UJIAN TENGAH SEMESTER FISIOLOGI

RESIDEN DEPARTEMEN/SMF OBSTETRI & GINEKOLOGI FKUP/RSHS

BANDUNG, 15 MEI 2017

1. Seorang Dokter dapat diminta tanggung jawab hukum bila melakukan kelalaian
dan kesalahan, jikalelalaian ini menimbulkan kerugian pada pasen
a. KUHPetd Pasal 1335
b. KUHperd Pasal 1365
c. KUHPerd Pasal 1312
d. KUHPerf Pasal 1360

2. Seorang majikan atau pimpinan rumah sakit dapat bertanggung jawab atas
kerugian pihak lain yang ditimbulkan oleh karyawannya yang berada dibawah
penguasaannya
a. Strict Liability
b.  Vicarious Liability
c. Inspanning Verbintenis
d. Onrechtmatigedaad

3. Unsur unsur perbuatan melanggar hukum kecuali

a. Melanggar undang undang
b. Melanggar hak orang lain
c. Tidak melaksanakan kewajiban
d. Bertentangan dengan sikap baik 
    yang berluki di dalam oerganisasi

4. Berdasarkan hukum perikatan dokter dalam mrlakukan tindakan yang benar bila
memenuhi syarat syarat kecuali
a. Indikasi
b. Informed Consent
c. Rahasia medik
d. Berdasarkan standar Pedoman

5. Seorang Remaja hamil 2 bulan datang ke SpOG menginginkan kehamilannya

dilakukan aborsi, unsur tidak sahnya syarat suatu perjanjian dibawah ini adalah 
a. Kesepakatan
b. Kecakapan
c. Objek tertentu
d. Suatu sebab yang halal

6. Baik buruknya sikap kewajiban yang berhubungan dengan akhlak, budi pekerti,
susila adalah
a. Etiket
b. Moral
c. Etika
d. Moralitas
7. Nilai nilai moral atau nilai nilai moralyang menjadi pegangan bagi seseorang atau
suatu kelompok dalam menjalankan tentang tingkah lakunya baik buruknya
berperilaku
a. Adat istiadat
b. Kode etik
c. Etika
d. Hukum

8. Persamaan antara etik dan hukum adalah

a. Keberadaannya tertulis
b. Harus dibuktikan bila terjadi
    pelanggaran 
c. Menggugah kesadaran bersikap 
    manusia
d. Hadil pemikiran para penguasa

9. Seorang ibu 35 tahun anak hidup 3 orang yang masih balita, dirawat selama 4 hari
dengan abortus inkomplit terinfeksi, karena keadaan umumnya sudah membaik
maka dokter menyarankan untuk dlakukan tindakan kuret, namun pasen dan
keluarga menolak denga alasan biaya, pekerjaan suami sebagai tukang becak dan
bekan peserta BPJS. Dokter memutuskan dilakukan kuret dengan biaya tindakan
maupun obat Free. Prinsip etika dibawah ini yang paling tepat adalah
a. Autonomy
b. Justice
c. Non Malficence
d. Beneficence

10. Untuk menjawab masalah dilema

 Etik pada no 9 sebagai masalah etika klinis yang merupakan alat bantu yang lebih
rasional bagi para klinisi dalam melakukan penalaran etis pada kasus tersebut ada 4
topik yang  terkait adalah Indikasi medis, Preferensi, _Quqlity of Life_ , faktor faktor
kontektul. Hal tersebut menurut :
a. Abel
b. McCullough
c. Jacobalis
d. Jonsen

11.  Induction of labour beyond 41 weeks completed gestation :

a.       Increases the rate of instrumental deliveries.
b.      Increases caesarean section rates.
c.       Reduces perinatal mortality rate.
d.      Reduces meconium aspiration syndrome.
e.       Reduces the incidence of neonatal seizures.
 
