IMU

SOAL OBSTETRI I
1. In the primigravida, engagement usually takes place at:
a. 35 weeks
b. 36 weeks
c. 37 weeks
d. 38 weeks
2. During palpation, you find fetal head lies on the fundus of the uterus. This is an abnormally on:
a. Lies
b. Presentation
c. Attitude
d. Position
3. You are going to determine whether the fetus flexed or deflexed. Which of the following Leopold
maneuver is used?
a. L-I
b. L-II
c. L-III
d. L-IV
4. The first maneuver of Leopold is used to determine which of the following?
a. Lies
b. Presentation
c. Engagement
d. Position
Case
A 40 y.o woman referred to Sardjito hospital by a midwife because of retained placenta bleeding about 20
minutes after delivery. Examination on the emergency unit revealed that blood pressure 60/30 mmHg and
pulse rate was 132 bpm. RL infusion and 4 L oxygen were given. She was survived after blood transfusion
was given.
6. Which is the most likely diagnosis in such a case?
a. Primary shock
b. Impending shock
c. Secondary shock
d. Irreversible shock
7. Which of following solution would be given first?
IMU

a. Dextrose 5% solution
b. Dextrose 10% solution
c. Electrolyte solution
d. Colloid solution
8. Which of the following shock in the above case classified?
a. Neurogenic shock
b. Septic shock
c. Anaphylactic shock
d. Hypovolemic shock
9. Which of the following is the first sign of hemorrhagic shock?
a. Decreased blood pressure
b. Increased pulse rate
c. Increased respiratory rate
d. Increased urinary output
10. Which of the following is the simplest way to monitor that homeostasis has been recovered after fluid
resuscitation during treatment of hypovolemic shock?
a. Blood pressure
b. Urinary output
c. Respiratory rate
d. Pulse rate
11. What causes Respiratory distress syndrome?
a. Decreased alveolar surface tension
b. Decreased alveolar surfactant
c. Increased alveolar fluid
d. Increased mucus plugging
12. Which of the following stimulates newborn respiration?
a. O2 accumulation and CO2 accumulation
b. O2 accumulation and CO2 deprivation
c. O2 deprivation and CO2 deprivation
d. O2 deprivation and CO2 accumulation
13. A low 1-min Apgar score helps identify which of the following?
a. Infant who need special attention
b. Infant with birth asphyxia
IMU

c. Infant destined to develop neurological problems

d. Normal infant
14. What is Apgar Score of a male infant at 5 minutes of life whose respiratory effort irregular, pulse is 90,
who is floppy, cyanotic and with minimal grimaces?
a. 1
b. 3
c. 4
d. 7
15. Which of the following is NOT part of APGAR Score?
a. Heart rate
b. Respiratory rate
c. Color
d. Amniotic fluid consistency
16. Primary germ layer consist of
a. Only 1 layer called inner cell mast
b. Ectoderm & endoderm
c. Consist 3 layers consist of ectoderm, mesoderm & endoderm
d. Syncytial trophoblast & cellular trophoblast
17. What must be released from sperm to break through corona radiates & zone pellucid?
a. Glyceraldehydes 3-phosphate dehydrogenate 9
b. Hexakinase
c. Enzyme amylase
d. Enzyme hyaluronidase
18. What hormone that will maintain corpus luteum thorough 1st four months
a. hCG
b. hPL
c. hCS
d. Estrogen & progesterone
A 15 y.o G1P0A0 came to emergency room with chief complaint with excessive vomiting. She was 10 weeks
pregnant. Her blood pressure 100/60 mmHg & pulse rate 100 bpm. Her skin’s turgor was decreased.
21. These statements below are the differential diagnosis of the disease, EXCEPT
a. Acute pyelonefritis
b. Gastritis
IMU

c. Hydatidiform mole a
d. Pancreatitis
e. Bladder’s stone
22. If you find the fundal height is higher than the expected gestational age, what should do next to confirm
the diagnosis?
a. Chest X-Ray
b. USG
c. MRI
d. Serial urine β-hCG level
e. CT scan
23. On the physical examination you found flank pain on the right costovertebral region. She also suffered
from high fever. What was the likely diagnosis?
a. Acute pyelonefritis
b. Gastritis
c. Hydatidiform mole
d. Pancreatitis
e. Bladder’s stone
24. What is the initial management for this patient?
a. Rehydration
a. Perform USG
b. Administer antiemetic
c. Administer antibiotics
d. Administer endoscopy
25. These statements below are required to establish the diagnosis, EXCEPT
a. Physical examination
b. Complete blood count
c. Chemical blood examination
d. USG
e. Perform pregnancy test
26. About puerperium
a. The 3rd trimester
b. Interval between birth of baby and the return of reproductive organs to nonpregnant state
c. Last in about 8 weeks
IMU

