BOARD QUSTIONS IN OB-GYN

NAME_____________________________DATE________SCORE_______________

CHOOSE THE BEST ANSWER:

1.The antidote for Magnesium sulfate toxicity is

a.Calcium gluconate c.Diazepam
b.Ca Channel blocker d.Midazolam
2.Which of the following is utilized for medical treatment of ectopic pregnancy?
a.dexamethasone c.methotrexate
b.vincristine d.adriamycin
3.Of the following, which is most consistently associated with low birthweight infants?
a.placenta previa c.diabetes mellitus
b.maternal ht.of <5 ft d.smoking in pregnancy
4.A 23 year old G1 at 35 weeks age of gestation comes in for severe headache and
visual blurring. On prenatal check-up 1 week prior, her BP was noted to be 130/85
mmHg from her usual 110/70. On examination, BP was now at 160/110 mmHg, FHT
140/min, no contractions after ten minutes of observation. Cervix was 1cm, 30%
effaced,intact membranes, station-2. Most likely diagnosis is-
a.chronic hypertension c.mild preeclampsia
b.severe preeclampsia d.chronic hypertension with
superimposed preeclampsia
5.One of the maternal hazards of prolonged fetal death in utero is-
a.hemorrhege form placental abruption
b.disseminated intravascular coagulation
c.hypertensive disorders
d.placental retention from calcification
6.Cervicovaginal fibronectin is used as a predictor of which condition?
a.preclampsia c.preterm labor
b.fetal growth restriction d.PROM
7.A G2P1 with 4 weeks missed period presents with one week duration of vaginal
bleeding and hypogastric pains. She also has watery vaginal discharge before
consultation. IE findings- 1 to 2 cm dilated with ruptured BOW. What is the diagnosis?
a.inevitable abortion c.incomplete abortion
b.imminent abortion d.missed abortion
8. The initial maternal immunologic response to a primary rubella infection is the
elaboration of:
a.IgG c.IgM
b.IgA d.IgD
9.The vein which is most commonly involved in pelvic thrombophlebitis is:
a.femoral c.pelvic
b.saphenous d.ovarian
10.In diamnionic monochorionic monozygotic twinning, the division occurs at this time
after fertilization-
a.within 72 hours c.8 days
b.4-8 hour d.after formation of embryonic
disc
11.Which is a cause of polyhydramnios?
a.esophageal atresia c.prematurity
b.renal agenesis d.abruption
12. Which of the following is an example of Buttram and Gibbons Class III abnormality
of the reproductive tract?
a.vaginal hypoplasia c.bicornuate uterus
b.unicornuate uterus d.uterine didelphys

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13. A patient was diagnosed to have high risk gestational trophoblastic tumor. This
means that the patient has which of the following?
a.disease duration of 10 weeks
b.pretherapy hCG of 89,000 IU/ml
c.antecedent pregnancy terminated at 20 weeks
d.no previous chemotherapy
14.On examining a pregnant patient with the ultrasound, the clinician noted that the
lower pole of the placenta was at the edge of the internal os. This type of placenta
previa is-
a.low lying c.marginalis
b.partialis d.totalis
15.A nullipara was admitted on active labor at 5 cms and ruptured bag of waters. IE
after 2 hours despite good contractions was 6 cms. This means that she has this
disorder-
a.prolonged latent phase c.prolonged deceleration phase
b.arrest of dilatation d.protracted active phase of
dilatation
16. A patient diagnosed to have asymptomatic bacteriuria is one who has
A. persistently multiplying bacteria in the urine but no symptoms
B. 100,000 organisms/ml in culture specimen with pyuria
C. a sterile urine culture with frequency and urgency
D. microscopic hematuria and colony count of 50,000/ml
17. Pigmentation of the face during pregnancy is considered as
A. an indication of increased androgen from a male fetus
B. an temporary state rapidly regressing postpartum
C. a benign but persistent condition
D. an indication for immediate hydroxyquinone application
18. A 25 year old consulted for vaginal spotting and sharp pelvic pain. History revealed
6 weeks amenorrhea. Pregnancy test was positive. Physical exam elicited cervical
wriggling tenderness with a vague mass and tenderness in the left adnexal. Posterior
vaginal fornix was full and bulging. BP was 100/60mmHg, PR 96/min. What should be
done next to this patient?
A. culdocentesis
B. immediate exploration
C. emergency TVS
D. blood transfusion
19.A 6 year old had difficulty in voiding and was brought for consult.Inspection revealed
agglutination of the labia minora with the translucent vertical line pathognomonic for
adhesive vulvitis. What should be done?
A.observation
B.testosterone
C.scalpel incision
D.topical estrogen
20. A preeclamptic patient at 34 weeks was rushed to the ER because of severe
abdominal pain. The best evidence to support the clinician’s suspicion of
abruption can be obtained from -
A. physical examination
B. ultrasonography
C. culdocentesis
D. abdominal tap