12.      Amniotomy in labour :
a.       Speeds up progress.
b.      Reduces the need for caesarean section.
c.       Decreases analgesia requirements.
d.      Avoids the need for oxytocin.
e.       Improves neonatal outcome.
 
13.      External cephalic version performed at 37 weeks :
a.       Does not reduce surgical intervention rates.
b.      Does not affect the incidence of breech delivery.
c.       Carries a risk of uterine rupture.
d.      Is successful in over half the attempts.
e.       Should not be attempted in rhesus-negative women.
 
14.      In normal pregnancy :
a.       The oxygen-carrying capacity of the bloodrises by 15-20 %.
b.      The arteriovenous oxygendifference falls.
c.       Cardiac output rises by 30-40 %.
d.      A fall ini haemoglobin concentration reflects anaemias.
e.       Dyspnoea on mild exertion is a commonsymptom in the third trimester.
 
15.      Bacteriuria in pregnancy :
a.       Is associated with lower socioeconomic status.
b.      Affects 15 % of women.
c.       If left untreated, will progress to symptomatic infection in about 75 % of
women.
d.      Should be treated with tetracycline.
e.       Is associated with increased risk of anaemia.
 
16.  Factor associated with increased perinatal mortality include :
a.       Primigravida.
b.      High parity.
c.       Low birthweight .
d.      Increasing maternal age.
e.       Previous perinatal death.
 
17.      Routine antenatal ultrasonography performed at or before 20 weeks :
a.       Will effectively replace maternal serum α fetoprotein in the assessment of
the fetal neural tube.
b.      Will help to identify close to 90 % of serious cardiac-anomalies.
c.       Is unreliable in predicting placental site.
d.      Is a good time to assess chorionicity in twins.
e.       Indicates a 50 % risk of Down’s syndrome if isolated choroid plexus cysts are
detected.
  
18.  Oxytocin :
a.       Is a nonapeptide.
b.      Is synthesized in the posterior lobe of the pituitary gland.
c.       Receptor concentration in the uterus increases inwards the end of pregnancy.
d.      Secretion is stimulated by alcohol.
e.       Has some antidiuretic action.
 
19.      With regard to cytomegalovirus (CMV) infection in pregnancy :
a.       It is an infection by a DNA virus.
b.      The maternal infection is often ‘silent’.
c.       Prognosis is poor forbabies who have clinically apparent disease at birth.
d.      The optimal indicator of intrauterine infection is anti-CMV IgA in fetal blood.
e.       Effective antiviral therapy exists for treatment.
 
           20.      In normal pregnancy the vagina shows :
a.       An increase in the concentration of Gardnerella vaginalis.
b.      An increased concentration of lactobacilli.
c.       A decreased concentration of anaerobes.
d.      A rise in PH.
e.       A more homogeneous flora.
 

21. A 27-year-old, P1A0, and her husband desire to use natural family planning for
contraception. They decide to use the calendar method. Based on her regular
28-day cycle, which of the following represents her fertile period?
a. Days 14 through 21
b. Days 10 through 17
c. Days 7 through 14
d. Days 12 through 19
e. Days 16 through 25

22. Family planning services in Indonesia is important because it has a role in efforts
to reduce maternal mortality. Select the statement that is not true:
a. The maternal mortality rate (MMR) by IDHS in 2012 amounted to 259 /
100,000 births.
b. Number of maternal death related to pregnancy or childbirth in Indonesia
based on the Demographic and Health Survey in 2012 a number of 17,000 up
to 18,000 mothers during one year.
c. Estimates of the number of maternal death related to pregnancy or childbirth
in Indonesia is about 50 deaths per day.
d. Family planning services for mothers immediately after delivery of the placenta
s / d 2 days postpartum included as postpartum family planning services.
e. In planning services we prioritize contraceptive Long Term Contraception
Method (LTM), the IUD, implant or tubal ligation or vasectomy

