OB-GynMCQ S Blueprint

JONELTA FOUNDATION SCHOOL OF MEDICINE
UNIVERSITY OF PERPETUAL HELP RIZAL
TEST BLUE PRINT
OBJECTIVES RECALL COMPREHENSION ANALYSIS/ QUESTION

PROBLEM SOLVING NUMBER
The Anatomy of the Female
Reproductive System
1. To describe the gross and 3 1,2,3
histological features, anatomical
relationship and use/importance
of the external and internal
female reproductive organs
including the bony pelvis
2. To illustrate the embryology of 1 4
the female reproductive tract
3. To identify the homologous 1 5
structure of each female external
and internal organs to that of the
male
The Physiology of the Female
Reproductive System
4. To discuss the factors which 2 6,7
control ovarian function from the 1 8
hypothalamus, anterior pituitary
& the hormones that contribute to
its normal function
5. To explain the role of the 1 9
different sex steroids of the 1 10
female reproductive organs
Morphologic and Functional
Development of the Fetus
6. To differentiate between 1 11
gestational age & ovulation age
7. To characterize the different 2 12,13
organ system
8. To discuss fetal circulation 1 14
9. To describe the determinants 1 15
of fetal gender
Development of the Placenta
& Placental Hormones
10. To discuss the effects and 2 16,17
levels of placental hormones 2 18,19
during pregnancy
11. To understand the 1 20
development of the placenta
Conduct of Normal Pregnancy
12. To differentiate the 4 types of 1 21
pelvis based on Caldwell-Moloy
Classification
13. To discuss the anatomy of the 1 22
female pelvis
14. To describe the normal 1 23
posture/attitude of the fetus in
utero 1 24
15. To discuss the signs &
symptoms of fetal death 1 25
16. To describe the station of the
presenting part during labor and
delivery
Normal Labor and Delivery
17. To characterize the 4 phases 1 26
of parturition
18. To describe the mechanisms 2 27,28
of labor in the occiput
presentation
19. To differentiate between true 1 29
and false labor pains
20. To describe maternal 1 30
monitoring in the various stages
of labor
Dystocia
21. To explain the diagnostic 1 31
criteria for prolonged phase of
dilatation
22. To describe the abdominal, IE 2 32,33
findings and management of 1 34
breech & brow presentations
23. To describe clinical
pelvimetry. 1 35
First Trimester Bleeding
24. To discuss the signs and 1 36
symptoms of ectopic pregnancy
25. To discuss the diagnostic
2 37,38
procedures used in ectopic
pregnancy
26. To discuss the etiology of 1 39
spontaneous abortion
27. To discuss the diagnostic 1 40
procedures used for first trimester
bleeding
Third Trimester Bleeding
28. To make a differential 1 41
diagnosis given a patient with
third trimester bleeding
29. To state the diagnostic 1 42
procedures for placental
localization
30. To distinguish abruptio 1 43
placenta from placenta previa
31. To enumerate signs &
symptoms of palcenta previa 1 44
32. To outline the management
1 45
of abruptio placenta
Premature Rupture of
Membranes
33. To define PROM & PPROM 1 46
1 47
34. To discuss the complications
1 48
of PROM and PPROM
Medical Complications in
Pregnancy
35. To discuss the screening 1 49
process of patients for
gestational diabetes 1 50
36. To learn how to classify
patients with diabetes mellitus in
pregnancy
Pregnancy-Induced
Hypertension
37. To discuss screening process
1 51
of patients for pregnancy-
induced hypertension
38. To explain the different types 1 52
of hypertension during pregnancy
39. To state the appropriate
treatment of pregnancy-induced 1 53
hypertension
Multifetal Pregnancy
40. To discuss the management 1 54
of multifetal pregnancy
41. To determine the fetal
1 55
outcome of multifetal pregnancy
Postpartum Complications
42. To define postpartum 1 56
hemorrhage
43. To enumerate the
1 57
predisposing factors and causes
of postpartum hemorrhage
44. To discuss management of 1 58
third stage bleeding
Family Planning
45. To illustrate the efficacy of 1 59
the different methods of
contraception
1 60
46. To explain the mechanism of
action of hormonal contraception
Vaginitis
47. To discuss the different 1 61
causes of vaginitis/leucorrhea 3 62,63,64
48. To discuss the possible fetal
1 65
complications of Chlamydia
trachomatis
Congenital Anomalies
49. To name the fundamental 4 66,67,68,69
types of development errors
giving rise to anomalies
50. Illustrates the different 1 70
Mullerian duct anomalies
Hyperandrogenism
51. To discuss the the underlying 3 71,72,73
pathology based on symptoms
and laboratory examination in
Hyperandrogenism
52. To identify types of hair 1 74
growth
53. To identify the pathways of 1 75
testosterone metabolism
Endometriosis
54. To discuss the pathogenesis 1 76
for the development of
endometriosis
55. To explain the diagnostic 1 77
method used in endometriosis
56. To learn the management
options of endometriosis 3 78,79,80
Gestational Trophoblastic
Disease
57. To identify the diagnostic
1 81
work-up for GTD based on
presentation
58. To discuss the inherent 1 82
pathology of theca lutein cyst
59. To identify the tumor marker 1 83
in PSTT
60. To give the appropriate
management in Persistent 1 84
trophoblastic disease
61. To enumerate the different
1 85
types of chemotherapy in GTD
PID and Pelvic TB
62. To identify the etiologic agent 1 86
that causes PID
1 87
63. To describe the clinical
manifestations of Pelvic TB
64. To describe the diagnostic 1 88
work-up of Pelvic TB
Human Sexuality
65. To enumerate the 4 phases of 1 89
the female sexual response cycle
66. To learn the different sexual
1 90
dysfunction
Benign Tumors of the Female
Reproductive Tract
67. To describe the signs and 1 91
symptoms associated with the
common benign tumors
68. To discuss the 1 92
pathophysiology of the different 1 93
tumors
69. To identify the modalities
used in the treatment of benign 2 94,95
tumors
Malignant Tumors of the
Female Reproductive Tract
70. To identify the epithelial 1 96
tumors of the ovary
71. To identify premalignant 1 97
condition of cervical cancer
72. To identify the risk factors for 1 98
endometrial malignancy
73. To discuss the signs & 1 99
symptoms of cervical malignancy
74. To discuss the diagnostic
approach to diagnose maligancy 1 100
TOTAL 21 39 40 100
EXAM QUESTIONS
SUBJECT: Obstetrics and Gynecology