d. Last in 4 weeks
27. Symptom in non lochial bleeding
a. Greater with uterine contraction
b. Gush with fundal massage
c. Continues to bleed bright red or excessive
d. Dark red indicates pooled blood and should lessen
28. Which is true about lochia?
a. Lochia rubra – bright red going to reddish brown (3-4 day pp)
b. Lochia serosa – pink or brown (usually lasting about 32-34 days)
c. Lochia albans – yellow or white (can last up to 8 weeks pp)
d. Lochia rubra – bright red going to reddish brown (13-14 day pp)
29. Retained placenta fragments
a. The uterus return to nonpregnant state
b. Within 12 hours of delivery, the fundus is about 1 cm above the umbilicus
c. Subinvolusion
d. The cervix doesn’t return to circular or shape
30. Changes that you have to observe at the abdomen
a. Decrease estrogen affects rugae & mucosa of vagina
b. Episiotomy and/or lacerations
c. Hemorrhoids
d. Diastasis recti abdominis
31. Signs of labor EXCEPT
a. Braxton Hicks
b. Regular uterine contraction
c. Bloody show
d. Rupture of the amniotic membrane
e. Cervical dilatation
32. Most cause of early postpartum bleeding
a. Uterine atonia
b. Placental retention
c. Perineal laceration
d. Cervical laceration
e. Abnormal coagulation
IMU

33. Signs of stage two of labor

a. Opening of both vulva & anus
b. Showing of the lowest fetal part at the vulva
c. Bearing down effort of the mother
d. Full dilatation of the cervix
e. All above
34. Mechanism of vaginal delivery
a. Flexion – Internal rotation - extension – external rotation
b. Internal rotation – flexion – external rotation – extension
c. Extension – Internal rotation - Flexion – external rotation
d. Flexion – external rotation - extension – Internal rotation
e. Not all above
35. Signs of placental separation should be recognized
a. Sudden gush of blood
b. Umbilical cord protrudes farther out of the vagina
c. Uterus becomes globular & firmer
d. All above
e. None
36. The LMP was June 30. The expected date of confinement (EDC) is approximately
a. March 23
b. April 7
c. March 28
d. April 23
e. March 7
37. Pregnancy may occur during a period of amenorrhea such as during lactation or following
discontinuance of hormonal methods of contraception. In such situation, determination of the most
accurate estimated date of delivery can then be made by:
a. Eliciting when breast tenderness or morning sickness began
b. Assessing uterine size by physical exam
c. Counting 280 days from the first positive serum pregnancy test
d. Asking the patient when she first felt pregnant
e. Obtaining fetal biometry by ultrasound prior 20 weeks of gestation
IMU

38. 20 y.o primigravida who is 24 pregnant weeks expresses concern about the normality of her fetus after
learning that a close friend has just delivered an infant with hydrocephalus. Details about hydrocephalus
that should be included in her counseling include the fact that:
a. Occurs spontaneously in 1 of 500 pregnancies
b. Has a multifactorial etiology
c. Usually an isolated defect
d. Can be cured by intrauterine placement of shunts
e. Can be identified as early as 10 weeks of gestation
39. Fundal height, part of obstetric examination, is taken of the top of the symphisis pubis to the top of the
fundus. It is measured:
a. By calipers, approximating the weeks of gestation
b. In inches, approximating the lunar month of gestation
c. In centimeters, divided 3.5 approximating the lunar month of gestation
d. In centimeters, approximating the weeks of gestation between 18 to 34 weeks
e. By calipers in centimeters, prognosticating the fetal weight
40. On the following, the most worry sign or symptom of potentially pathology in late pregnancy is
a. Swollen ankles
b. Constipation
c. Visual changes
d. Nocturia
e. Heartburn
41. Which one gives very accurate estimation of the gestational age can be made between 7 to 13 weeks?
a. CRL
b. BPD
c. FL
d. AC
42. When the earliest time we can use BPD to estimate the gestational age?
a. 8 weeks
b. 10 weeks
c. 13 weeks
d. 16 weeks
43. For 1st trimester ultrasonic soft markers of Down Syndrome are
a. Absence of fetal nasal bone and increased fetal nuchal translucency
IMU

b. Choroid plexus cysts

c. Single umbilical artery
d. Banana sign
44. False-positive results for diagnosis placenta previa with abdominal ultrasonography can occur caused
by:
a. Number of fetus
b. Parity
c. Scar cause by previous cesarean section
d. Bladder distention
45. What the anatomical landmarks should must be seen when we measure BPD be used to estimate
gestational age?
a. Midline falx, thalami symmetrically positioned, septum pellucidum
b. Orbita & thalami symmetrically positioned
c. Cerebellum & thalami symmetrically positioned
d. Cisterna magna, Cerebellum & thalami symmetrically positioned