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1. A baby is born with ambiguous genitalia. Which of the following statements is true?

A. A karyotype is rarely needed


B. Evaluation should be done by 1 month of age
C. It is sometimes associated with a history of a previous sibling with congenital adrenal hyperplasia (CA!
". A thorough physical e#amination can usually decide the true se#
2. Puerperal fever from breast engorgement
A. Appears in less than $% of postpartum women
B. Appears & to ' days after the development of lacteal secretion
C. Is almost painless
". (arely e#ceeds &).*+C (,,.*+-!
E. Is less severe and less common if lactation is suppressed
3. In the mother, sucling lea!s to which of the following responses?
A. "ecrease of o#ytocin
B. Increase of prolactin.inhibiting factor
C. Increase of hypothalamic dopamine
". Increase of hypothalamic prolactin
E. Increase of luteini/ing hormone0releasing factor
". Which of the following statements regar!ing the postpartum !evelopment of pulmonary embolism #P$%
is true?
A. It is a relatively uncommon phenomenon1 with an incidence of about 1 in $222
B. In most cases1 the classic triad of hemoptysis1 pleuritic chest pain1 and dyspnea suggests the diagnosis
C. A mismatch in ventilation.perfusion scan is pathognomonic of 3E
". 4he most common finding at physical e#amination is a pleuritic friction rub
&. 'eptic pelvic thrombophlebitis may be characteri(e! by which of the following statements?
A. It usually involves both the iliofemoral and ovarian veins
B. Antimicrobial therapy is usually ineffective
C. -ever spikes are rare
". It is usually associated with fever without pain or palpable masses
E. 5ena caval thrombosis may accompany either ovarian or iliofemoral thrombophlebitis
). A postpartum woman has acute puerperal mastitis. Which of the following statements is true?
A. 4he initial treatment is penicillin
B. 4he source of the infection is usually the infant6s gastrointestinal (7I! tract
C. -rank abscesses may develop and re8uire drainage
". 4he most common offending organism is Escherichia coli
E. 4he symptoms include lethargy
*. +reast,fee!ing can be encourage! !espite which of the following con!itions?
A. 9aternal hepatitis B
B. 9aternal reduction mammoplasty with transplantation of the nipples
C. 9aternal acute puerperal mastitis
". 9aternal treatment with lithium carbonate
1
-. Which of the following is.are signs of menopause/
A. high -:.
B. low -:
C. low estrogen
". high estrogen
E. a ; c.
0. 1he main symptom of menopause is /
A. hot flashes.
B. night sweat
C. vaginal dryness.
". sleep disturbance
E. all the above.
12. 1he contrain!ication for use hormonal replacement therapy#341% are /
A. smoking
B. une#plained vaginal bleeding
C. coronary artery disease
". breast cancer
E. all the above.
11. A && year ol! woman who has 5ust gone through her menopause is concerne! that she may !evelop
vertebral fractures. 'he has never ha! any surgery before an! has no relevant me!ical history. What is the
most effective way of preventing pathological fractures post,menopause?
A. Clonidine < 5aginal lubricant
B. Combined =estrogen and progestogen replacement therapy
C. =estrogen only (4
". 3rogestins
E. 9ineral supplements
12. all of the following appear to !ecrease hot flushes in menopausal women e6cept ?
A. androgens
B. ralo#ifene
C. isoflavones
". tibolone
13. 7enopause coul! be !iagnose! by
A. history of absent menstruation
B. igh -: level in young age group
C. Absent menstruation for 1 year at the age of $> year
". ot flushes
E. Insomnia

1". 341 is useful in all e6cept
A. -lushing
B. =steoporosis
C. 5aginal atrophy
". Coronary heart disease
>
1&. estrogen replacement for post,menopausal symptoms cause an increase in ?
A. ?"?
B. Cholesterol
C. 5?"?
". 4riglycerides
1). absolute contrain!ication of hormone replacement therapy is ?
A. thrombosis
B. fibrocystic disease
C. fibroadenoma
". hemorrhage
1*. 8n43 analogues may be given in all of the following e6cept ?
