1

SOAL MCQ
UJIAN AKHIR SEMESTER FISIOLOGI
RESIDEN PPDS-I DEPARTEMEN/SMF OBSTETRI & GINEKOLOGI FKUP/RSHS
BANDUNG, 9 JANUARI 2017
WAKTU 100 MENIT

No. 1 s.d 15
seorang pasien menderita ca serviks stadium 4 datang ke rumah sakit dalam keadaan
lemah dan kesadaran menurun, dokter igd hanya melakukan tindakan memberikan
infus saja tanpa melakukan konsultasi ke dokter spesialis. Karena tidak ada tindakan
apapun akhirna keluarga memutuskan untuk membawa pulang pasien.
1. Tindakan dokter IGD termasuk ke dalam euthanasia yaitu :
a. Pasif
b. Aktif
c. Voluntir
d. Involuntir
e. Pseudo

2.  Dokter telah mengabaikan prinsip etik yaitu :

a. Beneficence
b. Non malficnce
c. Justice
d. Autonomi
e. Maleficence

3.  Keluarga pasien meminta pasien untuk dibawa pulang ke rumah, tindakan ini
termasuk euthanasia jenis :
a. Pasif
b. Aktif
c. Voluntir
d. Involuntir
e. Pseudo

4. Dokter dapat dimasukkan/dijerat dalam KUHPpasal berapa :

a. Pasal 544
b. Pasal 344
c. Pasal 345
d. Pasal 340
e. Pasal 338

5.  Jika keluarga pasien menginginkan dilakukan euthanasia aktif maka mereka harus
mengajukan permintaannya ke :
a. Komisi etikrum sakit
b. IDI
c. Polisi
d. Pegadilan
e. MUI
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6 Etika menurut para ahli filsafat adalah:
A. Tentang motivasi
B. Ilmu atau kajian formal tentang moralitas
C. Masalah prilaku
D. Perbuatan baik buruknya manusia
E. Bagian dari agama
 
7. Yang berpendapat bahwa etika dan moral sebenarnya sama saja adalah:
A. Para ahli filsafat
B. Para sosiolog
C. Frans Magis Suseno
D. Hippocrates
E. Peter Senge
 
8. Moral menurut para ahli adalah:
A. Adat, kebiasaan dan prilaku lingkungan budaya tertetu
B. Bagaimana seorang isani harus hidup dan bertindak
C. Kewajiban dan tanggung jawab yang memenuhi harapan profesi
D. Bertindak dengan cara-cara profesi
E. Prilaku manusia yang diaggap baik dan buruk
 

9. Pelopor Kedokteran Kuno adalah

A. Galileo
B. Pluto
C. Ibnu sina
D. Imhotep
E. Alexander
 
10.  Prinsip bahwa seorag dokter harus bekerja yang bermanfaat bagi pasienya
disebut
A. Autonomy
B. Beneficience
C. Justice
D. Non malficience
E. Equity
 
11. Dalam melakukan pekerjaannya seorang dokter tidak boleh dipengaruhi oleh
sesuatu yang mengakibatkan hilangnya kebebasan dan kemandirian profesi. Ini
berarti
A. Tidak boleh berpartai
B. Tidak boleh memimpin organisasi masa (ORMAS)
C. Tidak boleh dipengaruhi dalam mengambil keputusa medik
D. Tidak boleh menolak pasien
E. Tidak boleh meonolong orang jahat
 
 3
12 Seorang dokter senantiasa berupaya melaksanakan profesinya degan standar
profesi tertinggi. Ini berarti
A. Berkaitan dengan kuantitas
B. Berkaitan dengan kepastian
C. Berkaitan dengan efisiesi
D. Berkaitan dengan Kualitas
E. Berkaitan dengan efektivitas
 
13.  Prinsip seorang dokter harus bekerja tidak mengerjakan tindakan yang
merugikan pasiennya disebut
A. Beneficience
B. Autonomy
C. Justice
D. Non malficience
E. Equity
 
14. Dalam melakukan tindakan seorang pasien, seorang dokter harus menghargai
dan mengabulkan keputusan yang diambil pasien. Hal ini disebut
A. Beneficience
B. Justice
C. Non malficience
D. Equity
E. Autonomy
 
15. Seorang dokter harus bersikap jujur dalam berhubungan dengan paseien dan
sejawatnya. Ini berarti
A. Mengingatkan sejawat agar tidak menerima jasa dari pasien
B. Mengingatkan sejawat agar tidak memberi informasi kepada pasien
C. Mengingatkan sejawat agar selalu bekerja untuk kepentingan kuratif
D. Mengingatkan sejawat agar selalu bekerja mandiri, tidak perlu bekerja sama
dengan pejabat dibidang kesehatan
E. Mengingatkan sejawat yang dia ketahui memiliki kekuragan dalam karakter
atau kompetensi
 
N0. 16 - 20
Seorang ibu hamil 9 bulan dengan keluhan mules da terdapat cairan berwarna
bening banyak keluar, datang ke rumah sakit tanpa didampingi oleh suaminya,
dokter kandungan tidak mau melakukan tindakan sebelum ada persetujuan dari
suaminya walaupun si ibu meyakinkan bahwa dirinya juga dapat
memberikan/menandatangani informed consent.

