🧠2023/09/14 @OB BM3

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OB BM II Sec3D 14 Sep 2023

1. Most important vital signs associated with obstetrical hemorrhage is

which of the following?
2 A. urine output
B. Blood pressure
C. oxygensaturation
D. pointofcarehematocrit

2. The differential diagnosis of clinically suspected twins includes all

EXCEPT which of the following?
A. Obesity
B. Hydramnios
C. Leiomyomas
2 D. Blightedovum

3. Undesirable effects attributed to the estrogen component of combination

oral contraceptive pills include all except which of the following?
A. Headache
2 B. Hirsutism
C. Weightgain
D. Breast tenderness

4. Which contraceptive method offers protection against both intended

pregnancy and sexually transmitted infections?
A. Convultion
B. Oral contraceptive pill
C. Tubal ligation
D. Vasectomy

5. Which of type of placenta implantation location that is frequently

associated in cases of uterine inversion?
A. Anterior
B. Posterior
2 C. Fundal
D. Lower uterine segment

6. Which of the following statement is true regarding the mechanisms of

multifetal pregnancy?
A. Twin fetuses result from fertilization of two separate ova- dizygotic or
fraternal twins
B. Twin fetuses result from single fertilized ovum that divides- dizygotic or
fraternal twins
C. Twin fetuses result from fertilization of two separate ova- monozygotic or
identical twins
D. Twin fetuses result from fertilization of two separate ova – dizygotic or
monochorionic

7. Characteristics of Braxton Hicks contractions can include all EXCEPT

which of the following?
A. Painful
B. Associated with cervical dilatation
C. Nonrhythmical
D. Irregular pattern
 8. Which of the following is the least complication of preterm birth
A. Fetal complication
B. Hypertension
C. Placental abruption
D. Noneoftheabove

9. Which of the following maternal complications are not recognized with

hydramnios?
A. Postpartum atony
B. Placental abruption
C. Ureteralobstruction
2 D. GestationalHypertension

10. What clinical sign or test can be used to detect hypermagnesemia prior
to development of respiratory depression?
A. Heart rate
2 B. Patellar reflex
C. Presence of clonus
D. Visualfieldtesting

11. 20 yrs old primagravida > 18wks (AOG) > noticed sudden gush of fluid
> you confirm preterm ROM > sonagraphic evaluation shows
anhydramnious > which organ is unlikely to develop?
A. brain
2 B. lungs
C. heart
D. kidneys

12. In pregnancies with estimated fetal weights > 4000 g after 37 weeks’
gestation, prophylactic labor induction has which of the following effects?
A. Increases the cesarean delivery rate
B. Decreases the shoulder dystocia rate
C. Decreases the postpartum hemorrhage rates
2 D. Alloftheabove

13. Oligohydraminos complication in the fetus

2 A. fetal distress
B. increase in infection
C. excessive fetal growth
D. low maternal Bp

14. Value for amniotic fluid index

A. 28cm - 2cm
2 B. 5cm - 24cm
C. 2cm-5cm
D. 2cm-8cm

15. During puerperium, which hormone plays a key role in uterine

involution?
2 A. Estrogen
B. Progesterone
C. Oxytocin
D. Prolactin
 16. Compared to appropriately grown features of equivalent gestational
age, growth restricted features have which of the following perinatal
advantages?
A. Lower still birth rate
B. Lower perinatal mortality rate
C. Lower rate of respiratory distress syndrome
D. Noneoftheabove

17. Among the following choices, which is the strongest risk factor for
multifetal pregnancy?
A. Advanced maternal age
2 B. Use of clomiphene citrate
C. AfricanAmericanethnicity
D. Have twin cousins on the paternal side.

18. All EXCEPT which of the following increase a woman's predisposition to

develop preeclampsia syndrome?
A. Obesity
2 B. Smoking
C. Nulliparity
D. Multiple gestation

19. A quantifiable method used to predict labor induction outcome

2 A. Bishop score
B. Ballards score
C. APGAR score
D. Internalexamination

20. Estimated delivery weight > 4000g after 37 weeks of gestation with
prophylactic labor induction in what effects?
A. Increase cesarean delivary rate
B. Decrease shoulders dystonia rate
C. Decrease postterm delivary rate
D. Alloftheabove

21. The ideal treatment of hypovolemia from catastrophic hemorrhage is

which of the following?
2 A. Whole blood
B. Packed red blood cells
C. Wholebloodandplatelets
D. Packed red blood cells and plasma

22. A 19 year old G1P0 at 32 weeeks AOG arrives at the emergency room
via ambulance after experiencing eclamptic seizures at the mall. Upon
arrival at the ER, her BP is 170/110 mmHg , HR 110bpm , RR 17cpm. She
is drowsy but responsive. FHT 130-140’s bpm. No contractions. DTR 3+.
What is your next step?
A. Immediate induction of labor
2 B. Give MgSO4
C. GiveDiazepam
D. STATCesareandelivery