A. prostate carcinoma
B. endometrial carcinoma
C. fibromyoma of uterus
". precocious puberty
1-. estrogen a!ministration in a post menopausal woman increases the ?
A. gonadotropin secretion
B. ?"? 0 cholesterol
C. Bone mass
". 9uscle mass
10. 9ontrain!ication to postmenpausal estrogen replacement therapy inclu!e the following e6cept
A. (esent deep vein thrombosis
B. Acute liver disease
C. igh serum triglyceride
". 3remenpausal mastectomy for breast cancer
E. "iabetes mellitus
22. A 2& years ol! primigravi!a reports at ) wees gestation with h:o sei(ure !isor!er. 'he has been on
phenytoin for the last ) months. 1he appropriate management in this case woul! be ;ne answer only.
A. Continue phenytoin and ad@ust the levels as per serum levels
B. :top phenytoin and start barbiturates
C. 4erminate pregnancy as phenytoin has had its teratogenic effect
". :top phenytoin and terminate pregnancy if sonography detects malformations
21. Which vitamin !eficiency is most commonly seen in a pregnant mother who is on phenytoin therapy
for epilepsy?
A. 5itamin BA
B. 5itamin B1>
C. 5itamin A
". -olic acid
&
22. Which of the following statements is incorrect in relation to pregnant women with epilepsy?
A. 4he rate of congenital malformation is increased in the offspring of women with epilepsy
B. :ei/ure fre8uency increases in appro#imately )2% of women
C. Breast feeding is safe with most anticonvulsants
". -olic acid supplementation may reduce the risk of neural tube defect
23. 'afest antiepileptic !rug in pregnancy
A. "ia/epam
B. 3henytoin
C. Carbama/epine
". 5alproate
2". Which of the following anticonvulsants is most liely to be associate! with a neural tube !efect?
A. phenobarbital
B. carbama/epine
C. phenytoin
". valproic acid
2&. 1he best perio! of gestation to carry out chorion villous biopsy for prenatal !iagnosis is?
A. *.12 weeks
B. 12.1> weeks
C. 1>.1' weeks
". 1'.1A weeks
2). prenatal !iagnosis is possible " all e6cept
A. sickle cell trait
B. beta thallasemia
C. "9"
". ectodermal dysplasia
2*. Prenatal !iagnosis at 1) wees of pregnancy can be performe! using all of the following, e6cept/
A. Amniotic fluid.
B. 9aternal blood.
C. Chorionic villi.
". -etal blood.
2-. Which one of the following congenital malformation of the fetus can be !iagnose! in first trimester by
ultrasoun! ?
A. Anencephaly
B. Inencephaly
C. 9icrocephaly
". oloprosencephaly
'
20. 1he best way of !iagnosing 1risomy,21 !uring secon! trimester of pregnancy is ?
A. 4riple marker estimation
B. Buchal skin fold thickness measurement
C. Chorionic villus sampling
". Amniocentesis
32. A patient with non,metastatic gestational trophoblastic !isease can be treate! with weely
intramuscular in5ections of which of the following agents ?
A. Cyclophosphamide
B. Carboplatinum
C. 53.1A (etoposide!
". Actinomycin "
E. 9ethotre#ate
31. <ive,year survival rates of patients with low,ris, non,metastatic gestational trophoblastic !isease
approaches ?
A. 122%
B. )$%
C. $2%
". >$%
E. $ to 12%
32. 9omparing complete hy!ati!iform moles gestations, complete an! partial moles are more liely to
!emonstrate all of these characteristics e6cept ?
A. more likely to re8uire chemotherapy after evacuation for gestational trophablastic disease
B. more likely to present with a uterus large for dates
C. more likely to present with theca lutein cysts
". more likely to Chave focal rather than diffuse trophoblastic proliferation
E. more likely to diffuse hydopic swelling of villi
33. A woman e6periencing a molar pregnancy has an increase! ris of which of the following in
subse=uent gestations ?
