcygeus, piriformis, internal anal sphincter
b. Arcus tendineus, levator ani, bulbocavernosus, puborectalis
c. Piriformis, arcus tendineus fascia pelvis, gluteus
d. Coccygeus, arcus tendineus fascia pelvis, ischiocavernosus
e. Iliococcygeus, puborectalis, piriformis
39. Which of the following statements best describes as drug clearance?
a. Drug clearance refers to the elimination of drugs from the body through sweating
and urination
b. Drug clearance measures how efficiently the body eliminates drugs over a
specific period of time
c. Drug clearance determines the dosage of a drug needed to achieve maximum
plasma concentration
d. Drug clearance refers to the absorption of drugs by the liver and kidney for
therapeutic purposes
e. Drug clearance is the process of breaking down drugs into smaller molecules for
easier absorption
40. One of the typical morphology of acute inflammation is?
a. Fluid transudation
b. Tissue damage
c. Lymphocyte migration
d. Fibrosis
e. ECM Deposition
41. Which of the following ovarian actions is attributable to LH during the follicular phase of
the ovarian cycle?
a. Stimulation of granulose cell mitosis and division
b. Stimulation of the production of androgen by thecal cells
c. Stimulation of the production of primordial follicles
d. Stimulation of the production of GnRH by the hypothalamus
e. Stimulation of the production of estrogen by thecal cells
42. Which of the following options correctly matches the type of drug transport with its
corresponding description?
a. Transcapillary movement: diffusion of the drug through the cell membrane along
a concentration gradient
b. Paracellular transport: carrier-mediated transport process in which there is no
input of energy
c. Passive transport: transfer of the drug with bulk transfer of water due to pressure
differences
d. Facilitated diffusion: principal mechanism of excretion of drugs by the kidney
e. Active transport: movement of a drug against an electrochemical gradient,
requiring energy
43. Choose the correct statement regarding to embryonic development!
a. Fertilization occurs on the second day in the cornu area
b. Implantation occurs at the early blastocyst stage in the cornu area
c. Fertilization occurs three days after ovulation, in the isthmic portion of the
fallopian tube
d. Implantation occurs at the blastocyst stage in the uterine cavity
e. On the fourth day, the morula formed in the ampulla
44. Which of the following were the characteristics of autosomal dominant diseases?
a. Affected individuals have a 25% risk of transmitting the variant to their offspring
b. Unequal ratio of affected males and females
c. Affected individuals have a 50% risk of transmitting the variant to their offspring
d. Affected individuals have a 75% risk of transmitting the variant to their offspring
e. Only affect one generation
45. The branches of the anterior division of the internal iliac artery that supply the pelvis are:
a. 3 vesical: superior vesical, umbilical, and inferior vesical arteries
b. 3 vesical: superior vesical, umbilical, and inferior gluteal arteries
c. 3 visceral: middle rectal, vaginal, internal pudendal arteries
d. 3 parietal: obturator, internal pudendal, and inferior vesical arteries
e. 3 visceral: middle rectal, umbilical, uterine arteries
46. What is ethical responsibilities toward patients in educational settings
 a. Professional obligations include disclosure of the risks and benefits inherent in the
teaching setting and provision of adequate supervision for junior levels of training
b. Physicians must learn new skills and techniques in a manner consistent with the
ethical obligations to provide benefit for the hospital
c. Respect for patient autonomy requires that patients be allowed to choose not to be
cared for or treated by learners when this is feasible
d. the obligations of the profession, the institution, and patients should not be
uniform and explicit.
e. Patient characteristics such as race, ethnicity, or socioeconomic status should be
the basis for selection patients for teaching.
47. Which of the following disease that is not X-Linked Recessive:
a. Glucose-6-phosphate dehydrogenase deficiency
b. Duchenne muscular dystrophy
c. Spinal muscular atrophy
d. Hemophilia A (Factor VIII deficiency)
e. Hemophilia B (Factor IX deficiency)
48. What is ethical responsibilities toward patients in educational settings?
a. Professional obligations include disclosure of the risks and benefits inherent in the
teaching setting and provision of adequate supervision for junior levels of training
b. Physicians must learn new skills and techniques in a manner consistent with the
ethical obligations to provide benefit for the hospital
c. Respect for patient autonomy requires that patients be allowed to choose not to be
cared for or treated by learners when this is feasible
d. the obligations of the profession, the institution, and patients should not be
uniform and explicit.
e. Patient characteristics such as race, ethnicity, or socioeconomic status should be
the basis for selectif patients for teaching
49. Which of the following physiological placental factors are known to influence
pharmacokinetics during normal pregnancy?
a. At term, the placental surface area is minimal, limiting the passage of substances
to the fetus
b. Placental metabolism plays a minimal role in drug transfer across the placenta
c. Placental pharmacokinetics are primarily determined by the thickness and density
of the placenta
d. Maternal drug disposition is unaffected by placental flow changes during
gestation
e. Blood flow through the placenta increases during pregnancy, affecting the transfer
of flow-limited drugs