\\\\ The word obstetrics is derived derived from Latin term obstetrix, which means means which of the following? \\ midwife \\\ deliverer \\\ attendant \\\ surgeon \\\\ Which of one of the following following corresponds to the perinatal perinatal period? \\\ 22 to 28 weeks gestation gestation \\\ 22 to 34 weeks gestation gestation \\\ 20 to 40 weeks gestation gestation \\ 20 weeks to 4 weeks postpartum postpartum \\\\ What is the upper gestational gestational age cutoff for defining defining the birth of a preterm infant? \\\ 29 weeks \\\ 33 weeks \\\ 35 weeks \\ 37 weeks \\\\ How is an infant classified classified that is born between 260 and 294 days of gestation? gestation? \\\ preterm infant \\ term infant \\\ postterm infant \\\ postmature infant \\\\ What is the single most common common cause of neonatal neonatal death? \\ low birthweight \\\ congenital anomalies \\\ infection \\\ perinatal asphyxia
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\\\\ How long after fertilization does it it take for the zygote to reach the uterine cavity? cavity? \\\ 1 to 2 days \\ 3 to 4 days \\\ 5 to 6 days \\\ 7 days \\\\ What hormone is responsible for maintenance maintenance of the corpus luteum if implantation of the fertilized ovum takes place? \\\ estrogen \\ progesterone \\\ hCG \\\ hPL \\\\ Which of the following isn’t a presumptive symptom of pregnancy? \\\ nausea \\\ fatigue \\\ urinary frequency \\ constipation \\\\ Which of the following following is not considered a probable probable sign of pregnancy? \\\ enlargement of the abdomen \\\ changes in shape, size, and consistency consistency of uterus \\\ cessation of menses \\ ballottement \\\\ The clitoris is the homologue homologue of which of the following following structure? \\ penis \\\ scrotum \\\ gubernaculum testis \\\ corpora cavernosa
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\\\\ What is the principal erogenous erogenous organ or area of women? \\\ vagina \\ clitoris \\\ labia minora \\\ G-spot \\\\ Which of the following following is the predominant bacteria bacteria of the vagina during pregnancy? pregnancy? \\\ Peptostreptococcus sp. \\\ Listeria monocytogenes \\ Lactobacillus sp. \\\ Streptococcus agalactiae \\\\ The uterine artery is a main branch branch of which of the following arteries? arteries? \\\ aorta \\\ common iliac \\\ external iliac \\ internal iliac \\\\ The ovarian artery is a direct branch of which of the following vessels? vessels? \\ aorta \\\ common iliac \\\ external iliac \\\ internal iliac \\\\ Which of the following following is not a component of the bony pelvis? \\\ coccyx \\\ sacrum \\\ ischium \\ femoral head
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\\\\ What is the shortest diameter of the pelvic cavity? \\\ diagonal conjugate \\ interspinous \\\ true conjugate \\\ obstetrical conjugate \\\\ What does the portion of the deciduas invaded by the trophoblast become? \\ decidua basalis \\\ decidua capsularis \\\ decidua vera \\\ decidua parietalis \\\\ What day of the menstrual cycle do subnuclear, glycogen-rich vacuoles develop on the glandular epithelium? \\\ 5 to 7 \\\ 10 to 12 \\ 14 to 16 \\\ 20 to 22 \\\\ What is the average amount of blood lost during normal menstrual cycle? \\\ 10 to 15 mL \\ 25 to 60 mL \\\ 85 to 120 mL \\\ 150 mL \\\\ What is the duration of the proliferative phase of the menstrual cycle? \\\ variable \\\ 10 to 12 days \\\ 12 to 14 days \\ most commonly over 14 days
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\\\\ What is the solid ball of cells formed by 16 or more blastomeres? \\ morula \\\ blastocyst \\\ zygote \\\ embryo \\\\ The survival of the conceptus in the uterus is attributable to the immunological peculiarity of which of the following? \\\ decidua \\\ amnion \\\ chorion \\ trophoblast \\\\ What are a main stem (truncal) villi and its ramifications? \\ placental cotyledon \\\ maternal cotyledon \\\ stem cotyledon \\\ primary cotyledon \\\\ Where is the complete molecule of human chorionic gonadotropins primarily produced? \\ syncytiotrophoblast \\\ cytotrophoblast \\\ chorionic membrane \\\ Hofbauer cells \\\\ What is the best known function of human chorionic gonadoptropin? \\ its maintenance of the corpus luteum \\\ that it helps protect against paternal antibodies \\\ that it stimulates human placental lactogen secretion \\\ that it stimulates fetal ovaries to produce estrogen
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\\\\ When (week of pregnancy) does human placental lactogen peak in the maternal serum? th
th
th
th
th
th
\\\ 10 to 12 \\\ 16 to 20 \\\ 28 to 30 th
\\ 34 to 36
th
\\\\ Pregnancy is said to consist of 10 lunar months. How long is an actual lunar month? \\\ 26 days \\\ 27 days \\ 28 days \\\ 29 days \\\\ What is the approximate weight of the fetus at 16 gestational weeks? \\\ 25 g \\\ 50 g \\ 110 g \\\ 250 g \\\\ What is the approximate weight of the fetus at 20 gestational weeks? \\\ 200g \\ 300 g \\\ 480 g \\\ 650 g \\\\ What is the approximate eight of the fetus at 24 gestational weeks? \\\ 500 g \\ 630 g \\\ 750 g \\\ 890 g