A. :tillbirth
B. 3rematurity
C. Congenital malformations
". (ecurrent molar gestation
E. Cancer later in life
3". 1he most liely aryotype of patient with a complete mole woul! be ?
A. 'A1 DD
B. 'A1 DE
C. "iandric triploidy
". 4riploidy with two haploid sets of maternal origin
E. Aneuploidy
$
3&. 1he most liely aryotype of patient with a partial mole woul! be ?
A. 'A1 DD
B. 'A1 DE
C. "iandric triploidy
". 4riploidy with two haploid sets of maternal origin
E. Aneuploidy
3). A woman with a complete mole is most liely to present with which of the symptoms ?
A. 5aginal Bleeding
B. E#cessive uterine si/e
C. ypermesis
". 3rominent theca lutein cysts
E. 3re.eclampsia
3*. A patient with a complete mole is foun! to have si(eable ovarian cysts that are presume! to be theca
lutein cysts. All of the following are true about theca lutein cysts $>9$P1 ?
A. :uch cysts arise more fre8uently in patients with complete moles
B. 4heca lutein cysts are more likely seen in patients with very high hC7 levels
C. Cysts are filled with serious or serosanguinous fluid and are usually bilateral
". =ften re8uire active management with surgical intervention
E. 3atients with large theca lutein cysts may be at increased risk for postmolar persistence of disease
3-. 1he lea!ing cause of !eath for woman ol!er than )& years ol! is ?
A. Cancer
B. 3neumonia
C. eart disease
". :troke
E. Al/heimerCs
30. A 2) year ol! presents to your office for preconception counseling. What is the highest probability of
pregnancy relative to ovulation ?
A. $ days before ovulation
B. > days before ovulation
C. 1 day before ovulation
". "ay of ovulation
E. 1 day after ovulation
"2. 1he a!vantages of a prophylactic oophorectomy at the time of hysterectomy for benign reasons inclu!e
all of the following e6cept ?
A. ?owers the incidence of ovarian cancer
B. ?owers the risk of coronary artery disease
C. ?owers the risk of subse8uent surgery for ovarian pathology
". Accommodates patients re8uest
A
"1. 1he a!vantages of preserving the ovaries at time of hysterectomy for benign !isease inclu!e all of the
following e6cept ?
A. (educes the risk of ovarian cancer
B. (educes the risk of coronary artery disease (CA"!
C. ?owers the risk of osteoporotic fracture
". (educes the risk of breast cancer
E. 3revention of climacteric symptoms
"2. At what age is there no significant !ifference in survival for prophylactic oophorectomy at the time of
hysterectomy for benign !isease in woman at low ris for ovarian cancer ?
A. $2 years
B. $$ years
C. A2 years
". A$ years
E. )2 years
"3. All of the following comprise systemic symptoms of a primary 3erpes 'imple6 outbrea e6cept ?
A. 9yalgias
B. -ever
C. ?ymphadenopathy
". Crusting of ulcers
E. eadaches
"". 1he minimum !iagnostic criteria for Pelvic Inflammatory ?isease inclu!e all of the following e6cept ?
A. Cervical motion tenderness
B. -ever
C. 3elvic pain
". Adne#al tenderness
"&. 1he best pre!ictive factor for 9hlamy!ia is ?
A. F> :e#ual partners in the past si# months
B. 9ultiple body piercing
C. Age G>$ years
". :ingle status
E. Current IH" user
"). 1he components involve! in the calculation of bo!y mass in!e6 #+7I% inclu!e all of the following
e6cept ?
A. eight in inches
B. Ieight in pounds
C. Ieight in kilogram
". :e#
"*. 1he incriminates of measurement of +o!y 7ass In!e6 #+7I% are ?
A. 1$.1,
B. 1,.>'
C. >$.&2
". &1.&$
E. &A.'2
)
"-. Which racial group has the highest prevalence of obesity in women in America ?
A. Black
B. Ihite
C. ispanic
". =riental
"0. Which of the following attributes the most increase obesity in a!olescent girls ?
