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WorksheetsOB-GYN
Total questions: 35
Worksheet time: 35mins
What is the mechanism by which the biparietal diameter passes through the pelvic inlet?
a. Flexion
b. Engagement
c. Descent
d. Internal rotation
In what functional labor division that the cardinal fetal movements of the cephalic presentation take place?
a. Preparatory division
b. Dilatational division
c. Pelvic division
d. Latent phase
A 37 year old G4P3 at term came in for check-up. On abdominal examination, the fetal back occupies the fundus, ballotable mass at right. What is her risk factor?
a. Maternal age
b. Gravidity
c. Parity
d. Age of gestation
The following are the signs of placental separation except:
a. Sudden gush of blood into the vagina
b. Globular and firm fundus
c. Uterus firm and palpable at the uterus
d. Lengthening of the cord
A 28 year old G3P2 at 38 5/7 weeks was admitted for labor pains. Cervix was fully dilated, fully effaced, mentum palpable beneath the symphysis pubis, ruptured membranes. What is the management?
a. Cesarean section
b. Vaginal delivery
c. Outlet forceps extraction
d. Low forceps extraction
The following are the risk factors for 3rd and 4th degree lacerations except:
a. Nulliparity
b. Midline episiotomy
c. Short perineal body
d. Mediolateral episiotomy
Which vessel can be injured while dissecting the subcutaneous layer of the abdomen during Pfannenstiel incision?
a. Superior epigastric artery
b. Inferior epigastric artery
c. Superficial epigastric artery
d. Superficial circumflex artery
The following are the absolute contraindications of combined oral contraceptive pills except:
a. Deep vein thromboembolism
b. Active liver disease
c. Age more than 35 years old
d. Breast carcinoma
A 20 year old, married woman plans to use the calendar rhythm method. Her longest cycle was 33 days and her shortest cycle is 26 days. When should you advise her to abstain from sexual intercourse?
a. Day 8-21
b. Day 15-22
c. Day 8-15
d. Day 1-7 and 22 onwards
The following statements are true of the adverse effects of intrauterine device except:
a. It causes heavy or prolonged menses or intermenstrual bleeding
b. It increases the rate of prostaglandin release in the presence of foreign body
c. Perforation is common and usually occurs at the fundus
d. Placement process not the device or its thread creates a transient risk of infection
There is a direct correlation between the increase of serum estrogen during the ovulatory cycle and the:
a. thickness of the theca externa
b. size of the dominant follicle
c. number pf hilar cells in the ovary
d. number of follicles in the ovary
e. thickness of the ovarian cortex
GnRH is the most active in producing an LH surge when it is secreted
a. tonically
b. in pulses every 2 to 4 minutes
c. in pulses every 12 minutes
d. in pulses every hour
e. in pulses every 3 hours
In patients with a ruptured tubal pregnancy, nonclotting blood is almost always found in the peritoneal cavity. The reason that this blood does not clot is that the blood
a. has not been outside of the body
b. has been mixed with peritoneal fluid
c. has previously clotted
d. is diluted to a hematocrit of less
e. is of fetal origin
The most consistent symptom of ectopic pregnancy is:
a. amenorrhea
b. vaginal bleeding
c. subjective symptoms of pregnancy
d. abdominal pain
e. passage of tissue
A 42-year-old gravida 4, para 4, has bothersome dysmenorrhea and menorrhagia. On pelvic examination the uterus is globular, tender, boggy, and approximately twice normal size. The most likely diagnose
a. endometriosis
b. adenomyosis
c. leiomyoma uteri
d. leiomyosarcoma
e. endometrial carcinoma
Effects of GnRH therapy for endometriosis include all the following except
a. decreased follicle-stimulating hormone (FSH)
b. decreased luteinizing hormone (LH)
c. amenorrhea
d. decreased high-density lipoprotein
In treating patients with severe menorrhagia secondary to anovulation, a theoretical advantage of high-dose conjugated equine estrogens over a high-dose combination oral contraceptive is that estrogen alone
a. promotes rapid endometrial growth
b. increases spiral artery recoil
c. increases platelet aggregation
d. promotes synthesis of prostaglandin F2a
e. can be given intravenously
The major clinical difference between PCOS and stromal hyperthecosis is a
a. greater ovarian enlargement in stromal hyperthecosis
b. thickened ovarian capsule in stromal hyperthecosis
c. higher levels of circulating free estradiol in stromal hyperthecosis
d. progressive androgen stigmata including virilization in stromal hypethecosis
e. anovulation in stromal hyperthecosis
In treating hirsutism with various pharmacologic agents, patients should be told all of the following except:
a. they will need to continue therapy for approximately 4 years
b. a response may take at least 3 months to become apparent.