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\\\\ What is the approximate weight of the fetus at 28 gestational weeks? \\\ 750 g \\\ 890 g \\ 1100g \\\ 1500 g \\\\ What is the average weight of the fetus at 32 gestational weeks? \\\ 1000 g \\\ 1500 g \\ 1800 g \\\ 2000 g \\\\ What is the average weight of the fetus at 36 gestational weeks? \\\ 1990 g \\ 2500 g \\\ 2850 g \\\ 3000 g \\\\ In the fetus or neonate, what are the two sutures between the frontal and parietal bones? \\\ frontal \\\ sagittal \\\ lambdoid \\ coronal \\\\ Which of the following diameters has the greatest length? \\\ occipitofrontal \\\ biparietal \\ occipitomental \\\ suboccipitobregmatic
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\\\\ The plane of which of the following diameters represents the greatest circumference of the head? \\ occipitofrontal \\\ suboccipitobregmatic \\\ bitemporal \\\ biparietal \\\\ The plane of which of the following diameters represents the smallest circumference of the head? \\\ occipitofrontal \\ suboccipitobregmatic \\\ bitemporal \\\ biparietal \\\\ Which of the following vitamins is important to be given prophylactically for the fetus soon after birth (especially in the breast-feeding newborn)? \\ vitamin K \\\ vitamin A \\\ vitamin C \\\ vitamin D \\\\ Which of the following immunological factors provides protection against enteric infections when ingested in the colostrum? \\\ IgG \\\ IgM \\ IgA \\\ IgE \\\\ At what gestational age will the fetus first demonstrate spontaneous movements if removed from the uterus? \\\ 8 weeks \\ 10 weeks \\\ 12 weeks
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\\\ 14 weeks \\\\ How early might the fetus hear sounds in utero? th
\\\ 14 week th
\\\ 18 week th
\\ 24 week th
\\\ 28 week \\\\ What is the average amount of amniotic fluid swallowed per 24 hours by the term fetus? \\\ 100 mL \\\ 200 mL \\ 500 mL \\\ 1500 mL \\\\ What is the average uterine weight at term? \\\ 200 g \\\ 450 g \\\ 780 g \\ 1100 g \\\\ Which of the following is not produced by the corpus luteum of early pregnancy? \\\ progesterone \\\ 17alpha-hydroxyprogesterone \\\ relaxin \\ prolactin \\\\ What is pigmentation of the midline of abdominal skin during pregnancy called? \\\ striae gravidarum \\ linea nigra \\\ chloasma
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\\\ melasma \\\\ What is the average weight gain during pregnancy? \\\ 5 kg \\\ 9 kg \\ 11 kg \\\ 15 kg \\\\ What is the average increase in maternal blood volume during pregnancy? \\\ 10% \\\ 25% \\ 50% \\\ 75% \\\\ What is the average increase in the volume of circulating erythrocytes during pregnancy? \\\ 100 mL \\\ 250 mL \\ 450 mL \\\ 700 mL \\\\ Which of the following hematologic changes does not occur during normal pregnancy? \\ The mean age of circulating red cells is increased. \\\ The mean cell volume is increased. \\\ There is moderate erythroid hyperplasia. \\\ There is an increase in plasma rythropoietin. \\\\ Which of the following in not increased in pregnancy? \\\ blood leukocyte count \\\ C-reactive protein \\\ leukocyte alkaline phosphate activity
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\\ alpha-interferon \\\\ What is the average increase in the resting pulse during pregnancy? \\\ 0 to 1 bpm \\\ 5 to 6 bpm \\ 10 to 15 bpm \\\ 18 to 20 bpm \\\\ Which of the following hemodynamic values remains unchanged during normal pregnancy? \\\ systemic vascular resistance \\\ pulmonary vascular resistance \\\ colloid osmotic pressure \\ pulmonary capillary wedge pressure \\\\ Which of the following is not increased during normal pregnancy? \\\ glomerular filtration rate \\\ renal plasma flow \\\ creatinine clearance \\ plasma concentration of urea \\\\ With regard to the hydronephrosis and hydroureter associated with pregnancy, which of the following is not true? \\\ Ureteral dilation is greater on the right side. \\ Ureteral dilation is primarily due to hormonal factors. \\\ There is elongation of the ureters. \\\ There is increase in the number of curves of the ureters. \\\\ Which of the following is most likely to cross the placenta? \\\ thyroxine \\\ triiodothyronine \\\ reverse triiodothyronine
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\\ thyroid-releasing hormone \\\\ What is the goal of prenatal care? \\\ to establish a god relationship with your patients \\ to deliver a healthy baby without impairing the mother’s health \\\ to set up a payment schedule for the delivery \\\ to see the patient often enough so you feel comfortable \\\\ What is a primipara? \\\ a woman who was pregnant once \\ a woman delivered once of a viable fetus \\\ a woman who has completed two pregnancies \\\ a woman who has had a 12-week miscarriage \\\\ What is a nulligravida? \\\ a woman who never delivered a live-born baby \\\ a woman who had one miscarriage \\ a woman who has never been pregnant \\\ a woman who had only one pregnancy \\\\ What is the mean duration of pregnancy from the first day of the LMP? \\\ 250 days \\\ 260 days \\\ 270 days \\ 280 days \\\\ Naegele’s rule estimates gestation age based on which of the following formulas? \\ Add 7 days to LMP and count back three months. \\\ Subtract 7 days from LMP and count back three months. \\\ Add 21 days to LMP and count back three months.