A. "ecreased e#ercise
B. Increased caloric intake
C. ormonal food supplementation
". :moking
E. 3regnancy
&2. What is the least liely effective treatment for a patient with 'tress @rinary Incontinence #'@I% without
a cystocele ?
A. Anterior colporraphy
B. Burch retropubic urethrope#y
C. 4ension free vaginal tape (454!
". 4ransobturator tape (4=4!
E. 3ubovaginal sling with autologous fascia
&1. ;f the following tests for evaluation of 'tress @rinary Incontinence #'@I%, the most sensitive is
A. :tanding stress test (::4!
B. J.tip test
C. 5alsalva leak point pressure (5?33!
". 9a#imal urethral closing pressure (9HC3!
&2. A tension free vaginal tape #1A1% is positione! un!er which anatomical lan!mar of the urethra ?
A. Hrethorvesical @unction (H5<!
B. 9id.urethra
C. "istal urethra
". 3ro#imal urethra
&3. 1he point of anchorage for a +urch retropubic colposuspension is which anatomical lan!mar ?
A. 3eriosteum of the pubic bone
B. Ileopectineal ligament
C. :acrospinous ligament
". =bturator membrane
E. :acrotuberous ligament
&". A Patient un!ergoes surgical repair of uterine porlapse, enterocele, rectocele, an! cystocele. 'urgery
was co!e! as &-2*2 an! &*2)2,&1 mo!ifier. Why was the surgery co!e! this way instea! of billing for each
proce!ure separately ?
A. bundled coding
B. un bundled coding
C. none of the above
". all of the above
*
&&. What type of pelvis is characteri(e! by a short anteriorBposterior !iameter an! a wi!e transverse
!iameter?
A. gynecoid
B. android
C. anthropoid
". platypelloid
&). What is the most common !eceleration pattern encountere! !uring labor?
A. late decelerations
B. early decelerations
C. variable decelerations
". mi#ed decelerations
&*. +efore one !eci!es to perform a cesarean section for !ystocia, there shoul! be how much uterine
activity?
A. )$ to 122 9ontevideo units
B. 1$2 to 1)$ 9ontevideo units
C. >22 to >>$ 9ontevideo units
". &22 to &>$ 9ontevideo HBI4:
&-. 7icroinvasion of carcinoma of the cervi6 involves a !epth below the base of the epithelium of no more
than
A. 1 mm
B. > mm
C. & mm
". ' mm
E. $ mm
&0. What is bra!ycar!ia?
A. baseline fetal heart rate G 122 for F $ min
B. baseline fetal heart rate G 122 for F 1$ min
C. baseline fetal heart rate G 1>2 for F $ min
". baseline fetal heart rate G 1>2 for F 1$ min
)2. What is a laceration involving the sin, mucous membrane, perineal bo!y, anal sphincter, an! rectal
mucosa calle!?
A. 1st degree
B. >nd degree
C. &rd degree
". 'th degree
)1. What is the me!ian !uration of the secon! stage of labor in multiparas?
A. $ min
B. 12 min
C. >2 min
". &2 min
,
)2. When shoul! the fetal heart rate be auscultate! !uring observation for labor?
