LATIHAN SOAL-SOAL UJIAN NASIONAL JULI 2011

OBGYN FK UNS (William 22)

1. How many weeks after delivery does it take the uterus to return to its nonpregnant
size?
a. 2 b. 4 c. 6 d. 12
2. t what point postpartum !weeks" does menstruation normally return in a non breast#
feeding woman?
a. 4 to 6 c. 12 to 14
b. 6 to $ d. 16 to 1$
%. &our patient has a peripheral neuropathy secondary to delivery in'ury. &ou counsel her
that the median duration of symptoms is which of the following?
a. 1 month c. 6 month
b. 2 month d. 12 month
4. &ou counsel your puerperal patient that most women return to their prepregnancy
weight by which time period following delivery?
a. 4 month c. $ month
b. 6 month d. 12 month
(. )hich test of fetal lung maturity is *+, affected by contaminants such as blood-
meconium- or vaginal secretions?
a. .ecithin# spingomyelin ratio
b. /hosphatidylglycerol detection
c. 0oam stability !shake" test
d. ll of the above
6. )hich of the following clinical signs indicates severe neonatal encephalopathy in
term infants?
a. 1oma c. 2ecurrent apnea
b. 3ultiple seizures d. ll of the above
4. )hat are the antigens of the rhesus blood group system?
a. 156 c. 156cde
b. c15e6 d. c5e
$. )hat type of blood is used for initial e7change transfusion in the anemic newborn?
a. +- 5#negative c. 8- 5#positive
b. +- 5#positive d. 8- 5#negative
9. )hich umbiliocal artery blood gas represents the e7pected mean in a normal term
neonate?
a. 4.%(- p1+2 49 mmHg- H1+% 1: m6;<.
b. 4.%(- p1+2 6: mmHg- H1+% 2% m6;<.
c. 4.2$- p1+2 6: mmHg- H1+% 1: m6;<.
By AA 1
d. 4.2$- p1+2 49 mmHg- H1+% 2% m6;<.
1:. ccording to the merican 1ollege of +bstetricians and =ynecologists- metabolic
acidemia is defined by which of the following?
a. >mbilical artery blood pH ? 6.9 and base deficit ? 12
b. >mbilical artery blood pH ? 4.: and base deficit ? 1:
c. >mbilical artery blood pH ? 4.1 and base deficit ? 1%
d. >mbilical artery blood pH ? 4.2 and base deficit ? 11
11. 8lood gas analysis from an umbilical artery sampling reveals a pH of 4.1- p1+2 6(
mmHg@ H1+% 14 m6;<. corresponds to which type of acidosis ?
a. 3etabolic c. respiratory
b. 3i7ed d. *ormal
12. 8lood gas analysis from an umbilical artery sampling reveals a pH of 4.1- p1+2 49
mmHg@ H1+% 1: m6;<. corresponds to which type of acidosis ?
a. 3etabolic c. respiratory
b. 3i7ed d. *ormal
1%. An what of cord insertion do the umbilical vessels separate in the membranes some
distance from the placental margin?
a. Belamentous insertion c. 0urcate insertion
b. 3arginal insertion d. ll of the above
14. )hich umbilical cord condition results from active fetal movements?
a. 8attledore placenta c. ,rue knots
b. 0alse knots d. Basa previa
1(. )hat is the etiology of true cysts of the umbiulical cord?
a. 67cessive maternal progesterone levels
b. Antra amnionic infection
c. .i;uefaction of )hartonCs 'elly
d. 2emnants of the allantois
16. )hat is the etiology of false cysts of the umbiulical cord?
a. 67cessive maternal progesterone levels
b. Antra amnionic infection
c. .i;uefaction of )hartonCs 'elly
d. 2emnants of the allantois
14. uterine dehiscence found during palpation after a succesful B81 re;uires repair in
which of the following situations?
a. 8leeding at dehisence site
b. 1oncurrent chorioamnionitis
c. /atient plans future fertility
d. ll of the above
1$. An defining the difference between incomplete and complete uterine rupture- which of
the following layers is evaluated?