c. approximately three quarters of patients will have a favorable response with 1 year of treatment
d. ovarian failure is a common side effect
An 18-year-old gives a 2-month history of intermittent, irregular bleeding. Her last normal menstrual period was 3 months ago. Before that, her cycle was regular at 28 days. Pelvic examination results are normal. The next step in management should be
a. endometrial aspiration
b. pelvic ultrasound imaging
c. a pregnancy test
d. laparoscopy
e. hysteroscopy
1. Girlie, 36 yrs old G3P2(1102) initially consulted a PMD and was requested CBC, Urine GS/CS, 75g OGTT. She never came back for follow up. Because of financial constraints, she opted to consult at a government hospital. On initial visit, you obtained the ff data:
Menstrual & OB Hx:
Regularly menstruating, 5 days duration, 2-3ppd, occasional dysmenorrhea
LMP: February 7, 2021
G1: preterm, NSD, weight unrecalled, complicated with Preeclampsia,
G2: term, NSD, 3.8 kg, no PNCU,
FHx: (+) Hypertension, DM, B. asthma
Pre-pregnancy weight: 63 kg; height: 5 ft
Labs:
CBC and Urine GS/CS: unremarkable
75g (FBS/1st hr/2nd hr): ( 90 mg/dl/ 185 mg/dl/ 152 mg/dl)
She now asks you to interpret her laboratory results & its importance to her condition. Which is the most appropriate advise?
a. Her results don’t matter anymore because she is about to deliver anyway
b. Her results show she has GDM based on an elevated 2nd hour blood glucose and a repeat exam be dome immediately after delivery
c. Her results show she has GDM based on an elevated 2nd hour blood glucose and a repeat exam be dome immediately after delivery
d. Re-evaluation can be done as early as 4 weeks postdelivery
What is the basis for the diagnosis in #1?
a. An elevated FBS
b. An elevated 1st hour
c. And elevated 2nd hour
d. Her results did not fit the criteria to diagnose GDM
If you have seen this patient on her early second trimester, what could you possibly give/ prescribe her?
a. Iron supplementation, Calcium, multivitamins
b. Iron supplementation, Calcium, multivitamins, low-dose aspirin
c. Iron supplementation, Calcium, multivitamins, corticosteroid
d. Iron supplementation and multivitamins as she cannot afford a lot of medications
You now conducted a thorough PE on her and had the ff findings:
BP: 130/80 CR: 87 bpm RR: 18 cpm T; 36.7 C
Wt: 72 kg
HEENT, Chest/Lungs, Cardiac: unremarkable
FH: 36 cm, FHT: 150’s LLQ
GUT: NEG, parous outlet
Cervix: 2-3 cm dilated, beginning effacement, cephalic, (+) BOW, station -2
You also noted contractions moderate every 3-5 minutes lasting for about 50-90 seconds
What will you advise her?
a. You may send her home and ask her to do fetal kick counting ( at least 10 kicks for 2 hours in a day)
b. Advise her she can go home and come back once contractions are more frequent in duration
c. Advise her admission to a nearby hospital
d. Let the patient decide depending on her financial capability
How will you advise this patient regarding her blood sugar monitoring?