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\\\ Subtract 21 days from LMP and count back three months.
\\\\ Which of the following statements are true? \\\ The granulosa cells secrete androstenedione. \\ The granulosa cells become luteal cells following the release of the oocyte. \\\ Luteal cells secrete progesterone alone. \\\ The ovary contains around 50 000 oocytes at menarche. \\\\ Which of the following statements are true of the menstrual cycle? \\\ Oestradiol causes the endometrial glands to secrete glycogen. \\\ The endometrium is shed because the spiral arterioles lose their elasticity and start to bleed. \\ The luteal phase lasts for a fixed duration of 12 –14 days. \\\ In the proliferative phase of the cycle the spiral arterioles become waved \\\\ Which of the following statements are true? \\\ Oestradiol exerts a posotive feedback on FSH. \\\ The secretion of FSH and LH is under the control of the thalamus. \\ Testosterone is essential for the production of oestradiol. \\\ Progesterone concentrations reach their peak at the time of ovulation. \\\\ Which of the following are associated with causing tubal damage leading to tubal subfertility? \\\ Trichomonas vaginalis. \\ Gonorrhoea. \\\ Candidos. \\\ Gardnelos. \\\\ Which of the following statements are true of sexually transmitted infections (STIs)? \\\ Gonorrhoea in women is best diagnosed by cultures of material from the posterior vaginal fornix. \\ Syphilis is adequately treated in penicillin-allergic pregnant women by doxyciklin. \\\ Contact tracing partners of women with first attack genital herpes is helpful.
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\\\ Bacterial vaginosis should be diagnosed by culture of a high vaginal swab (HVS) for Gardnerella vaginalis. \\\\ Which of the following statements are true about HIV infection? \\\ It is caused by a DNA virus that binds to the CD4 receptor. \\\ Seroconversion commonly presents with a glandular fever illness. \\ In the UK, all patients with a CD4 count below 200 ? 106/l should be encouraged to start antiHIV drugs. \\\ Antiretroviral resistance testing will show resistance patterns to both current and previous anti-HIV drugs. \\\\ Which of the following is the best treatment of a suspected dermoid cyst found in an 18 year –old nulliparous woman? \\\ Observation \\\ Hysterectomy \\\ Adnexectomy \\ Cystectomy \\\\ Which of the following statements are true? \\\ Fetal haemoglobin shifts the oxygen dissociation curve to the right of that for haemoglobin A. \\\ In fetal life oxygenated blood from the umbilical arteries flows directly to the left side of the heart. \\\ During fetal life the lungs are filled with amniotic fluid. \\ Exposure to teratogens is more likely to cause congenital abnormalities in the first trimester of pregnancy. \\\\ The functions of the placenta include which of the following? \\\ Transfer of oxygen from the fetus to the mother \\\ Transfer of urea from the mother to the fetus. \\\ Transfer of nutrients from the fetus to the mother. \\ Regulation of fetal metabolism of insulin and glucose. \\\\ The smallest diameters of the fetal skull include which of the following?
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\\\ Mentovertical. \\ Suboccipitobregmatic. \\ Biparietal. \\\ Occiptofrontal. \\\\ Which of the following statements are true of a hydatidiform mole? \\\ Is not associated with early onset pre-eclampsia. \\\ Should be treated with methotrexate. \\\ Should be followed up for only 6 months in a specialist centre. \\ Is associated with a higher than average hCG concentration. \\\\ Which of the following is true of choriocarcinoma? \\\ There is early spread to bones. \\\ Hysterectomy is only method of treatment \\\ After hydatidiform mole the risk of choriocarcinoma is 40%. \\ After hydatidiform mole the risk of choriocarcinoma is 4%. \\\\ A woman presents with her second miscarriage. Which of the following pieces of information should she be given in respect of miscarriage? \\\ She has a 75% chance of miscarrying again. \\\ She has a 55% chance of miscarrying again \\ She has a 25% chance of miscarrying again. \\\ She has a 65% chance of miscarrying again \\\\ Which of the following investigations are performed at the first antenatal visit? \\\ Toxoplasmosis. \\\ Cytomegalovirus (CMV). \\ Syphilis. \\\ Hepatitis C. \\\\ Which of the following are used as indicators of fetal well-being beyond 24 weeks of pregnancy?