23. Postterm pregnancy greater than ___ weeks is considered prolonged

A. 40
B. 41
2 C. 42
 D. 43

24. What is the most common etiology of persistent fevers after childbirth?
A. Atelectasis
B. Pyelonephritis
C. Breast engorgement
2 D. Genital tract infections

25. Which of following common complication untreat chronic hypertension

in pregnancy?
A. Preterm birth
B. Intrauterine death
2 C. Eclampsia
D. Gastationaldiabeticmallitus

26. Maternal adaption to multifetal gestation includes all except,

2 A. Excessive nausea and vomiting
B. Greater blood volume expansion (50 to 60 %)
C. Greater cardiac output
D. Decreased iron and folate intake

27. 23 year old, G2P2 (2002), hypertensive, came in for family planning
counseling. If she
desires to use COC pills, which clinical criteria should be met?
2 A. Nonsmoker
B. Younger than 35 years
C. Hypertension well controlled
D. Alloftheabove

28. During evaluation of postpartum hemorrhage following a vaginal

delivery, which of the following maneuvers or medications might be used?
2 A. Bimanual uterine compression
B. Ergot alkaloids for patients with hypertension
C. Carboprost tromethamine in patients with mild asthma
D. Alloftheabove

29. What is mechanism of COC?

2 A. Prevent ovulation
B. Spermicide
C. Block sperm reach to egg
D. Allabove

30. Which of the following medications is associated with oligohydramnios

when taken in the latter half of pregnancy?
A. Hydralazine
B. Beta blockers
C. Calcium-channelblockers
2 D. Angiotensin-receptor blockers

31. Which of the following has the highest relative risk in predisposing a
patient to abruptio placenta?
A. Preeclampsia
B. PPROM
C. Cigarette smoking
2 D. Prior abruption
32. Initial step in diagnosis of puerperial mastitis?
A. Mammogram
B. Blood culture
C. Clinical Examination
D. CBC

33. A 25 year old G2P1(1001) presents at 31 weeks of gestation, upon

examination at ER her cervix is dilated 5cm. What is next appropriate
management?
A. Magnesium sulfate
B. Corticosteroids
C. Delivery
D. Alloftheabove

34. What is the primary mechanism of action of combined oral

contraceptive pills?
A. Prevent ovulation
B. Spermicidal
C. Block sperm from reaching the egg
D. Alloftheabove

35. Which of the following is true concerning the prevention of fetal growth
restriction?
A. In the United states, malaria prophylaxis assists prevention
B. Preconceptional and antepartum smoking cessation assists prevention
C. For the gravida with chronic hypertension, antihypertensive therapy
assists prevention
D. Aspirin therapy assists prevention

36. All except, Which of following are infection cause in fetal growth
restriction?
A. congenital syphilis
B. maternal tuberculosis
C. first trimester primary cytomegalovirus infection
D. bacterialvaginosis

37. In the event of medical or other obstetrical complications, that are not
allowed to recommend pregnancy to until 42 weeks
A. true
B. false

38. True or false. Normal vaginal delivery with contraindication in twin

gestation with transverse cephalic presentation
A. true
B. False

39. What is the threshold for sever preeclampsia with severe features?
A. systolic bp >= 140 mm hg and diastolic bp >= 90mm hg
B. systolic bp >= 160mm hg and diastolic bp >= 100mm hg
C. systolic bp >= 120mm hg and diastolic bp >= 80mm hg
D. systolic bp >= 130mm hg and diastolic bp >= 85mm hg
 40. Why is an intraumbilical incision most favourable in puerperal tubal
ligation
A. It is thick, so it regains integrity (not the exact wordings)
2 B. Yeilds better cosmesis
C. Smallestincision
D. Decreases the risk of bleeding complications

41. During vasectomy, which of the following structures is ligated?

A. Epididymis
B. Spermatic cord
2 C. Ductusdeferens
D. Efferent ductile

42. A 44-year-old primigravida presents to clinic at 40 weeks' gestation.

She wants to go into labor naturally, and therefore wants to wait as long as
possible to be induced. Based on the American College of Obstetricians
and Gynecologists, when should she be induced?
A. 40 weeks' gestation
B. 41 weeks' gestation
2 C. 42weeks'gestation
D. When the patient is ready

43. Causes of uterine atory include which of the following

A. Obesity
B. Placenta previa
2 C. Multiple fetuses
D. Placental abription

44. what is the primary mechanism of action of tubal ligation as method for
contraception:
A. hormonal regulations
B. barrier effect
1 C. surgicalprocedure
D. spermicidal

45. Relative risk in increased for which of the following cancers with
combination oral contraceptive
A. Ovarian
2 B. Cervical
C. Endometrial
D. Hepatocellular carcinoma

46. Which intervention is considered for postterm preferred to avoid

complications
A. Induction of labor
0 B. Bed rest
C. cesarean section
D. Home birth