One mother after a normal delivery, P4, age 35, weight 56 kg, height 160 cm. Having
deliverery one day ago, 3,000 grams birth weight, breastfeeding, want injectable
contraceptives before returning home.
23. If in the cases mentioned above, the mother wanted contraception progestogen-
only contraceptives (POCs), the correct statement below is:
a. Breastfeeding women who are < 6 weeks postpartum should not use
levonorgestrel (LNG) and etonogestrel (ETG) implants.
b. Breastfeeding women who are < 6 weeks postpartum generally should not
use progestogen-only injectables (DMPA).
c. There is no theoretical concern about the potential exposure of the neonate to
DMPA/NET-EN during the first 6 weeks postpartum.
d. Breastfeeding women who are < 48 hours postpartum can generally use LNG-
IUDs.
e. Progestogen-only contraceptives (POCs) consist of POPs, progestogen-only
injectables (DMPA and NET-EN), and LNG and ETG implants.

24. In Indonesia, pregnancy-related morbidity and mortality risks are high, and
access to services is limited. the correct statement below is:
a. DMPA may be one of the few types of methods widely available and
accessible to breastfeeding women immediately postpartum.
b. In Indonesia DMPA injections should not be given one day after the delivery as
early postpartum contraception.
c. Breastfeeding women who are 6 weeks to < 6 months postpartum can use
without restriction the following contraceptive methods: progestogen-only
injectables (DMPA), and LNG and ETG implants.
d. Breastfeeding (and non-breastfeeding) women generally should not have an
LNG-IUD inserted from 48 hours to < 4 weeks postpartum.

25. Available data from clinical and observational trials do not suggest an increased
risk for either breastfeeding performance or infant health outcomes with use of
progestogen-only injectables compared to outcomes in studies using other
progestogen-only methods Which one of the following is the ideal
contraceptive for a patient with heart disease?
A. IUCD
B. Depoprovera
C. Diaphragm
D. Oral contraceptive pills

26. All of the following agents are used for emergency contraception, except?
A. Danazol
B. Levonorgestrel
C. Misoprostrol
D. Mifepristone

27. Emergency contraceptives are effective if administered within following period

after unprotected coitus?
A. 24 hours
B. 48 hours
C. 72 hours
D. 120 hours
28. Sterlization is commonly performed at which site of fallopian tube?
A. Ampulla
B. Infundibulum
C. Isthmus
D. Cornua

29. Contraceptive of choice in lactating female is?

A. Barrier
B. Lactational amenorrhoea
C. OCPs

30. Cu T 380A IUCD should be replaced once in?

A. 4 yrs
B. 6 yrs
C. 8 yrs
D. 10 yrs

31. Oral contraceptive pill of choice in a lactating woman is ?

A. Monophasic pill
B. Biphasic pill
C. Triphasic pill
D. Mini pill

32. What is the recommendation for use of Levonorgestrel for the purpose of
emergency contraception?
A. One tabletof0.75 mg Levonorgestrel to be taken soon after the act of
unprotected coitus butwithin 120 hours
B. One tablet of 0. 75 mg Levonorgestrel to be taken soon after the act of
unprotected coitus but within 72 hours
C. Two tablets of 0.75 mg Levonorgestrel to be taken soon after the act of
unprotected coitus but within 96 hours
D. None of the above

33. Hormonal contraceptives are contraindicated in women ?

A. less than 25 years of age
B. who are normotensive
C. who have thromboembolic disorders
D. who have anaemia

34. Which of the following is a third generation intrauterine device ?

 A. Cu-7
B. TCu-200
C. TCu-380A
D. Progestasert

35. Salah satu ciri dari dokter yang profesional adalah :

a. Lulusan Fakultas Kedokteran Negeri
b. Menguasai ilmu dan bioteknologi yang mutakhir
c. Bertugas sebagai Akademisi
d. Bertug as sebagai klinisi
e. Bertugas sebagai peneliti