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21. A 33 year old parturient had postpartum atony and as a consequence developed
symptomatic anemia. Which can benefit her best?
A. fresh whole blood C. packed RBC
B. whole blood D. fresh frozen plasma
nd
22. A woman on her 32 week of gestation was admitted for threatened preterm labor.
Tocolytic management was initiated with magnesium sulfate. Which of the following
needs to be monitored closely while on tocolysis?
A. SGOT C. Blood pressure
B. Glucose D. Potassium
23.Despite multiple oxytocic administration, continuous bleeding was still noted in a
woman on the 4th stage of labor. Which should be done first?
A.b egin transfusion
B. manual exploration of uterine cavity
C. .inspect vagina and cervix
D. d.bimanual compression
24. A 20 yo primigravid at 39 weeks came in due to labor pains. This patient was a
diagnosed case of rheumatic heart disease. When should she receive the initial dose of
ampicillin-gentamicin?
A. about 2-3 hours after admission
B. prior to amniotomy
C. after the first internal examination
D. 30 minutes prior to anticipated delivery
25. A puerperal woman was rushed to the ER because of profuse bleeding. On
examination, a sac-like structure was seen out of the introitus with the placenta still
attached. A crater-like depression was noted on abdominal palpation. Which of the
following is part of good management?
A. immediate removal of the placenta before replacement
B. give oxytocin to facilitate replacement
C. administer fluids and magnesium sulfate for uterine relaxation
D. do a vaginal hysterectomy
26. A 17 yo primigravid on her 28 th week consulted for the first time at the OPD. PE
revealed pale palpebral conjunctivae. Hgb was 9.2g/dl. How much elemental iron
(mg/dl) does this patient require?
A. 100 C. 300
B. 200 D. 400
27. A 32 yo G1P0 sought her first prenatal check up at 9 weeks AOG. Family
history is positive for DM (father). When should she have her GCT?
A. at term C. 28-32 weeks
B. 32-36 weeks D. 24-28 weeks
28. A pregnant woman consulted because of itchy reddish wheal-like rashes. The
lesions were first seen in the abdomen eventually spreading to the rest of the body. She
denied having any allergies to food or drugs. What treatment is appropriate?
A. Antibiotics C. 7corticosteroids
B. estrogen cream D. lindane
st
29. A pregnant woman on her 1 trimester of pregnancy was exposed to a neighbor with
german measles. What is the initial step in the management?
A. active immunization C. antiviral therapy
B. immunoglobulins D. ask history of past infection