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\\\ Liquor volume. \\\ Fetal movements. \\\ Auscultation. \\ Umbilical artery dopplers. \\\\ A woman presents at 12 weeks of pregnancy. She has had two livebirths at term, delivered a live baby at 21 weeks who died within a few minutes of birth, one pregnancy loss at 8 weeks and an intrauterine death at 25 weeks. Which one of the following correctly expresses her gravidity and parity? \\\ Gravida 6 Para 4 \\ Gravida 6 Para 3 \\\ Gravida 5 Para 3. \\\ Gravida 5 Para 4. \\\\ Which of the following features of a cardiotocograph (CTG) would be considered nonreassuring in labour? \\\ Baseline variability of 5 –15 beats per minute. \\
Late decelerations in the second stage of labour.
\\\ A fetal heart rate of 150 beats per minute. \\\ Accelerations. \\\\
Which of the following are indications for continuous electronic fetal monitoring (EFM)?
\\\ A woman at term in spontaneous labour who ruptures her membranes24 hours ago and has clear liquor \\\ A woman at term in spontaneous labour who ruptures her membranes 1 hour ago and has clear liquor. \\\ A woman who ruptured her membranes 6 hours ago, clear liquor and is in spontaneous labour. \\\ A woman at term in spontaneous labour who ruptured her membranes 12 hours ago, clear liquor and is in spontaneous labor \\\\ In normal labour which of the following statements are true? \\\ Uterine contractions are generated in the lower segment of the uterus.
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\\ The rate of cervical dilatation should be greater than 1cm/hour. \\\ The fetal heart should be checked every 15 minutes in the first stage of labour \\\ The second stage of labour should not exceed 2 hours in duration. \\\ An episiotomy should be performed in the majority of women. \\\\ A woman on the postnatal ward bursts into tears when you go and see her 48 hours after the birth of her baby.Which of the following might indicate that she is at high risk of developing postnatal depression? \\\ She does not show any interest in her infant who is crying insistently. \\\ She is bottle feeding the baby. \\ She is unable to sleep. \\\ Her partner was present at the birth of the baby .\\\\ A baby is born in the following condition at 1 minute. She is pink with a heart rate of 120 bpm. She is not moving or crying and has taken a few irregular gasps. Her limbs are flaccid but she is moving her facial muscles. What is her Apgar score? \\\ 9 \\\ 7 \\ 6 \\\ 5 \\\\ Submucous fibroids are commonly associated with which of the following? \\\ Constant lower abdominal pain. \\ Menorrhagia. \\\ Vomiting. \\\ Ectopic pregnancy. \\\\ A 24-year-old woman presents with unilateral abdominal pain, vomiting, abdominal rebound and guarding. She is apyrexial and her LMP was one week ago. Which of the following is the most likely diagnosis? \\\ Pelvic inflammatory disease. \\\ Bleeding into a corpus luteal cyst.
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\\\ Ruptured corpus luteal cyst. \\ Torted dermoid cyst. \\\\ Which of the following is true of dermoid cysts? \\\ May undergo degeneration. \\ May contain well differentiated tissues. \\\ May contain altered blood. \\\ May secrete testosterone. \\\\ A 19-year-old woman presents with right iliac fossa pain. The pain came on gradually and was associated with nausea and vomiting. On examination she has a temperature of 37.6°C. Abdominal examination reveals tenderness in the right iliac fossa (RIF) with guarding and rebound. Vaginal examination reveals mild tenderness on the right with no cervical excitation. What is the most likely diagnosis? \\\ Pyelonephritis. \\ Torted right ovarian cyst. \\\ Small bowel obstruction. \\\ Ruptured right ovarian cyst \\\\ Which of the following statements are true? \\\ Carcinoma of the cervix is the most common gynaecological malignancy. \\\ Few women die of ovarian cancer than any other gynaecological malignancy. \\ Endometrial cancer most commonly presents with postmenopausal bleeding. \\\ Ovarian cancer most commonly presents with postcoital bleeding. \\\\ A woman of 63 presents with a hard fixed abdominal mass noticed by her GP when she complained that her clothes were becoming tighter. Her menopause was 12 years ago and she has had no vaginal bleeding. She has no other abnormalities on examination. What is the most likely provisional diagnosis? \\ Stage 3 carcinoma of the ovary. \\\ Stage 1 carcinoma of the ovary. \\\ Stage 3 carcinoma of the uterus. \\\ Stage 4 carcinoma of the ovary.
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\\\\ A woman of 63 presents with a hard fixed abdominal mass noticed by her GP when she complained that her clothes were becoming tighter. Her menopause was 12 years ago and she has had no vaginal bleeding. She has no other abnormalities on examination. Which of the following are useful preoperative staging investigations for this woman? \\\ Hysteroscopy \\\ Curettage. \\ Serum tumour markers. \\\ Electrolytes. \\\\ Which of the following are common symptoms of detrusor instability? \\\ Slow urinary stream. \\\ Incomplete emptying. \\ Nocturia. \\\ Rtare) \\\\ Which of the following would be the next step after a 30 min. of the third stage of labour? \\\ Initiate oxytocin \\\ Wait an additional 30min \\\ Attempt a manual extraction of the placenta \\ make sure that placenta is detached \\\\ Which of the following is most likely to be a risk factor for uterine inversion? \\\ Long umbilical cord \\ Uncontrolled traction of the umbilical cord \\\ Placental abruption \\\ Attenuated umbilical cord
\\\\ A 31 year-old woman G2P1 at 40 weeks’ gestation has p rogressed in labor from 4 to 7cm. cervical dilatation during 2 hours. Which of the following best describes the labor?