36. Dalam memberikan pelayanan kepada pasien dokter ituy harus melakukan
informed consent. Yang disebut Informed Consent itu adalah :
a. Informasi tentang keadaan kesehatan pasien
b. Izin yang diberikan oleh pasien kepada dokter
c. Informasi tentang kesehatan kepada keluarga dan izin yang
diberikan oleh pasien kepada dokter untuk dilakukan tindakan kepada
dirinya.
d. Informasi yang dimengerti oleh pasien dari dokter kepada pasien
tentang keadaan kesehatannya dan izin yang diberikan olehnya kepada
dokter untuk dilakukan tindakan kepada dirinya.
e. Informasi yang diberikan oleh dokter kepada pasien dan si pasien
mengerti tentang informasi tersebut, kemudian, secara sadar si pasien
memberikan izin untuk dilakukan tindakan kepada dirinya.

37. Menurut Beachamp dan Childress, salah satu ciri dari Etika Profesi adalah :
a. Apa yang dilakukannya, hanya untu kebaikan pasien
b. Bersifar sabar
c. Berperilaku jujur
d. Menjaga kerahasiaan pas ien
e. Bersifat sosial

38. Dilihat dari segi Etika Profesi, dalam menghadapi ibu hamil, kewenangan
dokter umum terbatas hanya pada :
a. Kegiatan ANC semua jenis kehamilan
b. Kegiatan ANC dan PNC semua jenis kehamilan
c. Kegiatan ANC, PNC dan PPC kehamilan fisiologis
d. Semua jenis kehamilan, kecuali yang patologis
e. Ibu hamil umur tua, grande multi, tanpa komplikasi

39. Dalam memberikan pelayanan kesehatan kepada masyarakat, seorang

dokter harus bekerja sama dengan :
a. Semua petugas kesehatan lainnya
b. Dengan para Bidan
dan Perawat c. Dengan
teman sejawat
 d. Dengan anggota Dinas Kesehatan
e. Dengan Pemerintah Daerah
40. Seorang PPDS semester I dtugaskan oleh Seniornya untuk
melakukan tinda.kan ekstraksi forsep. PPDS tersebut menolak.
Alasan menolaknya adalah :
a. Takut kena sanksi
b. Karena bukan kewenangannya
c. Karena yang menugaskannya, bukan Konsulen
d. Karena takut melanggar aturan
e. Karena takut hasilnya tidak memuaskan

41. Seorang dokter umum, bekerja di Puskesmas PONED.Suatu hari

dia mendapat kiriman ibu hamil45 tahun, G5P4AO dengan
Preeklampsi Berat dan anak hidup tetapi dengan IUGR. Agar ibu
dan anak selamat, maka pasien tersebut harus dirujuk ke :

a. RSUD terdekat
b. RSUD Ponek
c. RSUD yang ada fasilitas untuk melakukan Seksio Sesaria
d. RSUD yang mempunyai dua spesialis, yaitu SpOG dan Sp Anastesi
e. RSUD yang mempunyai tiga spesialis, yaitu SpOG, Sp Anastesi dan Sp A.

42. Seorang dokter melanggar Etika Profesi, maka dia akan

mendapat sanksi. Bentuk sanksinya bisa berupa:
a. Hokum Pidana
b. Diadukan kepada Ikatan Dokter Indonesia
c. Diadukan kepada MKEK, kemudian dicabut izin prakteknya
d. Diadukan ke MKEK, kemudian diberi teguran, baik Lisan maupun
Verbal
e. Tidak diberi sanksi apa-apa

43. Seorang dokter, dalam menjalankan tugasnya, harus

mempunyai jiwa kepemimpinan. Yang disebut jiwa kepemimpinan
itu adalah :
a. Kalau perlu, bisa bertindak otoriter
b. Mampu bertindak sebagai Manajer yang baik.
c. Mempunyai segala kewenangan
d. Kalau perlu, bekerja sama dengan pihak lain
e. Pernah mengikuti pendidikan kepemimpinan

44. Seorang dokter umum, di tempat praktek pribadinya, suatu

waktu kedatangan ibu hamil dengan komplikasi. Untuk
menyelamatkan pasien tersebut, dia harus minta konsul kepada:
a. Ternan sejawatnya
b. Rumah Sakit Umum Darah c. SpOG terdekat
d. SpOG yang terkenal di daerahnya
e. SpOG yang sesuai dengan yang dikehendaki oleh pasien
tersebut.