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30. A G1P0 PU 32 weeks was brought to the ER because of severe headache and
blurring of vision. BP was 170/110 mm Hg. Fundic height was 30 cms, FB on the left,
FHT 157/min . There was also grade II bipedal edema, edema of hands and face. What
should be done first?
A. Load MgSO4
B. Give Hydralazine
C. Do immediate CS
D. Administer Diazepam IV
31. A G5P4 PU 39 weeks was in active labor for 3 hours. IE showed cervix 7 cm
dilated, fetal head at station -1 to 0. Suddenly, fetal head rate decelerated and maternal
blood pressure dropped from 120/80 mmHg to 90/60 mmHg. On doing IE, the
presenting part appeared to retract. What is the most probable diagnosis?
A. Abruptio placenta
B. Spontaneous uterine rupture
C. Acute cord torsion
D.Uterine atony
32. Immediately after an apparently normal labor and delivery, the mother suddenly
manifested with dyspnea and went into convulsions. Blood pressure likewise dropped
sharply from 120/80 mmHg. Cardiopulmonary arrest rapidly ensued. What is the
probable cause?
A. Cerebrovascular accident
B. Eclampsia
C. Amniotic fluid embolism
C. Postpartum cardiomyopathy
33. A G2P1 PU 31 weeks came to the clinic with complaints of watery vaginal
discharge. After noting some fluid pooling at the culdesac, the clinician requested for an
ultrasonographic examination. What information can be derived from an UTZ pertinent
to management?
A. Demonstration of site of bag rupture
B. Confirmation of fetal maturity
C. Assessment of AFV
D. Detection of fetal meconium staining
34. As part of management during observation period, the clinician advised a patient
with a growth restricted infant to obtain adequate bed rest. Which position can best
benefit or augment fetal growth?
A. Supine C.Prone
B. Half reclining D. Lateral recumnbent
35. During clinical pelvimetry, the ischial spines were noted to be prominent, the
sidewalls convergent and the sacrosciatic notch is narrow. Of the following, what is
the most common consequence of these findings?
A. This promotes cord prolapse
B. There is increase likelihood for transverse arrest of fetal head
C. Extreme posterior asynclitism is favored
D. Production of abnormal presentation is facilitated
36. Anticipating a large baby, the patient’s legs were removed from the stirrups and
sharply flexed upon her abdomen. What will be the effect of this maneuver?
A. Increase pelvic dimension
B. Facilitate bearing down effort
C. Rotates symphysis pubis toward maternal head
D. Dislodges the posterior shoulder

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37. A primigravid was brought to the ER by the attending midwife after 10 hours of
labor. Apparently she has been bearing down for 2 hours already. Exam showed that
the fetal scalp is visible at the introitus without separating the labia. The sagittal suture
was at AP diameter. The mother appeared weakened by her efforts to bear down. What
is the best management?
A. Strong fundal pressure
B. Outlet forceps extraction
C. Cesarean section
D. Await vaginal delivery
38. To deliver a foot in the vagina in cases of frank breech presentation, why is it
important for the clinician to push a fetal knee away from the midline?
A. This facilitates spontaneous flexion so that foot can be grasped
B. The maneuver will facilitate descent of fetal breech
C. This will push the umbilical cord out of the way
D. This will initiate rotation to occiput anterior
39. A woman consulted due to increased vaginal discharge with musty odor most
pronounced after coitus with her husband.She appeared distressed as this is the first
time she experienced this. Her pap smear 1 month prior was normal. She denied
pruritus, dyspareunia, or any missed period. However she recently had a bout of AURI
which was treated with an antibiotic regimen. Exam showed a thin homogenous,
grayish, white discharge with a pH of 5.5. Which of the following most likely predisposed
her to this type of vaginitis?
A.autoinoculation from her AURI
B.coital activity with the husband
C.intake of antibiotics
D.alkaline pH of 5.5
40. A 20 year old, primigravid , PU 39 weeks, presented at the ER in labor for 3
hours.PE revealed multiple vesicular lesions in the vulva and perineal area. IE showed
3 cm cervical dilatation, 50% effaced, (+) BOW, cephalic , station -1. Clinical pelvimetry
was adequate. What is the best route of delivery?
A. Cesarean section
B. vacuum extraction
C. Outlet forceps extraction
D. Spontaneous vaginal delivery
41.Damage to these muscles during vaginal delivery may cause rectal incontinence-
A.Coccygeus
B.Deep transverse perineal
C.External and internal sphincter ani
D.Bulbocavernosus
42. The most accurate ultrasonic parameter for fetal aging in the first trimester
is-
a.biparietal diameter C. head cercomference
b.crown-rump length D. femur lenght
43.A woman who had three pregnancies, all of which were aborted is a-
A.nulligravid C.multipara
B.nullipara D. primipara
44.A second degree perineal laceration involves up to the-
A.skin and mucosa C. anal sphincter
B.fascia and muscles D. rectal mucosa