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\\\ latent phase of the I stage \\\ Passive phase of the II stage \\\ Active phase of the II stage \\ Active phase of the I stage \\\\ An 18-year-old woman had a yellowish vaginal discharge. On examination, the cervix is erythematous an the discharge reveals numerous leukocytes. Which of the following is most likely etiology? \\\ Neisseria gonorrhea \\ Chlamydia thrachomatis \\\ Thrichomona vaginalis \\\ Ureaplazma species \\\\ A 34 year-old woman is diagnosed as having a vaginitis based on a “ fishy odor” to her vaginal discharge and vaginal pruritus. The cervix is normal in appearance. Which of the following most likely corresponds to the etiology? \\\ Neisseria gonorrhea \\\ Chlamydia thrachomatis \\ Gardnella \\\ Cytomegalovirus \\\\ A 28 year-old woman has multiple painful pustules erupting through out the skin of her body. Which of the following most likely corresponds to the etiology? \\ Neisseria gonorrhea \\\ Chlamydia thrachomatis \\\ Gardnella \\\ Cytomegalovirus \\\\ Which of the following maternal cervical infections causes blindness in the newborn? \\\ Toxoplazmosis \\
Chlamydia thrachomatis
\\\ Candidosis
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\\\ Cytomegalovirus \\\\ Which of the following is the ost accurate method for diagnosing acute salpingitis? \\\ Clinical criteria \\\ Sonography \\\ Computed tomographic scan \\ Laparascopy \\\\ Which of the following types of uterine fibroids would most likely lead tu recurrent abortion? \\ Submucosal \\\ Intramural \\\ Subserous \\\ Intraligamental \\\\ Which of the following is the most coon clinical presentation of uterine leiomyomata? \\\ Infertility \\ Menorrhagia \\\ Pelvic pain \\\ Recurrent abortion \\\\ Which of the following is the epithelial cell tumor of the ovary? \\\ Cystic teratoma \\ Brenner tumor \\\ Androblastoma \\\ Choriocarcinoma \\\\ Which type of drug suppresses uterine contractions \\\ Uterotonic \\\ Hypertensive \\\ Hemolytic \\ Tocolytic
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\\\\ Contractions in active phase of labor are tipically \\\ 5 minutes apart \\\ 15-20 minutes apart \\ 2-3 minutes apart \\\ 30-35 minutes apart \\\\ Hyperventilation leads to \\\ High levels of oxygen with maternal alkalosis \\\ low levels of oxygen with maternal alkalosis \\\ High level of carbon dioxide with maternal acidosis \\ Low level of carbon dioxide with maternal alkalosis \\\\ Maternal pushing efforts before complete cervical dilatation can lead to \\\ Cervical bleeding \\ Cervical edema \\\ cervical dilatation \\\ Cervical stenosis \\\\ Amnionic fluid is usually \\\ White \\\ Green \\ Clear \\\ Yellow \\\\ The fetal head should be delivered in a controlled manner to \\\ Allow stimulation of the fetal respiratory center \\\ Decrease the amount of mucus in the fetal airway \\\ Permit adequate perfusion through the umbilical cord \\ Prevent expansion related intracranial bleeding
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\\\\ During the delivery the \\\ Posterior shoulder should be delivered first \\\ Cord should be cut 8” from the baby \\ Mouth should be suctioned before the nose \\\ Baby should be given oxygen before the shoulders deliver \\\\ Newborn APGARS are \\\ Assigned by the delivering physician or midwife \\\ Based on a scale of 1-2 \\ Assigned at 1 and 5 minutes \\\ The legal basis for resuscitation \\\\ The TOTAL length of labor for primip is typically \\\ 39-45 hours \\ 20-24 hours \\\ 4-6 hours \\\ 2-6 hours \\\\ Primips typically push for \\\ 15 minutes \\\ 5 minutes \\ 1 hour \\\ 2 houres \\\\ Periurethral lacerations \\\ Always require surgical repair \\\ Will require laser repair following her six-week checkup \\ Usually heal spontaneously \\\ Commonly cause long-term urologic complications
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\\\\ The placenta usually delivers \\\ About 3 hours after the baby \\ With a gush of bleeding \\\ After the physician pull on the cord \\\ in several pieces \\\\ The initial newborn heart rate is determined by \\ Palpating at the base of the cord for 10 seconds and multiplying by 6 \\\ Using a stethoscope and counting an apical pulse for 2 full minutes \\\ Locating a brachial pulse and counting for 30 seconds and multiplying by 2 \\\ Averaging the final five minutes of the fetal heart rate tracing \\\\ The APGAR is assigned by \\\ Delivering Physician \\\ The staff obstetrician \\\ The nursery charge nurse \\ The person responsible for initial stabilization of newborn \\\\ APGAR score reliably indicates \\ The overall condition of the newborn during the first five minutes of life \\\ The risk of long-term neurologic deficiency \\\ The need for neonatal resuscitation \\\ Future intellectual performance \\\\ The most likely reason for increased bleeding during the immediate postpartum period is \\ Uterine atony \\\ Bladder atony \\\ Bladder distendsion \\\ An undelivered twin