a. No need to monitor blood sugar levels
b. Her blood glucose levels must remain above 70mg/dl
c. CBG monitoring can be postponed at this point until delivery
d. Monitor FBS instead and repeat 75g OGTT postpartum
After 1 day, the patient delivered via NSD, to a live baby boy, BW; 3930 grams. Immediately postpartum, you noted moderate to profuse bleeding. She was tachycardic, with faint pulses. You noted difficulty in assessing the uterine tone on abdominal examination due to her abdominal fat. What is the most probable diagnosis
a. Postpartum hemorrhage secondary to uterine atony
b. Hypovolemic shock secondary to early postpartum hemorrhage
c. Postpartum hemorrhage secondary to uterine atony; Anemia secondary
d. Hypovolemic shock secondary to early postpartum hemorrhage; Anemia secondary
What will you do to further evaluate the cause of bleeding to the patient?
a. Do speculum examination and internal examination
b. Proceed to the OR for hysterectomy
c. Bring the patient to the ultrasound room to check for uterine inversion
d. No need to do further evaluation. Just start fluid resuscitation and request for blood products
The patient in the above case was discharged after 5 days of hospital stay. She was advised follow up at the OPD, however, did not comply. After 1 year, she came back due to amenorrhea of about 12 weeks duration and claims that she was PT positive 2 days prior. TVS was done, cx was 2.3 x 2.5 x 3.1 cm. uterus was 8.1 x 5.6 x 5.8 cm. The CRl which was compatible with the age of gestation. You started her with Aspirin, Ferrous sulfate, calcium and Multivitamins. After 14 weeks, she followed up due to occasional hypogastric pain, with associated 1 day history of spotting. Initial Vital signs are as follows: BP: 140/90, CR 95 bpm, RR 19, T 36.6 C. On examination you noted uterine contractions on palpation which lasted for about 60-90 secs occurring every 3-4 minutes. IE revealed a 2 cm dilated cervix, beginning effacement, breech, (+) bow, station -2, with blood-tinged examining finger. What is the best management
a. Admit for tocolysis
b. Admit to determine the cause of preterm labor , tocolysis with nifedipine, corticoseteriods
c. Admit to determine the cause of preterm labor , tocolysis, corticosteroids, magnesium sulfate
d. Repeat BP, may give nifedipine, and 1st dose of dexamethasone/ betamethasone then send home after uterine contractions decreased
If corticosteroids were given on her previous admission and she goes into preterm labor again, which of the following statements is correct?
a. Another course of dexamethasone can be given as long as the fetus is still preterm
b. No need to repeat the corticosteroids
c. Can give corticosteroids after 34 weeks, because her last course was given at 24 weeks
d. Repeat course can be given if the fetus is still less than 34 weeks especially if at risk to deliver within the next seven days
If her BP on this follow up was documented at 140/90 on 2 readings taken after 4 hours, and her protein crea ratio is 0.35. What is the diagnosis
a. Gestational hypertension
b. Preeclampsia with severe features
c. Preeclampsia without severe features
d. Chronic hypertension
Which of the following is NOT part of the diagnosis criterion for PCOS?
a. menstrual irregularity
b. polycystic ovarian morphology
c. hyperandrogenism
d. obesity
Which of the following laboratory tests is/are necessary for to work-up oligo-anovulation
a. TSH
b. FSH
c. LH
d. Prolactin
Which of the following BEST describes the ovarian morphology of PCOS
a. one ovary having 12 or more cystic structures (2 to 8 mm)
b. ovarian volume >10 cc
c. peripherally oriented around a dense stroma
d. all of the above
e. A and B only
Which of the following hormones are NOT ELEVATED among PCOS patients?
a. FSH and LH
b. estrone and estradiol
c. dopamine
d. insulin
What is the criteria used for the diagnosis of hyperandrogenism?
a. rotterdam critea
b. feriman gallway score
metabolic syndrome
d. none of the above