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45.One of the following becomes the new source of endometrium after delivery-
A. placental implantation site
B. decidua vera C. decidua basalis
46.The earliest age of gestation when fetal sex can be identified by gross examination
of the external genitalia is at-
A.10 weeks C. 14 weeks
B.12 weeks D. 16 weeks
47.This is the midline brownish black pigment that is observed in pregnant patients-
A.striae gravidarum C. melasma
B.linea nigra D. chloasma gravidarum
48.How many weeks does it take for the entire endometrium to regenerate after
delivery?
A.1 C. 3
B.2 D. 4
49.The female pelvis has an inlet that is commonly-
A.android C. gynecoid
B.platypelloid D. anthropoid
th
50.A 24 year old patient on her 35 week of gestation has a hemoglobin level of 11.8
g/dl. What should be done for her?
A. request for blood transfusion
B. double daily dose of iron supplement
C. continue daily iron supplementation until puerperium
D. order for a peripheral smear
51.The third stage of labor commences –
A. when cervix is fully dilated
B. after epissiorraphy
C. after delivery of the fetus
D. after expulsion of placenta
52.This division /phase of labor is most sensitive toanalgesia and maternal sedation-
A.preparatory division
B.dilatational division
C.pelvic division
D.deceleration phase
53.The relation of the fetal parts to one another determines the-
A.presentation C. attitude
B.lie D. station
54.Rina, a ramp model, pregnant for the first time on her 6 th week AOG needs to gain
how much weight in pounds for the whole duration of her pregnancy?
A.10 C. 18
B.14 D. 20
55. On histopath, a placenta is found to have dense stroma containing round cells with
granular and vacuolated cytoplasm with vascular and eccentric nuclei. In terms of age,
this placenta is most probably-
A.8 weeks C. 24 weeks
B.14 weeks D. 40 weeks
56.If a neonate has increased IgM antibodies, it means that-
A.this was passively transferred from the mother
B.the neonate has congenital infection
C.this is a healthy normal newborn
D.the baby was born post term

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57.Amniotic fluid pocket of <1 cm vertical dimension is suggestive of-

A.oligohydramnios
B.normohydramnios
C.borderline oligohydramnios
D.polyhydramnios
58.What CTG finding can be anticipated if the mother develops chorioamnionitis during
labor?
A.sinusoidal pattern C. tachycardia
B.bradycardia D. variable cecelerations
59.A pregnant mother developed UTI. Which of the following antibiotics is safest to
give?
A.erythromycin C. chloramphenicol
B.tetracycline D. sulfonamides
60.A woman on her 41st week of pregnancy had a BPS with the following findings during
the 30 minutes test-sustained breathing movement of 45 secs, five simultaneous limb
and trunk movements, 2 episodes of arm flexion and extension, 3 episodes of fetal
heart rate accelerations each for 15 secs with fetal movement, amniotic fluid pocket of 3
cms in 2 perpendicular planes. What should be done for this patient based on the BBS
score?
A.induce labor immediately
B.repeat BPS after a week
C.Do CS
D.Repeat test on same day
61.Shortly before hospital discharge, a puerperal patient asked when she should start
protecting herself from subsequent pregnancy. If she has no intention to fully breast
feed, protection should be advised ____ weeks after delivery.
A.1-2 C. 6-8
B.2-4 D. 9-11
62.Two pregnant women were admitted at the same time both for induction of labor with
oxytocin. Patient A was at 27 weeks AOG IUFD while patient B was postterm at 42
weeks, EFW 2,700 grams. Both cervices were closed. Which patient will probably be
delivered first?
A. Patient A because the baby is smaller
B. Patient B because the term uterus has more oxytocin receptors
C. Both will deliver at about the same time since oxytocin dose is the same
D. It is impossible to predict
63.In attending the a delivery, the clinician observed that with each contraction the fetal
head already distends the perineum and opens the introitus to a diametr of 6 cms.What
should the clinician do?
A.hyperflex the mother’s thighs
B.catheterize the bladder
C.administer anesthesia
D.perform Ritgen manuever
64.A pregnant 85 lbs woman sought her very first prenatal consult. Being underweight,
the physician formulated a good nutritional surveillance for her. Which of the following
constitute a sound part of the plan?
A.ensure she force feeds herself everyday
B.serially weigh her to achieve appropriate weight gain
C.monthly hgb and hct determination
D.give 60 mg iron tablets 3x a day