a. bdominal fascia c. Bisceral peritoneum
b. /arietal peritoneum d. 67ternal layer of uterine muscle
By AA 2
19. )hich of the following reflects the rate of fetal survival with uterine rupture and
e7pulsion of the fetus?
a. 1: to 2(D c. (: to 4( D
b. 2( to (:D d. 4( to 9: D
2:. )hat is the rate of uterine rupture in women undergoing a trial of labor following
secarean delivery?
a. ? 1 D c. 1: D
b. (D d. 1( D
21. )ho wrote in detail about obstetrics in the 2nd century 5 ?
a. Eulius 1aesar c. Hippocrates
b. *uma /ompilius d. Foranus
22. )hat is the incidence of bladder laceration at the time of cesarean delivery ?
a. :.% per 1::: c. 1-4 per 1:::
b. :.4 per 1::: d. 2.$ per 1:::
2%. )hat percentage of women undergoing emergency peripartum hysterectomy receive a
blood transfusion?
a. %: b. (: c. 4: d. 9:
24. )hat is the average blood loss with an elective cesarean hysterectomy?
a. (:: m. c. 1(:: m.
b. 1::: m. d. %::: ml
2(. )hich of the following describes a frank breech presentation ?
a. 0le7ion of the hips and e7tension of the knees
b. 0le7ion of the hips and fle7ion of the knees
c. 67tension of the hips and fle7ion of the knees
d. 67tension of the hips and e7tension of the knees
26. )hich of the following best describes a complete breech presentation ?
a. .ower e7tremities fle7ed at the hips and e7tended at knees
b. .ower e7tremities fle7ed at the hips and one or both knees fle7ed
c. +ne or both hips not fle7ed or both feet or knees below breech
d. foot is in the birth canal
24. )hich of the following best describes the incomplete breech presentation ?
a. .ower e7tremities fle7ed at the hips and e7tended at knees
b. .ower e7tremities fle7ed at the hips and one or both knees fle7ed
c. +ne or both hips not fle7ed or both feet or knees below breech
d. 8oth feet are in the right fundal area
2$. )hich of the following help to differentiate a frank breech from a cephalic
presentation during vaginal e7amination?
a. Aschial tuberosities and anus form a straight line
b. Aschial tuberosities and anus form a triangle shape
c. Aschial tuberosities and anus form a circular shape
By AA 3
d. 3outh and malar eminences form a straight line
29. )hich forceps has a sliding lock?
a. ,ucker 3c.ane c. Gielland
b. Fimpson d. /iper
%:. )hich of the following forceps is best suited for low forceps delivery of a fetus with a
molded head?
a. Fimpson c. Gielland
b. ,ucker 3c.ane d. 1hamberlain
%1. )hich of the following forceps is best suited for low forceps delivery of a fetus with a
rounded head?
a. Fimpson c. Gielland
b. ,ucker 3c.ane d. 1hamberlain
%2. )hich type of pelvis most strongly predisposes to occiput posterior presentations and
opposed rotations?
a. ndroid c. gynecoid
b. nthropoid d. /latypeloid
%%. How long does it take o7ytocin to reach steady state levels in the plasma?
a. ( min c. 2: min
b. 1: min d. 4: min
%4. ,he 05 has approved misoprostol for which of the following ?
a. 1ervical ripening c. =astroesophageal reflu7
b. .abor induction d. /eptic ulcers
%(. )hat is the recommended time interval after /=62 administration to initiation of
o7ytocin?
a. %: min c. $ hr
b. 2 hr d. 6 to 12 hr
%6. )hich of the following is most likely to have a successful induction of labor?
a. /rimiparous@ cervi7 2 cm dilated< 2:D effaced< : station
b. /rimiparous@ cervi7 2 cm dilated< 2: D effaced< #1 station
c. multiparous@ cervi7 2 cm dilated< $: D effaced< #1 station
d. /rimiparous@ cervi7 1 cm dilated< 2: D effaced< : station
%4. )hich class of drugs is strongly associated with oligohydramnions?