INSTRUCTIONS: Choose the BEST answer
1. The portion of the uterus which is of obstetrical significance because it forms the lower uterine segment
during pregnancy is the
a. isthmus b. body of corpus c. cervix d. fundus
Answer: A
Reference: Williams Obstetrics, 21st edition, p. 39
MPL: 0.75
2. An important landmark for clinicians is the transformation zone of the cervix which encompasses the
transition from the stratified squamous epithelium to
a. stratified columnar epithelium c. squamous epithelium
b. cuboidal epithelium d. columnar epithelium
Answer: D
Reference: Comprehensive Gynecology, 4th edition, p. 46
MPL: 0.5
3. The anteroposterior diameter of the pelvic inlet which can be clinically measureable and accomplished
by measuring the distance from the lower margin of the symphysis pubic to the sacral promontory is
a. true conjugate c. diagonal conjugate
b. obstetrical conjugate d. interspinous diameter
Answer: C
MPL: 0.5
4. The uterus and the fallopian tubes arises from the
a. urogenital sinus c. mesonephric ducts
b. Wollfian ducts d. mullerian ducts
Answer: D
MPL: 0.5
5. Located near the superior extremity of the vulva is the clitoris which is the homologue of the
a. male scrotum c. male penis
b. caput epididymis d. gubernaculum testis
Answer: C
Reference: Williams Obstetrics, 21edition, p. 33
MPL: 0.5
6. The source of all neurohypophyseal hormone production is

a. thalamus c. anterior pituitary
b. hypothalamus d. posterior pituitary
Answer: B
MPL: 0.5
7. The phase of the ovarian cycle characterized by the orderly development of a single dominant follicle
a. pre-menstrual phase c. ovulatory phase
b. luteal phase d. follicular phase
Answer: D
MPL: 0.5
8. The Two-Cell Two Gonadotropin Theory explains the process of ovarian hormone production & states that
a. aromatase enzyme converts androstenedione to estradiol
b. LH stimulates the granulosa cells to produce androstenedione
c. aromatase activity is enhanced by LH stimulation
d. androgens are transported from the granulosa cells to theca cells
Answer: A
Reference: Novak’s Gynecology, 12th edition
MPL: 0.25
9. The pituitary gonadotropins which regulate the ovarian sex steroid secretion are
a. FSH & LH b. FSH & ACTH c. LH & ACTH d. ACTH & TRH
Answer: A
Reference: Novak’s Gynecology, 12th edition, p. 155
MPL: 0.5
10. The steroid hormone which precipitously rises after ovulation and can be used as a presumptive sign that
ovulation her occurred is
a. estradiol - 17ß c. estrone
b. progesterone d. estriol
Answer: B
MPL: 0.5
11. If today is August 16, 2005 and a patient comes to you with her last menstrual period as July 3, 2005,
what is the age of gestation in weeks?
a. 4 b. 6 c. 8 d. 10
Answer: B
MPL: 0.75
12. Which one characterizes the fetus at about the 28th week of gestation?
a. The testicles are in the scrotum.
b. The fetus has an excellent chance of survival.
c. Surfactant production is adequate.
d. The eyes are sensitive to light.
Answer: D
MPL: 0.5
13. A hemoglobin of 12 g/dl. at birth is considered

a. normal b. low c. high d. transient
Answer: B
MPL: 0.5
14. Oxygenated blood from the right atrium of the fetus proceeds to the
a. right ventricle c. right pulmonary artery
b. left atrium d. ductus arteriosus
Answer: B
MPL: 0.5
15. Which statement is true of sexual differentiation?