45. What phase of parturition corresponds with the clinical stages of labor ?
a. phase 0
b. phase 1
c. phase 2
 d. phase 4

46. The uterine quiescence :

a. some myometrial contraction cause cervical dilatation
b. During this phase the cervix must remain firm and unyielding
c. Prepare the uterus for labor, contraction of this type are more
common in nulliparuos women
d. The contractions are characteristized by increasing intensity

47. The cervical modifications during phase I of parturition :

a. the second change relates to the state of the bundle of collagen fibers
b. there are not changes in the relative amounts of the various
glycoaminogycans
c. the first change relates to the striking increase in the amount of
hyaluronic acid in the cervix
d. cervical softness is associated with increasing production of cytokines
that causes infiltration of leukocytes wich also degrade collagen

48. What is the most plausible hypothesis for the cause of labor pain ?
a. myometrial hypoxia
b. cervical stretching
c. peritoneum stretching
d. compression of nerve ganglia in the cervix

49. There are three principal structural components of the cervix :

a. Collagen, smooth muscle, extracellular matrix
b. Collagen, connective tissue, extracellular matrix
c. Collagen, dermatan sulfat, glycosaminoglycans
d. Collagen, striated muscle, extracellular matrix

50. Compared with the body of the uterus, the lower uterine segment and the
cervix :
a. region of lesser resistance
b. Both of them are same resistance
c. Region of stronger resistance
d. There is not relationship between the body and the lower segment of
uterus

51. After the cervix is dilated fully, the expulsion of the fetus produced by :
a. Uterine contraction
b. Presenting part of the fetus
c. Maternal intra-abdominal pressure
d. Sotfteness of the cervix

52. Regulation of myometrial contraction and relaxation :

 a. Devided temporally into acute and chronic mechanism
b. The mechanism occur simultaneously
c. The contraction doesnot involve the Ca2+
d. Interaction of actin and myosin is the chronic action

53. Phase 0 of human parturition are likely result of :

a. Action of estrogen and progesterone via intracellular receptor
b. Myometrial cell plasma membrane receptor-mediated increases in
cGMP
c. The generation of cAMP
d. Classical progesterone withdrawal

54. In Phase 1 (activation) the factor thought to regulate the phases of the
parturition is :
a. Prostacyclin
b. Progesterone
c. Estrogen
d. Nitric oxide

55. The cardinal movements of labor and delivery involve a sequence of events
that occurs in an orderly fashion. Which of the following sequences is correct
?
a. Descent, internal rotation, flexion
b. Engagement, flexion, descent
c. Engagement, internal rotation, descent
d. Engagement, descent, flexion

56. Engagement is said to have occurred when which of the following events
takes place ?
a. The infant’s head is within the pelvis
b. The biparietal diameter of the infant’s head is through the plane of
the inlet
c. The presenting part is just above the level of the ischial spines
d. The vertex is in the transverse position

57. The denominator (indication) :

a. Is the occiput in a flexed cephalic presentation
b. Is the fetal part most closely related to the symphysis pubis
c. Of a face presentation is the submento-bregmatic diameter
d. Of a breech presentation is the sacrum

58. The fetal head :

a. Engages by the mento-vertical diameter in face presentation
b. Has a suboccipito-bregmatic diameter of 10.5 cm
c. Contains as anterior fontanelle immediately behind the bregma
d. Has one occipital and two frontal bones
 59. Symptoms and signs of the onset of labour include :
a. Braxton Hicks contractions
b. Absent fetal movement
c. Shortening of the cervix
d. Dilatation of the cervix