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\\\\ A histerical labor patient is best managed by \\\ Callin Security \\\ Applying soft restrains \\\ Calling Administration \\ Teaching breathing technique \\\\ Labor epidurals are generally placed with the mother in \\\ The left lateral position \\\ The right lateral position \\ The sitting position \\\ The supine position \\\\ The chin is brought into intimate contact with the fetal thorax during which cardinal movement of labor \\ flexion \\\ extension \\\ engagement \\\ descent \\\\ The anterior shoulder appears under the symphysis during which cardinal movement \\\ extension \\ expulsion \\\ external rotation \\\ descent \\\\ The biparietal diameter passes through the pelvic inlet during which cardinal movement of labor \\\ descent \\ engagement \\\ expulsion \\\ extension
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\\\\ What is edematous swelling of the fetal scalp during labor \\\ molding \\ Caput succedaneum \\\ Subdural hematoma \\\ Erythema nodusum \\\\ Which of the following bones is most likely pushed under the parietal bones during molding? \\\ Frontal \\\ The ipsilateral bone \\\ Temporal \\ occipital \\\\What is the most reliable indicator of rupture of the fetal membranes? \\ Fluid per cervical os \\\ positive nitrazine test \\\ positive ferning \\\ positive oncofetal fibronectin \\\\ What is the major advantage of a mediolateral episiotomy? \\\ easy surgical repair \\\ less postoperative pain \\\ less blood loss \\ less extensions \\\\ What is the most common side effect of epidural anesthesia? \\\ maternal hypertension \\ maternal hypotension \\\ CNS stimulation \\\ infective block
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\\\\ Which of the following are absolute contraindications to spinal analgesia \\\ Preeclampsia \\ infected skin at site of needle entry \\\ convulsions secondary to seizure disorders \\\ diabetes \\\\ What is the most common complication of paracervical block \\\ maternal hypotension \\\ CNS toxicity \\ fetal bradycardia \\\ bleeding ////What is the incidence of vaginal bleeding in the first trimester of pregnancy? ///Abruption placenta ///Rupture of uterus //Threatened miscarriage ///Genital HSV ////When should dilatation and curettage be performed in the patient? ///Complete abortion ///Ectopic pregnancy ///Threatened abortion //Incomplete abortion ////How can one be certain that products of conception were obtained? //Serial ?-hCG measurements ///Baseline hematocrit measurements ///LH measurements ///Progesterone measurements
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////How is the diagnosis of endometriosis confirmed? ///By vaginal exam ///By blood test //By endoscopic exam ///By history ////What is the most common presenting symptoms of endometriosis? ///Uterine bleeding //Cyclical pelvic pain ///Vaginal discharge ///Infertility ////What is the major cause of ectopic pregnancy? //Salpingitis ///Endometriosis ///Ovarian cysts ///Cervical neoplasia ////Where do the majority of ectopic pregnancy occur? ///Ovarian ///Abdominal //Fallopian tubal ///Cervical ////Which is the type of physiological (functional) cyst? ///Dysgerminoma //Theca lutein ///Teratoma ///Dermoid
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////What is the mean age of menarche? ///10.5 years //12,7 years ///14 years ///11 years ////What is the mean duration for menses? ///7 days ///3 days //5 days ///6 days ////How many germ cells are in the pubertal ovary? ///6-7 million //300,000-400,000 ///2-3 million ///100,000-200,000 ////What is the most common cause of amenorrhea? //Pregnancy ///Puberty ///Pelvic inflammatory disease ///Polycystic ovarian disease ////What is the most common clinical manifestation of PCO? ///Bleeding //Infertility ///Acute pelvic pain ///Vaginal discharge
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////What is the most common presentation of twins? ///Breech-transverse ///Breech-breech ///Vertex-transverse //Vertex-vertex ////How often are infants in a breech lie at term? ///6-7% ///1-2% //3-4% ///7-8% ////What type of follow-up occurs after evacuation molar pregnancy? //?-hCG measurement ///PRL measurement ///FSH measurement ///DHEA measurement
\\\\ Which of the following statements are true? \\\ The granulosa cells secrete androstenedione. \\ The granulosa cells become luteal cells following the release of the oocyte. \\\ Luteal cells secrete progesterone alone. \\\ The ovary contains around 50 000 oocytes at menarche. \\\\ Which of the following statements are true of the menstrual cycle? \\\ Oestradiol causes the endometrial glands to secrete glycogen. \\\ The endometrium is shed because the spiral arterioles lose their elasticity and start to bleed. \\ The luteal phase lasts for a fixed duration of 12 –14 days. \\\ In the proliferative phase of the cycle the spiral arterioles become waved