a. The default sex is male.
b. Mullerian-inhibiting substance is required to produce a female.
c. The testes must be functional to produce a male.
d. Sexual differentiation is identical up to 10 weeks’ gestation.
Answer: C
MPL: 0.5
16. The levels of human placental lactogen in pregnancy

a. declines on the 10th to the 12th week
b. reaches a peak on the 16th week of pregnancy after which it declines
c. reaches a nedir on the 20th week
d. rises steadily until 34th to the 36th week
Answer: D
MPL: 0.25
17. Near term, the fetus is the source of 90% of placental estriol precursor in normal pregnancy.
What is the precursor?
a. androstenedione
b. testosterone
c. 16@ hydroxydehydroepiandrosterone sulfate
d. dehydroepiandrosterone sulfate
Answer: C
MPL: 0.5
18. What would you expect in the metabolic clearance of dehydroenpiandrosterone sulfate in a normally
pregnant woman near term?
a. There is no change in the clearance rate compared to a non pregnant woman
b. There is a 10 to 20 fold decrease in the metabolic clearance rate
c. There is a 10 to 20 fold decrease in the metabolic clearance rate
d. There is only a slight decrease in the metabolic clearance rate
Answer: B
MPL: 0.5
19. What is the best known biological function of hCG?

a. stimulation of maternal thyroid
b. maintenance of the function of corpus luteum
c. maintenance of the increase in estrogen secretion of the placenta
d. to decrease placental aromatase activity
Answer: B
MPL: 0.25
20. Villi on the abembryonic pole degenerate and is known as

a. chorion leave c. deciduas basalis
b. chorion frondosum d. deciduas capsularis
Answer: A
MPL: 0.5
21. Which type of pelvis (Caldwell-Moloy Classification) presages a poor prognosis for vaginal delivery?
a. Gynecoid c. android
b. Anthropoid d. platypelloid
Answer: C
MPL: 0.75
22. What is the shortest distance between the sacral promontory and symphysis pubis?
a. diagonal conjugate c. true conjugate
b. obstetrical conjugate d. sagittal conjugate
Answer: B
MPL: 0.5
23. The attitude of the fetus in utero if the cephalic prominence is on the same side as the fetal small parts is
a. flexed attitude c. partially flexed
b. extended attitude d. partially extended
Answer: A
Reference: Panlilio et. al Physiologic OB 1st edition, p. 189
MPL: 0.5
24. A 30 y/o, F/M, G2P1 35 weeks pregnant consulted you for cessation of fetal movements, 3 days ago.
Physical examination reveals a fundic height of 28 cm, cephalic presentation, FHT negative. Plain x-ray
of the abdomen reveals the presence of gas in the fetal aorta. What radiologic sign of fetal death is
present in this case.
a. Spaliding’s sign c. Brakemann’s sign
b. Robert’s sign d. Deuel’s Halo sign
Answer: B
Reference: Textbook of Obstetrics, 2nd edition /
Sumpaico et al, p. 123
MPL: 0.5
25. What is the station where the presenting part is at the level of the ischial spines?
a. -2 b. -1 c. 0 d. +1
Answer: C
Reference: Williams Ostetrics, 21st edition, p. 311
MPL: 0.75
26. In the latent phase of labor, the prominent feature is

a. increased rate of cervical dilatation
b. softening and effacement of the cervix
c. progressive downward movement of the presenting part
d. mother starting to “push”
Answer: B
Reference: Williams Obstetrics, 21st edition, p. 428, 266
MPL: 0.5
27. Which of the following statements best describes the cardinal movement flexion
a. It comes after internal rotation.
b. It occurs because of resistance offered by the pelvic walls.
c. It is promoted by cord coils around the neck.
d. It occurs in the second stage of labor.
Answer: B
MPL: 0.5
28. When the head does not complete internal rotation, the pelvis is most likely
a. adequate c. contracted at the level of the mid-pelvis
b. contracted at the level of the inlet d. contracted at the level of the outlet
Answer: C
MPL: 0.5
29. Which of the following best describes true labor pains?

