MALANG 1. During normal pregnancy there is a. a 7.0% increase in plasma volume by 32 weeks gestation b.

a decreased white cell count c. an increase in the proportion of B to T lymphocytes d. an increase in antithrombin III e. lupus anticoagulant in the circulation 2. In the fetal nervous system a. sensory input does not reach the cerebral cortex until term b. fetal movements increase in response to an acoustic stimulus from 20 weeks onwards c. fetal movements can be seen from 12 weeks onwards d. low frequency sounds are attenuated by maternal tissues e. the fetus can `learn' olfactory stimuli 3. Immunoglobulin G a. combines with placental receptors b. can only be synthesised in the presence of T helper cells c. Fc fragment includes light chains d. is produced in similar amounts in all individuals exposed to the same stimulus e. chains are coded for by adjacent genes on the same chromosome 4. Luteinising hormone (LH) a. is secreted as pulses every 5-10 minutes b. pulsatile secretion ceases during sleep c. peak occurs about 30 hours before ovulation d. levels reach a peak at 20 weeks of intrauterine life e. levels are higher in the male than the female fetus 5. The following methods are used for investigating the fallopian tubes, except: A. mucosal biopsy B. salpingoscopy C. bacteriological investigation D. tuba) fluid sampling E. dilatation and cutterage (D&C) 6. A large placenta has an association with, except: A. hypertensive disorders of pregnancy B. maternal anaemia C. A80 incompatibility D. fetal lung malformation E. alpha thalassaemia 7. With regard to HIV infections: A. oligomenorrhoea and amenorrhoea are predominant symptoms in HIV-positive patients B. combined oral contraceptive pills are contraindicated in an HIV -positive woman. C. there is an increased risk of CIN in a patient who is HIV positive . D. the intrauterine contraceptive device (IUCD) is the ideal contraceptive for a woman with HIV E. a woman who is HIV positive has a 10% chance of developing AIDS in 5 years 8. The following relate to pelvic inflammatory disease (PID): A. it is common in early pregnancy B. the incidence of PID is higher in women who use barrier methods of contraception C. oral contraceptives render the patient more susceptible to PID D. chlamydial infection is a recognized risk factor in PID
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E midcycle is the most common time for infection 9. The following relate to hydatidiform mole: A. the complete mole arises from fertilization of an empty ovum B. in the complete mole, half the chromosomes are paternally derived C. the usual chromosome pattern in the partial mole is a triploidy D. partial hydatidiform chromosomes are paternally derived E. 2-3% of complete moles will progress to choriocarcinoma 10. With regard to Turner's syndrome: A. it is characterized by non-pitting oedema at birth B. the incidence is 1 in 2500 live births C. it may occur either in the pure or mosaic form D. positive sex chromatin is a feature E mosaicism can occur only after fertilization , 11. The following are characteristic features of antiphospholipid antibody syndrome: A. recurrent miscarriages B. severe fetal growth retardation C. large placental infarcts D. venous thrombosis E. a lower risk of pregnancy loss with a new partner 12. The following relate to trophoblastic tumours, except A. there is usually a unilateral adnexal mass B. they are associated with high titre beta hCG C. they are more common in Africa D. there is no risk of recurrence in subsequent pregnancies E the majority are malignant in young women 13. The following are ultrasound features of polycystic ovarian syndrome (PCO, except A. ten or more follicles, typically 2-8 mm in diameter B. central distribution of follicles C. decreased ovarian stroma D. diminished ovarian volume E. an enlarged uterus 14. The following relate to the puerperium: A. it only includes the first 4 weeks post-delivery B. 2 weeks after delivery, the uterus will have returned to the true pelvis C. beta human gonadotrophin will be negative 4 weeks after term delivery D. necrotizing fasciitis is a lethal complication that may result from perineal infection E. hypotension and ischaemic necrosis of the pituitary may result in panhypopituitarism (Sheehan's syndrome) 15. Obesity is associated with: A. infertility B. ovarian cancer C. breast cancer D, polycystic ovaries E. urinary dysfunction 16. Vasomotor symptoms of the menopause include: A. palpitations B. sweats C. hot flushes D. poor memory E. insomnia