a. ngiotensin converting enzyme inhibitors
b. H#adrenergic blockers
c. 1alcium channel blocking agents
d. Hydralazine
%$. mnionic fluid volume may be altered by changes in all 6I16/, which of the
following?
a. 3aternal hematocrit c. 0etal swallowing
b. 3aternal hydration d. ltitude
By AA 4
%9. An cases of anencephaly- fetal increases in which of the following is the most likely
cause of hydramnions?
a. Fwallowing c. inspiration
b. ,ransudation d. Basopresin secretion
4:. )hich of the following fetal conditions is *+, associated with hydramnions?
a. 1entral nervous system anomalies
b. *onimune hydrops
c. 1hromosomal abnormalities
d. 2enal agenesis
41. +f the following methods used for management of shoulder dystocia- which is
associated with the highest incidence of orthopedic and neurological damage?
a. Fuprapubic pressure c. Hibbard manuver
b. 3c2oberts maneuver d. )oods crew manuver
42. )hat is the appro7imate incidence of breech presentation at term?
a. :.(D b. % D c. 4 D d. 12 D
4%. )hat percentage of vaginal deliveries are complicated by torn anal sphincter?
a. :.( to 1 D c. 9 to 12 D
b. % to 6 D d. 1( to 1$ D
44. )hich of the following has the weakest association with fetal head molding?
a. 3ultiparity c. Bacuum e7traction delivery
b. +7ytocin labor stimulation d. /rolonged labor
4(. )hat is the level of testosterone in umbilical venous plasma likely to be in a pregnant
woman with an androgen secreting tumor?
a. undetectable
b. slighty lower than maternal serum levels
c. e;ual to maternal serum levels
d. higher than maternal serum levels
46. )hat is the mechanism of action af nalo7one hydrochloride?
a. Ftimulates acethylcholinesterase
b. 5isplaces narcotic from spesific receptors
c. Anhibit muscarinic receptors
d. 8lokcs b receptors
44. )hich of the following ! according to 8ricker and .avender" provides superior pain
relief for labor ?
a. 3eperidine c. morphine
b. 8utorphanol d. 6pidural analgesia
4$. 8uthorphanol administration has been associated with which fetal heart rate
abnormality?
a. 2epetitive late decelerations
b. 0etal tachycardia
c. Finusoidal rhythm
By AA 5
d. Faltatory patter
49. )hich of the following fetal conditions is the suspected cause of early fetal heart rate
decelerations?
a. nemia c. acidemia
b. Hypo7ia d. Head compression
(:. gradual- smooth deceleration of the fetal heart rate that follow the peak of a
contraction describes which of the following deceleration type ?
a. .ate c. variable
b. 6arly d. /rolonged
(1. gradual decrease in the fetal heart rate that coincides with a uterine contraction
describes which of the following deceleration type ?
a. .ate c. variable
b. 6arly d. prolonged
(2. 5ecreased beat to beat variability has been une;uivocally linked with which of the
following ?
a. nalgesia use c. 3agnesium sulfate use
b. 0etal breathing d. ll of the above
(%. An which of the following presentations does the fetal altitude !vertebral column
posture" become concave !e7tended"?
a. 0ace c. cephalic
b. Fhoulder d. 8reech
(4. An which presentations is the fetal head partially fle7ed and a large anterior fontanel
presenting?
a. Berte7 c. brow
b. 0ace d. Finciput
((. An which presentations is the fetal neck sharply e7tended and the back and occiput in
contact?
a. Berte7 c. brow
b. 0ace d. Finciput
(6. An which presentations is the fetal head fle7ed and the occipital fontanel presenting ?
a. Berte7 c. brow
b. 0ace d. Finciput
(4. 6ncephalocele is usually associated with which of the following?
a. Hepatomegaly c. *ormal intelligence
b. Hydrocephalus d. ll of the above
($. =astroschisis is associated with which of the following ?
a. neuploidy c. /oor postnatal survival
b. +ther bowel abnormalities d. ll of the above
By AA 6
(9. )hat is the most common chromosomal anomaly associated with cystic hygroma in
second or third trimester fetuses?