a. Intervals are regular, pain is confined to lower abdomen & disappears with sedation.
b. Intervals regular, intensity increases over time, pain confined to lower abdomen.
c. Intervals regular, intensity increases over time & not affected by sedation.
d. Intervals regular, disappears with sedation & felt over lower abdomen & back.
Answer: C
MPL: 0.5
30. You were assigned to watch over the patient in the delivery room. When the fundus was hard, you
listened to the fetal heart tones and obtained 108 beats per minute. What is your assessment?
a. The fetus is distress.
b. This is expected during a contraction.
c. The fetus has a cardiac anomaly.
d. This is an indication for operative intervention.
Answer: B
MPL: 0.75
31. A primigravida comes in 4 cm. at 8:00am. Three hours later the cervix was 4-5 cm. At 2:00pm it
was 6 cm. What is your evaluation?
a. normal progress of labor c. prolonged latent phase
b. arrest in cervical dilatation d. protracted active phase dilatation
Answer: D
MPL: 0.5
32. A 34 y/o G5P4 (4004) patient comes to the delivery room in labor. Abdominal examination revealed a
hard rounded body in the fundus, the FHT was above the umbilicus, and nodulations felt on the right.
There was a wide movable mass over the pubic symphysis. What is the presentation?
a. cephalic b. shoulder c. breech d. face
Answer: C
MPL: 0.5
33. A patient comes to the ER 8 cms. The frontal sutures, the anterior fontanel orbital ridges and
root of the nose can be felt. What is the presentation?
a. face b. brow c. occiput posterior d. compound
Answer: B
MPL: 0.5
34. A G3P2 patient had a cesarean delivery in her last pregnancy because of a myomectomy in between
the two pregnancies. She is now in the ER awaiting admission. Internal exam showed she was 3 cm,
breech presentation, contractions coming at 5-7 minute intervals. What is the best management?
a. Admit and await vaginal delivery, since her first delivery was vaginal.
b. Start oxytocin drip, because contractions are still irregular.
c. Prepare for an emergency cesarean delivery.
d. Send her home, contractions are irregular.
Answer: C
MPL: 0.75
35. A 28 y/o primigravida on clinical pelvimetry was found to have prominent spines with converging
sidewalls. In which cardinal movement of labor might difficulty be expected?
a. descent b. flexion c. internal rotation d. extension
Answer: C
MPL: 0.5
36. What is the classic symptom triad of ectopic pregnancy?

a. Amenorrhea, abdominal enlargement, vaginal bleeding
b. Abdominal pain, amenorrhea, vaginal bleeding
c. Vaginal bleeding, amenorrhea, partial expulsion of products of conception
d. Amenorrhea, abdominal tenderness, palpable adnexal mass
Answer: B
Reference: Comprehensive Gynecology, 4th edition, p. 455/
Williams Obstetrics, 21st edition, p. 889-890
MPL: 0.75
37. What is a true statement regarding culdocentesis?

a. A positive culdocentesis confirms an ectopic pregnancy.
b. A negative culdocentesis means that non-clotting blood was extracted.
c. A positive culdocentesis indicates a positive pregnancy test.
d. A positive culdocentesis identifies hemoperitoneum.
Answer: D
MPL: 0.75
38. What is the gold standard in diagnosing ectopic pregnancy?

a. Ultrasound c. Laparoscopy
b. Hysteroscopy d. Sonohysterography
Answer: C
Reference: Comprehensive Gynecology, 4th edition, p. 457, Williams, 21st edition, p. 894
MPL: 0.75
39. Which among these women presents the most relevant risk factor for spontaneous abortion?
a. A 24 year old G3P2 (1100) on her 16th week of pregnancy.
b. A 38 year old G1P0 on her 6th week of pregnancy.
c. A 30 year old G1P0 on her 10th week of pregnancy, with a husband who is 44 years of age.
d. A 28 year old G3P2 (0020) on her 8th week of pregnancy, with a husband 29 years of age.
Answer: D
MPL: 0.5
40. A 22 y/o G1P1 (1001) with 7 weeks amenorrhea has vaginal spotting for 5 days. She has a history
of irregular menses since menarche. Presently, she has mild hypogastric pain and nausea. On internal
examination, the cervix is closed, corpus slightly enlarged, no adnexal mass / tenderness. What is the
first laboratory examination that should be requested?
a. Transvaginal ultrasound c. Pregnancy test
b. Pelvic ultrasound d. Paps smear
Answer: C
MPL: 0.5
41. During a case conference, you are asked to present a 35 y/o patient, G2P1 who complained of
vaginal bleeding during the third trimester of pregnancy. Your impression is placenta previa. One of
your differential diagnosis is a rare anomaly associated with velamentous insertion of the cord in which
the vessels insert between the amnion and the chorion, cross the internal cervical us and presents ahead
of the fetal presenting part. What is your differential diagnosis?
a. Tumor previa c. Vasa previa
b. Abruptio placenta d. Ruptured marginal sinus
Answer: C
MPL: 0.5
42. A 29 y/o, G3P2, 35 weeks gestation presents for prenatal care. She complains of on and off scanty
vaginal bleeding not associated with other signs and symptom. Your impression is placenta previa.
The simplest, most precise and safest method to confirm your diagnosis is
a. Double set-up examination c. Computed tomography
b. Sonography d. Magnetic resonance imaging
Answer: B
MPL: 0.5
43. In contrast to placenta previa, the placenta in abruptio placenta is implanted in the
a. Uterine fundus c. Lower uterine segment
b. Uterine isthmus d. Passive uterine segment
Answer: A
MPL: 1
44. The classic symptom of placenta previa that usually occurs during the third trimester of pregnancy is
a. Painful vaginal bleeding c. Marked pallor
b. Painless vaginal bleeding d. Excruciating pain
Answer: B
MPL: 0.5
45. A 32 y/o, G3P2, 38 weeks gestation is admitted because of abruptio placenta. Renal failure seen in
severe forms of this condition can be prevented by
a. Transfusion of packed RBC c. Volume replacement
b. Intravenous diuretics d. Cryoprecipitate
Answer: C
MPL: 0.5
46. PROM is defined as spontaneous rupture of the membranes anytime prior to