16. Berdasarkan scenario diatas, maka tindakan dokter 

A. Melanggar hukum
B. Tidak melanggar hukum
C. Perbuata melawan hukum
D. Melanggar HAM
E. Tidak melanggar HAM
 
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17. Pasal berapa dari UUD yang menjamin atas pelayanan kesehatan yang berhak
diterima si ibu
A. Pasal 28H ayat 1
B. Pasal 27 ayat 1
C. Pasal 34 ayat 1
D. Pasal 33
E. Pasal 29 ayat 2
 
18. Salah satu prinsip/ asas hukum kesehata yang diyakini si ibu adalah
A. Mendapatkan pertologan dokter
B. Mendapatkan pelayanan kesehatan
C. Menentukan nasib sendiri
D. Menentukan kapan melahirkan
E. Mengadakan perjanjian
 
19. Prinsip etika yang dilanggar oleh dokter pada skenario di atas adalah:
a. Beneficenci
b. Nonmaleficence
c. Justice
d. Autonomy
e. Maleficence 
20 Sifat darsar dari etika yang menyebabkan perbedaan pandangan adalah
a. International
b. Lintas batas
c. Pluralis
d. Nasional
e. Interdisiplin

21. Regarding fetal head, Choose the CORRECT answer:

a. Can be delivered vaginally in persistent occipito-mental Presentation.
b. Considered to be engaged when the Biparietal diameter passes the level of
the pelvic inlet.
c. Will show Spalding's sign within 12 hours of Intrauterine death.
d. Can be delivered vaginally in persistent brow presentation.
e. Is likely to be a vertex presentation when the head is deflexed.

22. The levator ani muscle :

a. Is a voluntary muscle
b. Is attached laterally to the ”white line of the pelvis ”
c. Is composed of pubococcygeus and iliococcygeus muscle
d. Contracts to prevent spillage of urine during strain
e. All of the above

23. The normal lining of the fallopian tube is:

a. Squamous epithelium.
b. Transitional epithelium.
c. Columnar epithelium with cilia.
d. Cuboidal epithelium.
e. Fibrous connective tissue.
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24. The Wolfian duct in the female :
a. Regresses and becomes vestigial
b. Develops into the fallopian tube
c. Forms the ovary
d. Forms the round ligament
e. None of the above
25. The definitive epithelium of vagina is derived from :
a. Urogenital epithelium
b. Wolfian duct
c. Mullerian duct
d. Coelomic epithelium
e. Parameshonephric duct
26. Uterine Cervix:
a. Is the portion of the uterus below the isthmus
b. External OS cell lining is columnar epithelium
c. Laterally is attached to the round ligament
d. The cervical canal is covered with stratified squamous epithelium
e. Can be dilated with dilators without the need of anesthesia
27. Organogenesis is complete at
a. 2 weeks after ovulation
b. 6 weeks after ovulation
c. 8 weeks after ovulation
d. 18 weeks after ovulation
e. 20 weeks after ovulation
28. The main support of the uterus is provided by
a. The round ligament
b. The infandilo-pelvic ligament
c. The integrity of the pelvis
d. The broad ligament
e. The cardinal ligament
29. The function of round ligament is :
a. Vestigial with no apparent function
b. To prevent uterine prolapse
c. To provide nerve supply of the upper vagina
d. To prevent retrodisplacement of the uterus
e. None of the above
30. The most important muscle in the pelvic flooris:
a. Bulbo cavernousus.
b. Ischio-cavernosus.
c. Superficial transverse perineal muscle.
d. Deep transverse perineal muscle.
e. Levator ani.
31. The pelvis includes which of the following bones:
a. Trochanter, hip socket, ischium, sacrum & pubis.
b. Ilium, ischium & pubis.
c. Sacrum, Ischium, ilium & pubis.
d. Ilium, ischium, pubis, sacrum & coccyx.
e. Trochanter, sacrum, coccyx, ilium & pubis.
 6
32. Causes of post partum amenorrhoea may be :
a. Anorexia nervosa
b. Cervical atresia
c. Chlorpromazaine therapy
d. None of the above
e. Any of the above
33. The ovarian artery is a branch of:
a. Common iliac artery.
b. Internal iliac artery.
c. Hypogastric artery.
d. Sacral artery.
e. Aorta.
34. Molding of the fetal head:
a. Usually cause brain damage.
b. Becomes progressively easier as gestational age increase.
c. Increase the difficulty of delivery.
d. Does not happen when maternal pelvisis adequate.
e. Does NOT have time to occur in breech delivery.
35. The main blood supply of the vulva is:
a. Pudendal artery.
b. Inferior hemorrhoidal artery.
c. Ilioinguinal artery.
d. Femoral artery.
e. InferiorHypogastricartery.
36. The following are typical in the female bony pelvis EXCEPT:
a. Has a transverse diameter of the inlet greater than the antero-posterior
diameter.
b. Has an obstetric conjugate of 11-12 cm.
c. Has an obtuse greater sciatic notch.
d. Has a pubic angle greater than 90 degrees.
e. Is funnel shaped.
37. The greatest diameter of the feta lhead is:
a. Occipitofrontal.
b. Suboccipit bregmatic.
c. Occipitomental.
d. Bitemporal.
e. Biparietal.
38. The joint between the two pubic bones is called the:
a. Sacroiliac joint.
b. Sacrococcygeal joint.
c. Piriformis.
d. Pubis symphysis.
e. Inter vertebral joint
39. The cilia of the fallopian tube has the following function:
a. Transport the ovum towards the uterus.
b. Remove the zona pellucida which surrounds the ovum.
c. Enhance the rapid division of the zygote.
d. Transport the ovum towards the peritoneal cavity.
e. Has a bactericidal function to prevent peritoneal function
 7
40. Which of the following terms best describes the pelvic type of small posterior
saggital diameter, convergent sidewalls, prominent ischial spines, and narrow
pubic arch?