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17. Which of the following is the predominant type of bacteria in the vagina during pregnancy? a. Lactobacillus sp. b. Peptostreptococcus sp. c. Listeria monocytogenes d. Streptococcus agalactiae 18. Which part of the uterus becomes the lower uterine segment during pregnancy? a. cervix b. cornua c. corpus d. isthmus 19. Uterine enlargement in pregnancy is due to which myometrial process? a. hypertrophy b. hyperplasia c. decidualization d. collagen dissociation 20. Ovarian vessels are found in which of the following ligaments? a. broad b. round c. uterosacral d. infundibulopelvic 21. Which of the following is the most potent of the naturally occurring estrogens? a. estriol b. estrone c. estradiol d. ethinyl estradiol 22. By which day of the endometrial cycle is restoration of the epithelial surface of the endometrium complete? a. 2 b. 5 c. 8 d. 12 23. Sloughing of the endometrium during menstruation is thought to be triggered by which of the following? a. pressure necrosis from stromal edema b. vascular stasis from spiral artery coiling c. atrophy from cessation of stromal cell mitosis d. pressure necrosis from inspissated gland glycoproteins 24. Which of the following is thought to be a mediator of dysmenorrhea? a. interleukin-8 b. enkephlinase c. prostaglandin FZa d. monocyte chemotactic factor-1 25. The decidua found directly beneath the site of blastocyst invasion is termed which of the following? a. vera b. basalis c. parietalis d. capsularis 26. Pregnancy is said to consist of 10 lunar months. How long is a real lunar month?
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a. 25 days b. 26,5 days c. 28 days d. 29,5 days 27. What is the residual volume of the intervillous space at term? a. 140 mL b. 210 mL c. 280 mL d. 350 mL 28. What is the gap junction protein? a. actin b. myosin c. connexin d. laminin 29. What is the carrier protein for oxytocin transport to the posterior pituitary? a. neurophysin b. relaxin c. binding globulin d. actin 30. In what percentage of cases does tubal rupture occur after methotrexate therapy for ectopic pregnancy? a. < 1 b. 5 to 10 c. 25 to 30 d. >50 31. What is the preferred therapy for a cervical pregnancy in a stable patient? a. hysterectomy b. cerclage c. embolization d. methotrexate 32. Which of the following represents the fetal period? a. implantation through week 8 b. implantation through week 12 c. week 9 until term d. week 12 until term 33. By how many weeks of gestation is formation of the heart complete? a. 8 b. 10 c. 12 d. 14 34. What is the goal of antepartum fetal surveillance? a. prevent fetal deaths b. prevent early deliveries c. increase fees for obstetricians d. delay delivery until lung maturity achieved 35. What is the positive-predictive value of antenatal fetal testing? a. <10% b. 10 to 40% c. 40 to 80% d. 80 to -100%
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36. What is the average diameter in millimeters of the lateral ventricular atrium at 15 weeks' gestation and older? a. 2 to 4 b. 6 to 8 c. 10 to 12 d. 14 to 16 37. The "double-bubble" sign is an ultrasonographic finding of which of the following anomalies? a. cystic hygroma b. duodenal atresia c. aqueductal stenosis d. two-vessel umbilical cord 38. In modern obstetrical management, approximately what percentage of parturients experience spontaneous labor and delivery, i.e., without induction or augmentation of labor? a. 90 b. 75 c. 50 d. 30 39. In which presentation is the fetal head flexed and the occipital fontanel presenting? a. vertex b. face c. brow d. sinciput 40. What is the most common position of the fetal vertex as it enters the pelvis? a. right occipitoanterior (ROA) b. right occipitotransverse (ROT) c. left occipitoanterior (LOA) d. left occipitotransverse (LOT) 41. The base of the occiput is brought into contact with the inferior margin of the symphysis during which cardinal movement of labor? a. extension b. expulsion c. descent d. flexion 42. What is baseline fetal bradycardia? a. <90 bpm b. < 100 bpm c. < 110 bpm d. < 120 bpm 43. What is baseline fetal tachycardia? a. > 160 bpm b. > 170 bpm c. > 180 bpm d. > 190 bpm 44. Fetal bradycardia typically may result from which of the following? a. maternal fever b. fetal head compression c. maternal atropine use d. none of the above 45. What is the most common cause of fetal tachycardia?