A. before the contraction
B. during the contraction
C. at the end and immediately after a con.traction
". anytime
)3. A 3* year ol! woman complains of postcoital blee!ing . 1he least liely cause of her blee!ing woul! be
cervical
A. 3olyp
B. Ectropion
C. Carcinoma
". Babothian cyst
E. Infection
)". At the eights wees gestation a women has an I@9? an! the strings are visible at the e6ternal os. 1he
best management is
A. Antibiotics
B. 3rogestrone
C. "ilation and curettage
". (emoval of IHC"
E. Bed rest
)&. 8enital prolapse is associate! with the following e6cept 9hronic
A. constipation
B. 3rolonged second stage
C. Hnreparied hidden perineal tear
". Improper applied forceps
E. 4he use of (4 at the menpause
)). In!uction of labor at term is contrain!icate! in
A. breech presentation
B. 7"9
C. 3lacenta previa
". postmaturity
E. A and C
)*. 7icro invasion of carcinoma of the cervi6 involves a !epth below the base of the epithelium of no more
than
A. 1 mm
B. > mm
C. & mm
". ' mm
E. $ mm
12
)-. 4ectal e6amination in the gynecological practice
A. Is useful in the diagnosis of enterocele
B. Is useful in suspected pelvic abscess
C. Is indicated in the assessment of carcinoma of the cervi#
". All of the above
E. Bone of the above
)0. 4is factors for !evelopment of cancer cervi6 inclu!e the following e6cept
A. Early se#ual activity
B. Bulliparous
C. 35 infection
". :moking
*2. 1he best contraceptive metho! for patients with gestational trophoblastic !isease
A. 4ubal ligation
B. ystrectomy
C. Combined contraceptive pills
". IHC" device
E. :ubcutaneous implant
*1. 1he bishops score is use! to assess
A. pelvic diameters
B. fetal head diameter
C. fetal presentation
". the recommended method of delivery
E. the recommended method of induction of labour
*2. 1he following investigations are component of routine antenatal care e6cept
A. (h type
B. emoglobin
C. Hrine analysis for sugar and protein
". Blood grouping
E. Hrine culture
*3. 1he following vessels contains o6ygenate! bloo! e6cept
A. Hmbilical artery
B. "uctus venosus
C. 4he inferior vena cava as enters the right atrium
". Carotid artery
E. Hmbilical veins
*". 1he most common benign mass of the cervi6 an! en!ocervi6 is
A. 3olyp
B. ?ieomyoma
C. Bobothian cyst
". Cervical hood
E. 7artner duct cyst
11
*&. 1he si!e effects of combine! ;9P inclu!e the following e6cept
A. Bausea
B. "i//iness
C. 5aginal discharge
". 9enorrhagia
E. Ieight gain
*). 1he true statement about retroversion of the uterus is
A. Is a common cause of infertility
B. :hould be corrected with a odge pessary
C. 9ay be corrected with a -othergill operation
". occurs in >2% of normal women
E. Is caused with heavy lifting
**. Which of the following is an absolute contrain!ication for oral progesterone only contraceptive pills
A. Cigarette smoking
B. "epression
C. 7all bladder stone
". 9ild hypertension
E. Hne#plained vaginal bleeding
*-. An enterocele is best characteri(e! by which of the following statement
A. It is not true hernia
B. It is herniation of the bladder floor into the vagina
C. It is prolapse of the uterus and vaginal wall outside the body
". It is protrusion of the pelvic peritoneal sac and vaginal wall into the vagina
E. It is a herniation of the rectal and vaginal wall into the vagina
*0. All of the following statements with regar! to the copper I@9? are correct e6cept
A. 9odern copper IHC" is effective and safe for at least five years
B. It reduce s the number of sperm reaching the fallopian tube and their capacity to fertili/e the eggs
C. 4he risk of pelvic infection is low and does not increase with long term use
". Is contraindicated in women with irregular vaginal bleeding
E. ?evenorgestrel releasing devices are associated with menorrhagia
-2. As regar! fetal presentation , the incorrect statement is
A. Is the part of the fetus that enters the pelvis first
B. In face presentation the occiput and back comes into contact
C. is usually cephalic
". 4he denominator is the lowest part of the presenting area
E. In cephalic presentation it is more common to be verte#
-1. 1he shortest !iameter of the pelvic cavity is