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65.During CTG intrapartum monitoring, minimal variability was noted with one episode
of deceleration (15 beats below the baseline) after a contraction in a 10 minute period of
observation. Which of the following is an appropriate next step?
A.do amnioinfusion
B.place the patient on left lateral recumbent
C.prepare for immediate
D.perform scalp bllod pH determination
66.If a pregnant woman on her 24 weeks of gestation was accidentally administered
oxytocin in her IVF instead of the antibiotic prescribed for her, what will be the effect on
her pregnancy?
A.she will have tetanic uterine contractions
B.her cervix will efface
C.no labor pains is likely tio set in
D.there will be immediate lactation
67.On performing the third Leopold’s manuever, the cephalic prominence is palpated on
the left lower quadrant and the fetal heart tones is maximally heard at the right lower
quadrant, which of the following can be concluded?
A.the head is already engaged
B.the vertex is presenting
C.the head is extended
D.the presenting part is sinciput
68.On physical examination of a pregnant woman, the clincian detected a 2/6 systolic
murmur intensifying during inspiration. What should be done for this patient with regards
this finding?
A.cardiology referral
B.ECG
C.no intervention needed
D.echocardiogram
69.Which of the following is a component of a good plan for conducting labor and
delivery?
A.pain reliever every 3 hours
B.strict bed confinement from 2 cms on
C.hourly internal examination
D.IV hydration for lengthly labor
70.On the second postpartum day, a parturient developed a temperature of 39.0C
pertinent PE included breast that were edematous,tender,firm and nodular.What must
be done for this patient?
A.give analgesic and breast support
B.stop breastfeeding immediately
C.give antistaphylococcal agents
D.give bromocriptine for 7 days
71. Which of the following events is associated with menstrual flow-
A.withdrawal of progesterone
B.prolonged maintenance of estrogen
C.withdrawal of LH
D.prolonged maintenace of progesterone
72.A 47 year old woman has poorly differentiated endometrial carcinoma and a uterine
cavity that measures 10 cm in depth. The endocervix has stromal invasion of
endometrial carcinoma but no other structure is involved. What is the stage of her
disease?
A.IA C.IIA
B.IB B. 11B

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73.Endoscopic procedure utilized to evaluate tubal disease-

A.colposcopy
B.laparoscopy
C.hysteroscopy
D.hysterosalpingography
74.Tuberculosis of the genital tract invariably involves the-
A.fallopian tubes
B.ovaries
C.cervix
D.vagina
75.A 26 year old G1P1 had cervical intraepithelial neoplasia involving the entire
thickness of the cervical epithelium. This is best managed by-
A.cryosurgery
B.electrocautery
C.conization
D.hysterectomy
76.A 25 year old woman and her husband use natural family planning as their method
of contraception. Her menstrual cycle length range from 26 to 32 days. She does not
measure her basal body temperature. The time of her maximum or peak fertility with the
first day of her menses defined as day 1 would be between cycle days-
A.hari 1-14
B.hari 8-14
C.hari 8-21
D.hari 14-21
77.The drug of choice for vaginal trichomoniasis is-
A.tetracycline
B.fluconazole
C.cefoxitin
D.metronidazole
78. This type of myoma insinuates itself between the leaves of the braod ligament-
A.parasitic
B.serosal
C.interstitial
D.intraligamentary
79.The tumor marker HCG is positive in this tumor-
A.embryonal carcinoma
B.choriocarcinoma
C.endodermal sinus tumor
D.adenocarcinoma
80.Uterine bleeding excessive in amount and duration of flow occuring at regular
intervals is-
A.menorrhagia
B.metrorrhagia
C.polymenorrhea
D.menometrorrhagia
81.A 67 year old had episodes of vaginal bleeding 15 years after menopause.
Biopsy reveals cystic endometrial hyperplasia. Transvaginal sonogram reveals a
solid adnexal mass of 4 cm diameter. She is not on hormonal replacement
therapy. Most likely cause of bleeding is-
A.sertoli-leydig tumor
B.granulosa cell tumor
C.serous cystadenocarcinoma
D.endodermal sinus tumor