a. ,riploidy c. ,risomy 21
b. ,risomi 1$ d. 3onosomy I
6:. )hich of the following is *+, characteristic of /otter syndrome ?
a. ,ight skin c. .imb deformities
b. bnormal facies d. /ulmonary hypoplasia
61. ,he most important consideration in deciding when to begin antepartum testing is
which of the following ?
a. /rognosis for neonatal survival
b. ,ype of maternal disease
c. Feverity of maternal disease
d. *one of the above
62. ccording to the 1+=- which of the following is considered the 8est test to
evaluate fetal well being?
a. 3odified biophysical profile
b. 1F,
c. >mbilical artery 5oppler velocimetry
d. *one of the above
6%. 0etal heart rate accelerations during *F, are affected by which of the following?
a. 0etal lie c. 0etal se7
b. 0etal acidemia d. ll of the above
64. ll of the following have been used to describe fetal behavioral states- 6I16/,
a. 8reathing c. 6ye movement
b. Heart rate d. 8ody movement
6(. )hich of the following antimicrobials given to the mother near delivery may result in
significant hiperbilirubinemia in the preterm neonate ?
a. /enicillins c. macrolides
b. 1ephalosphorins d. Fulfonamides
66. )hich of the following antimicrobials is a folate antagonist but not associated with
adverse fetal effects ?
a. ,rimetrophrim c. tetracycline
b. *itrofurantoin d. 6rytromicyn
64. )hich of the following antifungal agents has apossible association with con'oined
twins in human ?
a. *ystatin c. mphotericin 8
b. 1lotrimazole d. =riseofulvin
6$. )hich of the following ntiviral drugs- used as an aerosol inhalation agents in
intensive care nurseries- consistently produces hydrocephalus and limb abnormalities
in rodents?
a. cyclovir c. famciclovir
By AA 7
b. mantadine d. 2ibavirin
69. /reimplantation genetics analysis techni;ues can use genetic material from which of
the following?
a. 8lastocyst c. Fecond polar body
b. 0irst polar body d. ll of the above
4:. )hich of the following is a maternal serum marker used in first trimester 5own
syndrome screening?
a. /lacental lactogen c. /regnancy associated plasma protein
b. cetylcholinesterase d. ll of the above
41. )hich of the following fetal structures is *+, involved in the synthesis of alpha
fetoprotein !0/"?
a. .iver c. 8one marrow
b. &olk sac d. =atrointestinal tract
42. )hich of the fofetal neural tube llowing has *+, been associated with an increased
risk of fetal neural tube defects?
a. 1oncurrent trisomy 1%
b. /oorly controlled diabetes
c. 0irst trimester acetaminophen use
d. High maternal fever early in gestation
4%. ppro7imately how many mutations have been shown to cause cystic fibrosis?
a. 9 c. 9::
b. 9: d. 9:::
44. )hich of the following trinucleotide repeats is associated with the fragile I gene
!032#1"?
a. 1== 1. =1,
b. 1= d. ===
4(. )hich of the following is an I#linked disease?
a. Bon willebrand disease c. 0abry disease
b. *eurofibromatosis d. ,ay#Fachs disease
46. )hich of the following is *+, an autosomal recessive disease?
a. ,ay#Fachs disease c. 3yotonic dystrophy
b. 1ongenital adrenal hyperplasia d. Fickle cell anemia
44. &our patient has been assigned a 0A=+ score of ( for choriocarcinoma and has
received standard treatment. &ou counsel her that her chances for cure are closest to
which of the following ?
a. 4:D c. $: D
b. (:D d. 9( D
4$. =estasional tropobkastic neoplasia includes all of the following 6I16/, J
a. Anvasive mole c. Hydatidiform mole
b. 1horiocarcinoma d. /F,,
By AA 8
49. common site of gestasional tropoblastic disease metastasis includes which of the
following ?
a. Bagina c. spleen
b. 8one d. 8reast
$:. 1horiocarcinoma is spread metastatically by which of the following methods ?