A. 4he e#ternal con@ugate
B. 4he diagonale con@ugate
C. 4he interspines
". 4he true con@ugate
E. 4he transverse
1>
-2. As regar! the mechanism of labor , which of the following se=uences is correct
A. "escent 1 internal rotation 1 fle#ion
B. Engagement 1 fle#ion 1 descent
C. Engagement 1 internal rotation 1 descent
". Engagement 1 descent 1 fle#ion
E. "escent 1 fle#ion 1 engagement
-3. 1he following statements regar!ing ischial spines are correct e6cept
A. 4hey make the beginning of the forward curve of the pelvis
B. 4he are landmarks for pudendal nerve block procedure
C. 4hey indicate a normal pelvis when particularly prominent
". 4hey help to assess station of the presenting part
E. 4hey lie at the level of the plane of least pelvic dimensions
-". 9aput succe!aneum
A. (esolves spontaneously after labor
B. 9ay lead to @aundice of the baby postpartum
C. Indicate traumatic vaginal delivery
". Indicates that the fetal head engaged
E. Is a sign of intrauterine fetal death
-&. Aariable !eceleration on fetal heart rate monitoring are usually !ue to
A. -etal head compression
B. Hteroplacental isufficiency
C. -etal metabolic acidosis
". Hmbilical cord compression
E. -etal distress
-). $pi!ural anaesthesia
A. "oes not affect uterine activity
B. Is contraindicated in patient with heart valve lesions
C. :hould be routinely administerted during the first stage of labor
". Increase the risk of 33
E. :hould be offered to highly selected cases in labor
-*. 1he following hormone is responsible for the contraction of the myoepithelial cells of the breast
A. =#ytocin
B. 3rolactin
C. 3rogestrone
". 3lacental lactogen
E. Estrogen
1&
--. 7aternal mortality refers to the number of maternal !eaths that occur as the result of the repro!uctive
process per
A. 1222 births
B. 12.222 births
C. 122.222 births
". 12.222 live births
E. 122. 222 live births
-0. What are the car!inal movements of labor #in or!er%?
A. descent1 engagement1 fle#ion1 internal rotation1 e#tension1 e#ternal rotation1 e#pulsion
B. descent1 fle#ion1 engagement1 internal rotation1 e#tension1 e#ternal rotation1 e#pulsion
C. engagement1 descent1 fle#ion1 internal rotation1 e#tension1 e#ternal rotation1 e#pulsion
". engagement1 fle#ion1 descent1 internal rotation1 e#tension1 e#ternal rotation1 e#pulsion
02. Which of the following is characteristic of asynclitism?
A. :agittal suture is not parallel to the transverse a#is of the inlet.
B. :agittal suture lies midway between the symphysis and sacral promontory.
C. :agittal suture1 although parallel to the transverse a#is of the inlet1 does not lie e#actly midway between
the symphysis and sacral promontory.
". :agittal suture rotates '$ degrees from the sacral spines.
01. 1he chin is brought into intimate contact with the fetal thora6 !uring which car!inal movement of
labor?
A. fle#ion
B. e#tension
C. engagement
". descent
02. ?uring labor in the occiput posterior position, the occiput has to rotate to the symphysis pubis how
many !egrees?
A. '$
B. ,2
C. 1&$
". 1*2
03. What is e!ematous swelling of the fetal scalp !uring labor?
A. molding
B. caput succedaneum
C. subdural hematoma
". erythema nodusum
0". ?uring the thir! stage of labor, which of the following is C;1 a sign of placenta separation?
A. a gush of blood
B. uterus rises in the abdomen
C. umbilical cord protrudes out of the vagina
". a sudden1 sharp1 unrelenting contraction
1'
0&. Which of the following is a complication of the thir! stage of labor associate! with force! placental
separation?
A. endometritis
B. uterine atony
C. Asherman syndrome
". uterine inversion
1 C >1 " '1 A1 C *1 C
> E >> B '> " A> C *> "
& " >& C '& " A& " *& C
' A >' " '' B A' " *' A
$ E >$ B '$ C A$ E *$ "
A C >A 'A " AA E *A A
) C >) " ') A) E *) A
* E >* A '* A A* " ** E
, E >, " ', A A, B *, C
12 E &2 E $2 A )2 E ,2 A
11 B &1 A $1 A )1 E ,1 A
1> B &> " $> B )> E ,> C
1& C && " $& B )& A ,& B
1' " &' A $' A )' A ,' "
1$ &$ C $$ " )$ " ,$ "
1A A &A A $A B )A "
1) B &) " $) C )) E
1* C &* C $* E )* "
1, E &, $, B ), E
>2 A '2 B A2 " *2 "
1$

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