a. onset of labor c. expected date of confinement
b. 2nd stage of labor d. stage of fetal viability
Answer: A
Reference: Williams Obstetrics – 21st ed. p.259/281
MPL: 1
47. Which of the ff. patients with PROM will go into spontaneous labor first?
a. 22-28 weeks gestation c. 32-36 weeks gestation
b. 29-32 weeks gestation d. 37-40 weeks gestation
Answer: D
Reference: Williams Obstetrics – 21st ed. p.705
MPL: 0.5
48. A 30 y/o G1P0 on her 28th weeks of gestation based on her LMP, & early ultrasound. She presents
with a history of a “gush of fluids” from her vagina, an hour ago. Speculum exam shows fluid from the
os, which is nitrazine and fern positive. The patient’s cervix is 1-2 cm dilated, 80% effaced EFM
revealed FHR of 170/min and there are occasional uterine contractions. The patient is afebrile and her
uterus is not tender. Her WBC is 13,000/cc. Which of the ff. is the most likely problem in this case
a. premature labor c. pulmonary hypoplasia
b. intrauterine infection d. neonatal intraventricular hemorrhage
Answer: A
MPL: 0.5
49. A 37 y/o G2P1 (1001) came for her first prenatal prenatal check-up on her fifth month of amenorrhea.
Her first baby was delivered by low segment caesarean section with a birthweight of 4000 grams. What
diagnostic screening test is indicated?
a. HbA1C
b. 50-gram oral glucose challenge test
c. fasting blood sugar
d. 100-gram oral glucose tolerance test
Answer: B
MPL: 0.75
50. A 30 y/o G1P0 had the following results for her 3 hr glucose tolerance test
Fasting 95 mg/dl
1st hr 205
2nd hr 170
3rd hr 135
Diagnosis would be
a. Class A1 diabetes c. Normal
b. Class A2 diabetes d. Class B diabetes
Answer: A
MPL: 0.75
51. D.S., a 21 y/o G1P0 was seen at the OPD on her 24 weeks AOG. Her BP was 130/90 mmHg and she
has +2 bipedal edema. Her BP reading has always been in the range of 110-120/ 70-80. This was the first
time that an elevation of her BP was noted. Her sister gave birth last year and was likewise hypertensive.
What is the best screening procedure for this patient that can be done at once in the clinics?
a. 24 hour urine protein c. deep tendon reflex
b. roll over test d. fundoscopy
Answer: B
MPL: 0.5
52. M.D. is 38 y/o, G4P3 (2012) on her 32 weeks AOG. Her weight is 180 lbs and she has facial edema.
She has family history of hypertension. Her last pregnancy was 5 years ago. She was never hypertensive
during her pregnancies. Urine protein is +1. She was first seen today with a BP of 160/100 mmHg. The
most appropriate diagnosis for this patient is
a. Chronic hypertension with superimposed pre-eclampsia
b. Pre eclampsia, severe
c. Transient hypertension
d. Essential hypertension
Answer: A
MPL: 0.5
53. The drug of choice to control eclamptic seizures and prevent recurrent convulsions is
a. diazepam c. magnesium sulfate
b. phytoin d. hydralazine
Answer: C
MPL: 0.5
54. A 35 y/o primigravida with twin pregnancy came in at term in early labor. Presentation was breech-
cephalic. Best management would be
a. vaginal delivery for both twins
b. ceasarean section for both twins
c. partial breech extraction for Twin A, internal podalic version for Twin B
d. partial breech extraction for Twin A, ceasarean section for Twin B
Answer: B
MPL: 0.75
55. A 28 y/o multipara with dizygotic twinning was diagnosed to have an intertwin weight difference of 15%,
amniotic fluid single vertical pocket of 3 cm for both twins. Both twins have the same sex. After delivery, the
following complications are expected.
a. heart failure in smaller twin
b. occlusive thrombosis in the bigger twin
c. severe hyperbilirubinemia in the bigger twiin
d. no complications
Answer: D
MPL: 0.5
56. After the completion of the third stage of labor, the condition is called postpartum hemorrhage if the
bleeding is in the amount of
a. 300 cc b. 500 cc or more c. 200 cc d. 400 cc or more
Answer: B
MPL: 0.75
57. The most common cause of postpartum hemorrhage is