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\\\\ Which of the following statements are true? \\\ Oestradiol exerts a posotive feedback on FSH. \\\ The secretion of FSH and LH is under the control of the thalamus. \\ Testosterone is essential for the production of oestradiol. \\\ Progesterone concentrations reach their peak at the time of ovulation. \\\\ Which of the following are associated with causing tubal damage leading to tubal subfertility? \\\ Trichomonas vaginalis. \\ Gonorrhoea. \\\ Candidos. \\\ Gardnelos. \\\\ Which of the following statements are true of sexually transmitted infections (STIs)? \\\ Gonorrhoea in women is best diagnosed by cultures of material from the posterior vaginal fornix. \\ Syphilis is adequately treated in penicillin-allergic pregnant women by doxyciklin. \\\ Contact tracing partners of women with first attack genital herpes is helpful. \\\ Bacterial vaginosis should be diagnosed by culture of a high vaginal swab (HVS) for Gardnerella vaginalis. \\\\ Which of the following statements are true about HIV infection? \\\ It is caused by a DNA virus that binds to the CD4 receptor. \\\ Seroconversion commonly presents with a glandular fever illness. \\ In the UK, all patients with a CD4 count below 200 ¥ 106/l should be encouraged to start antiHIV drugs. \\\ Antiretroviral resistance testing will show resistance patterns to both current and previous anti-HIV drugs. \\\\ Which of the following is the best treatment of a suspected dermoid cyst found in an 18 year –old nulliparous woman? \\\ Observation \\\ Hysterectomy
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\\\ Adnexectomy \\ Cystectomy \\\\ Which of the following statements are true? \\\ Fetal haemoglobin shifts the oxygen dissociation curve to the right of that for haemoglobin A. \\\ In fetal life oxygenated blood from the umbilical arteries flows directly to the left side of the heart. \\\ During fetal life the lungs are filled with amniotic fluid. \\ Exposure to teratogens is more likely to cause congenital abnormalities in the first trimester of pregnancy. \\\\ The functions of the placenta include which of the following? \\\ Transfer of oxygen from the fetus to the mother \\\ Transfer of urea from the mother to the fetus. \\\ Transfer of nutrients from the fetus to the mother. \\ Regulation of fetal metabolism of insulin and glucose. \\\\ Which of the following statements are true of a hydatidiform mole? \\\ Is not associated with early onset pre-eclampsia. \\\ Should be treated with methotrexate. \\\ Should be followed up for only 6 months in a specialist centre. \\ Is associated with a higher than average hCG concentration. \\\\ Which of the following is true of choriocarcinoma? \\\ There is early spread to bones. \\\ Hysterectomy is only method of treatment \\\ After hydatidiform mole the risk of choriocarcinoma is 40%. \\ After hydatidiform mole the risk of choriocarcinoma is 4%. \\\\ A woman presents with her second miscarriage. Which of the following pieces of information should she be given in respect of miscarriage? \\\ She has a 75% chance of miscarrying again.
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\\\ She has a 55% chance of miscarrying again \\ She has a 25% chance of miscarrying again. \\\ She has a 65% chance of miscarrying again \\\\ Which of the following investigations are performed at the first antenatal visit? \\\ Toxoplasmosis. \\\ Cytomegalovirus (CMV). \\ Syphilis. \\\ Hepatitis C. \\\\ Which of the following are used as indicators of fetal well-being beyond 24 weeks of pregnancy? \\\ Liquor volume. \\\ Fetal movements. \\\ Auscultation. \\ Umbilical artery dopplers. \\\\ A woman presents at 12 weeks of pregnancy. She has had two livebirths at term, delivered a live baby at 21 weeks who died within a few minutes of birth, one pregnancy loss at 8 weeks and an intrauterine death at 25 weeks. Which one of the following correctly expresses her gravidity and parity? \\\ Gravida 6 Para 4 \\ Gravida 6 Para 3 \\\ Gravida 5 Para 3. \\\ Gravida 5 Para 4. \\\\ Which of the following features of a cardiotocograph (CTG) would be considered nonreassuring in labour? \\\ Baseline variability of 5 –15 beats per minute. \\
Late decelerations in the second stage of labour.
\\\ A fetal heart rate of 150 beats per minute. \\\ Accelerations.
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Which of the following are indications for continuous electronic fetal monitoring (EFM)?