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82.A 40 year old housewife complains of foul smelling vaginal discharge. On

examination, discharge was greenish-gray in color, foul-smelling and frothy.
Primary consideration is-
A.Yeast
B.Trichomoniasis
C.Chlamydia
D.Bacterial vaginosis
83.A 36 year old G2P2 has amenorrhea of 11 months with hot flushes.Examination
reveals a small uterus. If this is a case of premature ovarian failure, which finding
is applicable?
A.biphasic basal body temperature
B.endometrial hyperplasia
C.elevated FSH >40 iu/ml
D.tonically raised LH
84. Contraindication to hormonal replacement therapy-
A.history of pulmonary thromboembolism
B.hot fluches, insominia in a 50 y.o with irregular menses
C.history of fibrocystic disease of the breast
D.elevated serum lipid
85.Which of these is the most likely site for implantation of endometriosis-
A.omentum
B.appendix
C.bladder mucosa
D.Peritoneum of cul-de-sac
86.Which disease of the vulva is best treated with wide excision?
A.hidradenitis suppurativa
B.invasive vulvar cancer
C.angioma
D.contact dermatitis
87. The ovarian tumor that most commonly causes precocious puberty is-
A.teratoma
B.luteoma
C.granulosa cell tumor
D.sertoli leydig tumor
88. A woman with this type of pelvis is more prone to urethrocoele because of more
force of the fetal head on this area during descent in labor-
A. platypelloid
B. anthropoid
C. gynecoid
D. android
89. Stage III vaginal cancer means extension of lesion up to-
A. vaginal wall
B. subvaginal tissue
C. pelvic wall
D. rectal mucosa
90.On endometrial biopsy, glycogen-rich subnuclear vacuoles were seen in the base of
the cells lining the glands. What does this mean?
A.the woman is in her late luteal phase
B.ovulation has occurred*
C.she is progesterone deficient
D.mestruation is about to set in

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91.Which theory of endometriosis best explains remote sites if the disease such as in
the spinal cord, nasal septum or lungs?
A.iatrogenic dissemination
B.coelomic metaplasia
C.immunologic changes
D.lymphovascular metastasis
92.Which is an abnormal semen parameter?
A.white cell count of 105 per ml
B.sperm morphology 31%
C.sperm count 40 x 105 per ml
D.progressive motility in 65%
93.A 32 year old has been having her regular pap testing for the last ten years. Her
latest result however revealed low grade SIL.What is the next step to do?
A.colposcopic examination
B.repeat smear in 4 months
C.conization
D.laser ablation
94.A 19 year old was brought to the ER because of acute pain. There was also vaginal
spotting. Examination revealed a small tender adnexal mass. Based on her LMP, she is
on day 25 of her cycle. Pregnancy test was negative. What is the most likely diagnosis?
A.ectopic pregnancy
B.acute salpingitis
C.ruptured corpus luteum
D.ruptured endometrial cyst
95.A 28 year old nulligravid with primary infertility and cyclic pelvic pain was diagnosed
to have endometriosis. She was placed on hormonal treatment. However, while on this
drug, syhe developed acne,hirsutism, and deepening of the voice. What is a better
alternative?
A.laparoscopic fulguration
B.GnRH agonist
C.progesterone injectables
D.Oral contraceptives
96.A 35 year old consulted because of vesicular lesions in the vulva. She related that
several days prior to the appearance of the vesicles, she felt numbing sensation over
her vulvar skin. Which is the best treatment?
A.metronidazole
B.acyclovir
C.doxycyline
D.penicillin
97.A 17 year old consulted because of lower abdominal pain of 3 days duration
described as constant and dull.On speculum exam, purulent vaginal discharge was
noted. Patient was febrile at 38.5 C. Perinent finding on internal exam: tenderness with
motion of the uterus and cervix. Which is the most pressing reasoin for admitting this
patient?
A.purulent discharge
B.fever
C.tenderness on IE
D.age

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98.A woman consulted because of spontaneous milky discharge and missed period of 8
weeks. Pregnancy test was negative. Prolactin levels after appropriate blood collection
was 35 ng/ml. What should be the next step in the work-up?
A.repeat prolactin in a quiet room
B.CT scan of the brain
C.Cone view of the sella turcica
D.TSH determination
99.A patient was diagnosed to have squamous cell cervical cancer. Clinical evaluation
revealed that the disease has involved the upper third of the vagina. Parametrial tissues
were indurated. However, there was no evidence of pelvic wall involvement. What is the
best treatment for her?
A.radiotherapy
B.chemoradiation
C.RHBLND
D.chemotherapy
100. A 19 year old consulted because of primary amenorrhea. On clinical evaluation,the
patient was found to have breast development but absent uterus. Which of the following
can best help arrive at diagnosis?
A.progesterone challenge test
B.GnRH level determination
C.Karyotypin
D.Gonadal biopsy

END OF EXAMINATION