a. perineal lacerations c. uterine atony
b. vaginal lacerations d. retained secundines
Answer: C
MPL: 0.5
58. The best way to avert third stage bleeding is

a. I.V. fluid administration c. suturing of lacerations
b. immediate manual extraction of the placenta d. kneading and squeezing of the uterus
Answer: B
MPL: 0.5
59. Select the list which arranges the methods of contraception in the proper descending order by their
method effectiveness.
a. sterilization, IUD, condom, oral contraceptives
b. sterilization, oral contraceptives, IUD, condom
c. sterilization, IUD, oral contraceptives, condom
d. oral contraceptives, sterilization, IUD, condom
Answer: B
MPL: 0.5
60. The main mechanism of action of oral contraception is

a. effects a positive feedback on the pituitary gland
b. suppression of FSH & LH thus preventing ovulation
c. renders the endometrium unfavorable for implantation
d. renders the cervical mucus thick & less penetrable to sperm
Answer: B
MPL: 0.5
61. The anatomic site within the female genital tract that is most commonly infected with chlamydial
infection is
a. cervix uteri c. ovary
b. fallopian tube d. corpus uteri
Answer: A
MPL: 0.5
62. A 25 y/o commercial sex worker consulted you for yellowish vaginal discharge, abnormal odor and vulvar
pruritus. She’s single, but she uses oral contraceptives. Speculum exam revealed vulvo-vaginal erythema
and “colpitis macularis” or “strawberry cervix”. This case is most likely
a. bacterial vaginosis c. candidiasis
b. trichomoniasis d. senescent vaginitis
Answer: B
MPL: 0.5
63. A 35 y/o, F/M, diabetic for 5 years, and under medication consulted you for pruritus vulvae, “cheesy”
white discharge. Pelvic exam revealed an erythematous, edematous vulva. Speculum: “cheesy” white
discharge; with a pH of 4.0. Presumptive diagnosis is
a. trichomoniasis c. Candidiasis
b. Chlamydia trachomatis d. bacterial vaginosis
Answer: C
MPL: 0.5
64. A pregnant patient, 12 weeks AOG was diagnosed to have Chlamydia Trachomatis infection.
What is the accepted drug therapy at this stage of gestation?
a. metronidazole c. penicillin
b. erythromycin d. tetracycline
Answer: B
MPL: 0.5
65. A 2- week old baby, born by spontaneous vaginal delivery was brought by his mother to the ER for
watery eye discharge that became purulent and redness of the conjunctivae. The mother is a
commercial sex worker. The most likely diagnosis is
a. bacterial conjuctivitis
b. inclusion conjunctivitis in the newborn
c. allergic conjunctivitis
d. measles conjunctivitis
Answer: B
MPL: 0.5
66. What will a female pseudohermaphrodite have?

a. 2 testes c. 2 ovaries
b. Testis and streak gonads d. 2 testes and 2 ovaries
Answer: C
Reference: Novak’s Gynecology, 12th edition, pp. 796-804
Comprehensive Gynecology, 4th edition, pp. 253-265
MPL: 0.5
67. What will a male pseudohermaphrodite have?

Answer: A
MPL: 0.5
68. What will a true hermaphrodite have?

Answer: D
MPL: 0.5
69. What will a patient with Pure Gonadal Dysgenesis have?

b. Testis and streak gonads d. bilateral streak gonads
Answer: D
MPL: 0.25
70. E.M. a 21 y/o G0 newly married who never had any menses, on examination, speculum inserted up
to 2 cm depth, and cervix was absent, rectal exam: uterine corpus was absent, no adnexal mass/tenderness.
Pregnancy test was negative. Ultrasound reveals absence of corpus, bilateral ovaries normal. What is your
most likely impression?
a. Class l MDA (Mayer-Rokitansky-Kuster-Hauser Syndrome)
b. Class ll MDA (Unicornuate)
c. Class lll MDA (Didelphys)
d. Class lV MDA (Bicornuate)
Answer: A
MPL: 0.75
71. A patient consulted with the problem of abrupt onset of hirsutism and virilization. Laboratory examination
showed normal levels of testosterone and elevated levels of dehydroenpiandrosterone sulfate. What is the
probable cause based on symptoms and lab results?
a. ovarian pathology c. problem with peripheral conversion of testosterone
b. adrenal pathology d. problem with testosterone excretion
Answer: B
MPL: 0.5
72. A patient consulted with problem of hirsutism. The laboratory examinations done showed normal
levels of testosterone and DHEA-S. Menstrual cycles are regular and she gave a history of an aunt with a
similar problem. What is the most probable pathology in this patient?
a. ovarian pathology c. problem with peripheral conversion of testosterone
b. adrenal pathology d. problem with testosterone excretion
Answer: C
MPL: 0.5
73. Patient consulted with complaint of postpubertal onset of hirsutism and oligomenorrhea. In addition,
there was finding of short stature with accelerated growth noted between 6 to 8 years of age. What is
the most probable diagnosis?
a. Polycystic ovarian syndrome c. Stromal hyperthecosis
b. Late onset congenital adrenal hyperplasia d. Idiopathic hirsutism
Answer: B
MPL: 0.5
74. Increased growth in the extremities is

a. hirsutism c. hypertrichosis
b. virilization d. acanthosis nigricans
Answer: C
MPL: 0.5
75. What is the more active metabolite of testosterone?