a. .ymphatic c. 1ontiguous invasion
b. Hematogenous d. 5isseminated via peritoneal fluid
$1. )hat is the lowest normal increase for 8 h1= levels in early normal pregnancies
during a 4$ hour interval?
a. %% D c. ((D
b. 44D d. 66 D
$2. )hat is the mean doubling time for 8h1= levels in early pregnancy?
a. 24 hr c. 42 hr
b. 4$ hr d. 96 hr
$%. t what level of serum h1= can intrauterine gestations be detected with (:D
sensitivity using vaginal sonography?
a. 1:: mA><m. c. 1::: mA><m.
b. (:: mA><m. d. (::: mA><m.
$4. )hich of the following signs of or symptoms most strongly indicates a ruptured
ectopic pregnancy with sizable intraperitoneal hemorraghe?
a. Heavy vaginal bleeding
b. .ower abdominal pain- unilateral
c. *ausea and vomiting
d. Fhoulder pain on inspiration
$(. How many weeks after an abortion does ovulation usually occur?
a. 2 to % c. ( to 6
b. 4 to ( d. 6 to 4
$6. 1ommon side effects of prostaglandin 62 include which of the following?
a. 0ever c. seizure
b. 5ysuria d. arthralgia
$4. ,he dilatation an evacuation method of surgical abortion should be used beginning at
which of the following gestational ages?
a. 12 weeks c. 1$ weeks
b. 16 weeks d. 2: weeks
$$. )hich of the complications following surgical abortion occurs .6F, commonly?
a. Anfertility c. 1ervical laceration
b. 6ndometritis d. 2etained products of conception
$9. 67essive ingestion of which vitamin can lead to a functional vitamin 812 deficiency?
a. b. 86 c. 1 d. 5
By AA 9
9:. Ftrict vegetarianism may cause maternal and fetal deficiency of which vitamin due
tom its availability e7clusively from animal sources?
a. b. 812 c. 1 d. G
91. couple of Andia or /akistan descent is at greatest risk for which of the following
genetic disease?
a. aKthalasemia c. 1ystic fibrosis
b. bKthalasemia d. ,ay#Fachs disease
92. primigravida present at 2: weeks gestation. )hich of the following laboratory test
is *+, obtained during the first prenatal visit?
a. ntibody screen c. HAB screen
b. =roup 8 streptococcus culture d. /ap smear
9%. )hat is the relationship between advanced paternal age and genetic birth defects?
a. 5ecreased c. Ancreased markedly
b. Ancreased slightly d. *o relationship
94. )hat is the predominant genetic abnormality in the fetus seen with advanced maternal
age?
a. neuploidy c. Fingle gene mutation
b. 0ragile I d. ,ranslocation
9(. ,he incidence of which genetic disorder has plummeted as a result of preconceptional
screening and counseling?
a. /henylketonuria c. Fickle cell anemia
b. /olycystic kidney disease d. ,ay#Fachs disease
96. )hat is the most common single gene disorder worldwide?
a. 1ystic fibrosis c. /G>
b. 0ragile I d. ,halasemia
94. )hich of the following is *+, a primary regulator of o7ytocin receptor e7pression?
a. 6stradiol c. pitocin
b. /rogesterone d. ll of the above
9$. )hich of the following is *+, a part of the urogenital diaphragm?
a. 5eep transverse perineal muscle c. 1occygeus muscle
b. .evator ani muscle d. Aschiorectal fascia
99. )hat causes the pathological 8andl ring?
a. ,hinning of the lower uterine segment
b. ,hinning of the upper uterine segment
c. ,hickening of the lower uterine segment
d. band of fibromuscular tissue at the level of the internal os
1::. )hich of the following characterizes phase 1 of parturition?
a. L 3yometrial o7ytocin receptors plus M conne7in 4%
By AA 10
b. L 3yometrial o7ytocin receptors plus L conne7in 4%
c. M 3yometrial o7ytocin receptors plus M conne7in 4%
d. M 3yometrial o7ytocin receptors plus L conne7in 4%
By AA 11