60. Uterine contractions in labour :

a. Start at the cornu
b. Involve uterine muscle retraction
c. Are painful due to ischaemia
d. Are efficient at 5 mmHg

61. Active management of the third stage :

a. Involves the Matthews Duncan method
b. May involve intravenous syntocinon
c. Increases the chance of post-partum haemorrhag
d. Begins with delivery of the fetal trunk

62. The Fallopian tube from ovarii to the uterine divide into :
a. Portion of infundibulum, isthmus, interstitial, ampulla
b. Portion of ampulla, infundibulum, interstitial, isthmus
c. Portion of infundibulum, ampulla, isthmus, interstitial
d. Portion of isthmus, interstitial, infundibulum, ampulla

63. When should the fetal heart rate be auscultated observation during labor ?
a. Before the contraction
b. During the contraction
c. Immediately after contraction
d. Anytime

64. Which one of the following changes is considered abnormal during

pregnancy :
a. Hyperplasia and hypertrophy of myometrial fibre
b. The uterus protrudes out of the minor pelvis after 12 weeks of
pregnancy
c. Trophoblastic invasion of spiral arteries
d. The resting pulse rate increases about 50 bpm

65. In Early pregnancy , amniotic fluid is composed of which of the following?

a. Fetal uterine
b. Fetal pulmonary fluid
c. Ultrafiltrate of maternal plasma
d. Extracellular fluid that diffuses through fetal skin

66.At 10 weeks gestation based on the last menstrual period, all EXCEPT which of the
following are true?
 a. Arms bend at the elbows
b. Crown-rump length is 7 cm
c. The upper lip is complete
d. Heart is completely formed

67.During which week of development is the primitive heart partitioned?

a. 4th week
b. 6th week
c. 8th week
d. 10th week

68.Which of the statements regarding fetal swallowing is true?

a. A. Swallowing begins at 20 weeks gestation
b. Term fetuses swallow between 200 and 760 ml per day
c. If swallowing is inhibited in late pregnancy oligohydramnions will occur
d. Swallowing greatly affects amniotic fluid volume, particularly in early
pregnancy.

69. Uterus is at the level of umbilicus at:

A. 10 weeks
B. 12 weeks
C. 16 weeks
D. 20 weeks
E. 24 weeks
70. The internal iliac artery:
A. Divides into anterior and posterior divisions at the upper border of the
lesser sciatic foramen.
B. The median sacral artery arises from the posterior division.
C. At the level of the sacroiliac joint it is crossed anteriorly by the
ureter.
D. The superior gluteal artery arises from the anterior division.
E. The superior and inferior vesical arteries arise from the umbilical
artery.
71. These methods suppress lactation
A. Oestrogen
B. Restricted fluid intake
C. Intermittent, reducing frequencies of expressing milk
D. Adequate breast support
E. Bromocriptine
72. Compared with a midline episiotomy , an advantage of mediolateral episiotomy :
A. ease of repair
F. fewer break downs
G. lower blood loss
H. less dyspareunia
I. less extension of the incision
73. Perinatal mortality refers to:
A. Number of stillbirths per 1,000 total births.
B. Number of stillbirths & neonatal deaths per 1,000 total births.
C. Number of stillbirths & neonatal deaths per 1,000 live births.
 D. Number of neonatal deaths per 1,000 total births.
E. Number of stillbirths & neonatal deaths per 100,000 total births.
74. The luteal phase of the menstrual cycle is associated with:
A. High luteinizing hormone level
B. High progesterone levels
C. High prolactin level
D. Low basal body temperature
E. Proliferative changes in the endometrium
75. The order of cardinal movements in labor:
A. Engagement, internal rotation, flexion
B. Engagement, descend, flexion, internal rotation
C. Descend, engagement, flexion
D. Internal rotation, flexion, decent, engagement.
E. Engagement, flexion, internal rotation.