a. androstenedione c. dehydroepiandrosterone
b. dihydrotestosterone d. etiocholanolone
Answer: B
MPL: 0.5
76. A 13 y/o prepubertal female was found to have endometrial glands and stroma at the posterior aspect of
the cul de sac during laparotomy for appendicitis. What is the pathogenesis for this?
a. lymphatic and vascular metastasis c. metaplasia
b. retrograde menstruation d. iartrogenic dissemination
Answer: C
MPL: 0.75
77. A 29 y/o nulligravida has intermittent constipation, hematuria and frequency coincident to her
menstruation. The following diagnostic procedure must be done
a. CA 125 c. Ultrasound of the uterus, kidney, bladder
b. HCG titers d. Pap Smear
Answer: C
MPL: 0.75
78. A 16 y/o nulligravida has severe dysmenorrhea. Management would include to

a. GnRH Agonist treatment
b. Danazol treatment
c. Continuous use of monophasic oral contraceptives
d. Presacral neurectomy
Answer: C
MPL: 0.75
79. An asymptomatic 24 nulligravida consulted for infertility. A laparoscopy was done which revealed a small
retroverted uterus with powder burn lesion over the peritoneum and 1 cm chocolate cysts on both ovaries.
Treatment would be
a. Medroxyprogesterone Acetate 30 mg/day PO
b. Leuprolide 3.75 mg/mo IM
c. Bilateral oophorocystectomy
d. Conservative surgery with presacral neurectomy
Answer: B
MPL: 0.75
80. A 45 y/o nulligravida had cyclic abdominal pain and menorrhagia. Pelvic examination showed thickened
uterosacrals and bilateral adnexal masses
a. Danazol 800 mg/day
b. Depomedroxyprogesterone Acetate 150mgh/3 mos IM
c. Total abdominal hysterectomy with bilateral salpingooophorectomy
d. Continuous monophasic oral contraceptives
Answer: C
MPL: 0.75
81. A 26 y/o G3P2 patient consulted at the ER for complaint of vaginal bleeding. She gave a history of
amenorrhea of 12-13 weeks. There was no fetal heart tones appreciated by Doppler. Pelvic examination
showed cervix to be closed with minimal bleeding and corpus to be enlarged to 16 weeks AOG. What
diagnostic exam should be done?
a. MRI b. CT scan c. Pelvic ultrasound d. Abdominal xray
Answer: C
MPL: 0.5
82. A 24 y/o patient G2P1 consulted your clinic after she was diagnosed to have hydatidiform mole.
She was old that she has bilateral theca lutein cysts measuring 6-7 cm in its largest diameter. What will you
advise patient?
a. bilateral oophorocystectomy after curettage
b. total hysterectomy with bilateral oophorectomy
c. observation of the size of the cysts after curettage
d. chemotherapy
Answer: C
MPL: 0.5
83. What is the tumor marker for Palcental Site Trophoblastic Tumor?
a. human chorionic gonadotropin c. alpha feto protein
b. human placental lactogen d. carcinoembryonic antigen
Answer: B
MPL: 0.5
84. A 29 y/o G3P2 patient being monitored for hCG after evacuation of Hmole 6 weeks ago showed elevation
of hCG titers for 3 consecutive determinations. What should be done?
a. continue observing titers
b. start chemotherapy
c. advise need for hysterectomy because of probable persistent disease
d. advise need for another curettage
Answer: B
MPL: 0.5
85. What is one course of chemotherapy given to a patient who just underwent suction curettage for H mole
for the purpose of decreasing incidence of persistence?
a. clean up chemotherapy c. prophylactic chemotherapy
b. salvage chemotherapy d. consolidation chemotherapy
Answer: C
MPL: 0.75
86. What is the most common organism that causes PID?
a. Neisseria gonorrhea c. Klebsiella
b. Peptostreptococcus d. Hemophilus
Answer: A
MPL: 0.5
87. Besides infertility, the most common presentation of TB salpingitis is

a. abdominal pain c. fever
b. abnormal uterine bleeding d. cough
Answer: B
MPL: 0.75
88. What is the gold for the definitive diagnosis of pelvic TB?
a. histologic section b. AFB culture c. hysterosalpingogram d. chest X-ray
Answer: B
MPL: 0.5
89. During this phase, sexual tension and erotic feelings intensify and vasocongestion reaches maximum
intensity. This phase of the female sexual response cycle is
a. arousal phase c. plateau phase
b. excitement phase d. orgasmic phase
Answer: C
MPL: 0.5
90. The most common sexual dysfunction characterized by the absence of sexual fantasy causing marked
distress and interpersonal difficulty is
a. orgasmic dysfunction c. inhibited sexual desire
b. vaginismus d. arousal disorder
Answer: C
MPL: 0.5
91. A 30 year old sexually active female consulted your clinic for a 3 cm sausage-shaped cystic mass
protruding from the anterolateral wall of the upper vagina. What is your most likely impression?
a. Bartholin’s cyst c. Gartner’s Duct cyst
b. Skene’s gland cyst d. Vaginal Cancer
Answer: C
MPL: 0.5
92. VIN stands for?