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a. drug-induced b. thyroid storm c. maternal fever d. cardiac arrhythmia 46. Of the following, which is NOT considered a. potential component of dystocia? a. power (force of contractions and expulsive efforts) b. passenger (fetus) c. passage (pelvis) d. pitocin augmentation 47. What is the most common reason for primary cesarean delivery? a. malpresentation b. placental abruption c. prematurity d. dystocia 48. Differing from ACOG criteria, Rouse and colleagues (1999) suggest that at least how many hours without cervical change are necessary to diagnose active-phase arrest? a. 2 b. 4 c. 6 d. 8 49. Which of the following is NOT associated with precipitous labor and delivery? a. amnionic fluid embolism b. postpartum hemorrhage c. increased perinatal mortality and morbidity d. chorioamnionitis 50. 23-1. What is the incidence of operative vaginal delivery? a. < 1% b. 5 to 10% c. 15 to 20% d. 25 to 30% 51. Which forceps has a sliding lock? a. Tucker-McLane b. Simpson c. Kielland d. Piper 52. Which of the following is true of high forceps deliveries? a. forceps applied at + 1 station b. fetal head engaged c. indicated for fetal distress d. no place in obstetrics today 53. Which of the following describes a frank breech presentation? a. flexion of the hips and extension of the knees b. flexion of the hips and flexion of the knees c. extension of the hips and flexion of the knees d. extension of the hips and extension of the knees 54. Which of the following best describes a complete breech presentation? a. lower extremities flexed at the hips and extended at knees b. lower extremities flexed at the hips and one or both knees flexed c. one or both hips not flexed or both feet or knees below breech d. a foot is in the birth canal
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55. The commonly used definition of the puerperium describes which of the following time periods? a. 2 weeks following delivery b. 4 weeks following delivery c. 6 weeks following delivery d. 12 weeks following delivery 56. Which of the following is the term used to formally describe the process in which the uterus contracts and atrophies to its nonpregnantsize? a. decompression b. contracture c. reparation d involution 57. Which of the following lower genital tract organisms is NOT associated with increased puerperal infection? a. Trichomonas vaginalis b. group B streptococcus c. Gardnerella vaginalis d. Mycoplasma hominis 58. In addition to fever, which of the clinical findings are commonly associated with puerperal metritis? a. nausea and vomiting b. parametrial tenderness c. positive blood cultures d. vulvar edema 59. What percentage of pregnancies are complicated by hypertension? a. < 1 b. 3 to 4 c. 6 to 8 d. 10 to 12 60. According to Chames (2002), 25 percent of eclamptic seizures occur a. antepartum b. intrapartum c. immediately postpartum d. beyond 48 hr postpartum 61. Your patient, at 37 weeks gestation, fell and struck her abdomen on the pavement. Fetal heart rate is 140 bpm. Her vital signs are stable and she denies pain. Cervical examination reveals no bleeding. Her cervix is 1 to 2 cm dilated and 50 percent effaced. The fetal head is at -1 station. The next most appropriate management of this patient includes which of the following? a. cesarean delivery b. induction of labor c. monitoring in labor and delivery for several hours d. discharge home to bed rest for the following 24 hr 62. Your newly pregnant patient suffered a placental abruption at 35 weeks during her first pregnancy. Her chronic hypertension is a complicating factor again this pregnancy. Which of the following antepartum fetal assessment tools has been shown to improve fetal outcome in subsequent pregnancies following an initial placental abruption? a. nonstress testing b. contraction testing c. uterine artery Doppler velocimetry
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d. none of the above