\\\ A woman at term in spontaneous labour who ruptures her membranes24 hours ago and has clear liquor \\\ A woman at term in spontaneous labour who ruptures her membranes 1 hour ago and has clear liquor. \\\ A woman who ruptured her membranes 6 hours ago, clear liquor and is in spontaneous labour. \\\ A woman at term in spontaneous labour who ruptured her membranes 12 hours ago, clear liquor and is in spontaneous labor \\\\ In normal labour which of the following statements are true? \\\ Uterine contractions are generated in the lower segment of the uterus. \\ The rate of cervical dilatation should be greater than 1cm/hour. \\\ The fetal heart should be checked every 15 minutes in the first stage of labour \\\ The second stage of labour should not exceed 2 hours in duration. \\\ An episiotomy should be performed in the majority of women. \\\\ A woman on the postnatal ward bursts into tears when you go and see her 48 hours after the birth of her baby.Which of the following might indicate that she is at high risk of developing postnatal depression? \\\ She does not show any interest in her infant who is crying insistently. \\\ She is bottle feeding the baby. \\ She is unable to sleep. \\\ Her partner was present at the birth of the baby .\\\\ A baby is born in the following condition at 1 minute. She is pink with a heart rate of 120 bpm. She is not moving or crying and has taken a few irregular gasps. Her limbs are flaccid but she is moving her facial muscles. What is her Apgar score? \\\ 9 \\\ 7 \\ 6
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\\\ 5 \\\\ Submucous fibroids are commonly associated with which of the following? \\\ Constant lower abdominal pain. \\ Menorrhagia. \\\ Vomiting. \\\ Ectopic pregnancy. \\\\ A 24-year-old woman presents with unilateral abdominal pain, vomiting, abdominal rebound and guarding. She is apyrexial and her LMP was one week ago. Which of the following is the most likely diagnosis? \\\ Pelvic inflammatory disease. \\\ Bleeding into a corpus luteal cyst. \\\ Ruptured corpus luteal cyst. \\ Torted dermoid cyst. \\\\ Which of the following is true of dermoid cysts? \\\ May undergo degeneration. \\ May contain well differentiated tissues. \\\ May contain altered blood. \\\ May secrete testosterone. \\\\ A 19-year-old woman presents with right iliac fossa pain. The pain came on gradually and was associated with nausea and vomiting. On examination she has a temperature of 37.6°C. Abdominal examination reveals tenderness in the right iliac fossa (RIF) with guarding and rebound. Vaginal examination reveals mild tenderness on the right with no cervical excitation. What is the most likely diagnosis? \\\ Pyelonephritis. \\ Torted right ovarian cyst. \\\ Small bowel obstruction. \\\ Ruptured right ovarian cyst \\\\ Which of the following statements are true? \\\ Carcinoma of the cervix is the most common gynaecological malignancy.
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\\\ Few women die of ovarian cancer than any other gynaecological malignancy. \\ Endometrial cancer most commonly presents with postmenopausal bleeding. \\\ Ovarian cancer most commonly presents with postcoital bleeding. \\\\ A woman of 63 presents with a hard fixed abdominal mass noticed by her GP when she complained that her clothes were becoming tighter. Her menopause was 12 years ago and she has had no vaginal bleeding. She has no other abnormalities on examination. What is the most likely provisional diagnosis? \\ Stage 3 carcinoma of the ovary. \\\ Stage 1 carcinoma of the ovary. \\\ Stage 3 carcinoma of the uterus. \\\ Stage 4 carcinoma of the ovary. \\\\ A woman of 63 presents with a hard fixed abdominal mass noticed by her GP when she complained that her clothes were becoming tighter. Her menopause was 12 years ago and she has had no vaginal bleeding. She has no other abnormalities on examination. Which of the following are useful preoperative staging investigations for this woman? \\\ Hysteroscopy \\\ Curettage. \\ Serum tumour markers. \\\ Electrolytes. \\\\ Which of the following are common symptoms of detrusor instability? \\\ Slow urinary stream. \\\ Incomplete emptying. \\ Nocturia. \\\ Rtare) \\\\ Which of the following would be the next step after a 30 min. of the third stage of labour? \\\ Initiate oxytocin \\\ Wait an additional 30min \\\ Attempt a manual extraction of the placenta
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\\ make sure that placenta is detached \\\\ Which of the following is most likely to be a risk factor for uterine inversion? \\\ Long umbilical cord \\ Uncontrolled traction of the umbilical cord \\\ Placental abruption \\\ Attenuated umbilical cord \\\\ A 31 year-old woman G2P1 at 40 weeks’ gestation has progressed in labor from 4 to 7cm. cervical dilatation during 2 hours. Which of the following best describes the labor? \\\ latent phase of the I stage \\\ Passive phase of the II stage \\\ Active phase of the II stage \\ Active phase of the I stage \\\\ An 18-year-old woman had a yellowish vaginal discharge. On examination, the cervix is erythematous an the discharge reveals numerous leukocytes. Which of the following is most likely etiology? \\\ Neisseria gonorrhea \\ Chlamydia thrachomatis \\\ Thrichomona vaginalis \\\ Ureaplazma species \\\\ A 34 year-old woman is diagnosed as having a vaginitis based on a “ fishy odor” to her vaginal discharge and vaginal pruritus. The cervix is normal in appearance. Which of the following most likely corresponds to the etiology? \\\ Neisseria gonorrhea \\\ Chlamydia thrachomatis \\ Gardnella \\\ Cytomegalovirus \\\\ A 28 year-old woman has multiple painful pustules erupting through out the skin of her body. Which of the following most likely corresponds to the etiology?
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\\ Neisseria gonorrhea \\\ Chlamydia thrachomatis \\\ Gardnella \\\ Cytomegalovirus \\\\ Which of the following maternal cervical infections causes blindness in the newborn? \\\ Toxoplazmosis \\
Chlamydia thrachomatis
\\\ Candidosis \\\ Cytomegalovirus \\\\ Which of the following is the ost accurate method for diagnosing acute salpingitis? \\\ Clinical criteria \\\ Sonography \\\ Computed tomographic scan \\ Laparascopy \\\\ Which of the following types of uterine fibroids would most likely lead tu recurrent abortion? \\ Submucosal \\\ Intramural \\\ Subserous \\\ Intraligamental \\\\ Which of the following is the most coon clinical presentation of uterine leiomyomata? \\\ Infertility \\ Menorrhagia \\\ Pelvic pain \\\ Recurrent abortion
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