a. Vaginal Intraepithelial Neoplasia c. Vaginal Intraepithelial Neoplastic Carcinoma
b. Vulvar Intraepithelial Neoplasia d. Vulvar Intraepithelial Neoplastic Carcinoma
Answer: B
MPL: 0.75
93. The main difference between CIN and VAIN is?

a. CIN originate from the transformation zone c. VAIN is malignant
b. VAIN has keratinizing epithelium d. CIN is premalignant
Answer: A
Reference: Novak’s Gynecology, 12th edition, pp. 447/474
MPL: 0.5
94. Which disease of the vulva is best treated with wide excision?
a. Hidradenitis suppurativa c. angioma
b. Invasive vulvar cancer d. contact dermatitis
Answer: A
Reference: Comprehensive Gynecology, 4th edition, p. 486-488
MPL: 0.5
95. Endocervical Polyps are treated by

a. Cautery c. Grasping & twisting base
b. Cryotherapy d. Cervical Punch Biopsy
Answer: C
MPL: 0.5
96. What is the common epithelial type of tumor of the ovary?

a. serous b. mucinous c. endometriod d. clear cell
Answer: A
MPL: 0.5
97. Considered as precancerous lesion of the cervix is

a. leukoplakia b. metaplasia c. dysplasia d. erosion
Answer: C
MPL: 0.5
98. A 45 y/o, G1P1 patient stands 5 feet and weighs 200 lbs complains of menometrorrhagia. She has
history of diabetes and hypertension. What type of malignancy is associated with her profile?
a. cervical b. endometrial c. ovarian d. tubal
Answer: B
MPL: 0.5
99. A 48 y/o, G6P5 (5015), was seen at the OPD because of vaginal spotting after coitus. On internal
examination, an elevated, irregular, friable bleeding lesion was seen at the posterior lip of the cervix
extending into the cervical canal. The uterus is small and movable. No adnexal mass was appreciated.
This is most probably a case of
a. Nabothian cyst b. cervical polyp c. cervical carcinoma d. condyloma accuminata
Answer: C
MPL: 0.5
100. A 27 y/o woman who has 2 living children, recently had 2 cervical smears which revealed moderate
dysplasia. The next step in the management of this patient should be
a. colposcopically guided cervical biopsy c. simple hysterectomy
b. cervical conization d. fractional D & C
Answer: A
MPL: 0.5
RECOMMENDED MPL: 60+/- 0.5

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JONELTA FOUNDATION SCHOOL OF MEDICINE

UNIVERSITY OF PERPETUAL HELP RIZAL

TEST BLUE PRINT

OBJECTIVES RECALL COMPREHENSION ANALYSIS/ QUESTION

SUBJECT: Obstetrics and Gynecology

6. The source of all neurohypophyseal hormone production is

13. A hemoglobin of 12 g/dl. at birth is considered

15. Which statement is true of sexual differentiation?

16. The levels of human placental lactogen in pregnancy

19. What is the best known biological function of hCG?

20. Villi on the abembryonic pole degenerate and is known as

26. In the latent phase of labor, the prominent feature is

29. Which of the following best describes true labor pains?

36. What is the classic symptom triad of ectopic pregnancy?

37. What is a true statement regarding culdocentesis?

38. What is the gold standard in diagnosing ectopic pregnancy?

46. PROM is defined as spontaneous rupture of the membranes anytime prior to

57. The most common cause of postpartum hemorrhage is

58. The best way to avert third stage bleeding is

60. The main mechanism of action of oral contraception is

66. What will a female pseudohermaphrodite have?

67. What will a male pseudohermaphrodite have?

68. What will a true hermaphrodite have?

69. What will a patient with Pure Gonadal Dysgenesis have?

74. Increased growth in the extremities is

75. What is the more active metabolite of testosterone?

78. A 16 y/o nulligravida has severe dysmenorrhea. Management would include to

87. Besides infertility, the most common presentation of TB salpingitis is

92. VIN stands for?

93. The main difference between CIN and VAIN is?

95. Endocervical Polyps are treated by

b. Cryotherapy d. Cervical Punch Biopsy

96. What is the common epithelial type of tumor of the ovary?

97. Considered as precancerous lesion of the cervix is

RECOMMENDED MPL: 60+/- 0.5

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