a. Gynecoid.

b. Anthropoid.

c. Platypelloid.

d. Android.

e. Mixed.

41. A pelvic inlet is felt to be contracted if :

a. The anterio-posterior diameter is only 12 cm.

b. Platypelloid pelvis.

c. The mother is short.

d. The transverse diameter is only 10 cm .

e. The patient had a previous C-section.

42. During clinical pelvimerty, which of the following is routinely measured:

a. Shape of the pubic arch.

b. Bi-ischealdiameter.

c. Transverse diameter of the inlet.

d. Flare of the iliac crest.

e. Elasticity of the levator muscles.

43. At term, the ligaments of the pelvis change. This can result in:

a. Enlargement of the pelvic cavity.

b. Increasing rigidity of the pelvis.

c. Degeneration of pelvic ground substance.

d. Decreasing width of the symphysis.

e. Posterior rotation of the levator muscles.

44. 35 years o;d women who is now in her 5th pregnancy with 4 alive childrean
presented in the antenatal clinic and in diagnosed as a case of anaemia. Cause of
anaemia in her case is:
 8
a. Folac deficiency
b. Sickle cell anaemia
c. Iron deficiency
d. Pernicious anaemia
e. Thalassaemia
45. Cardiac ouput is highest in:
a. 1st trimester
b. 2nd trimester
c. 3rd trimester
d. During labour
e. During delivery
46. Vaginal examination is contraindicated in pregnancy in wich situation:
a. Cercinoma of cervix
b. Gonorrhoea
c. Prolapsed cord
d. Placenta previa
e. Active labour

47. A 24-year-old primigravid woman, who is intent on breast-feeding, decides

on a home delivery. Immediately after the birth of a 4.1 kg (9-lb) infant, the
patient bleed massively from extensive vaginal and cervical lacerations. She is
brought to the nearest hospital in shock. Over 2 hours, 9 units of blood are
transfused, and the patients blood preassure returns to a resonable level. A
hemoglobin value the next day is 7.5 g/dL, and 3 units of packed red blood cells
are given The most likely late sequelae to consider to the woman is which of the
following?
a. Hemochromatosis
b. Stein-Leventahl syndrome
c. Sheehan syndrome
d. Simmonds syndrome
e. Cushing syndrome.
48. A 27-year-old G4P3A0 at 37 weeks of presents to the hospital with heavy
vaginal bleeding and painful uterine contractions. Quick bedside ultrasound
reveals a fundal placenta. The patient’s vital signs are blood pressure 140/92
mmHg, pulse 118 beats per minute, respiratory rate 20 breaths per minute and
themperature 37⁰C. The fetal heart rate tracing reveals tachycardia with
decreased variability and a few late decelerations. An emergency cesarean
section delivers a male infant with APGAR 4 and 9. With delivery of
placenta, a large retroplacental clot is noted. The patients becomes
hypotensive, and bleeding is notedd from the wound edges and her IV catheter
sites. She requires 12 units of packed red blood cells and fresh frozen plasma
for resuscitation. After a short stay in the intensive care unit the patient
recovers. When can long-term complications related to sequela of postpartum
heorhage first be noted?
a. 6 hours postpartum
b. 1 week postpartum
c. 1 month postpartum
 9
d. 6 month postpartum
e. 1 year postpartum
49. A 38-years old P3A0 begins to breast-fed her 5-days old infant. The
baby latches on appropriately and begins to suckle. In the mother, which
of the following is a response to suckling?
a. decrease of oxytocin
b. increase of prolactin inhibiting factor
c. increase of hypothalamic dopamine
d. increase of hypothalamic prolactin
e. increase of luteinizing hormone-releasing factor.
50. A 22-year-old G1P0A0 has just undergone a spontaneous vaginal
delivery. As the placenta is being delivered, a red fleshy mass is noted to the
protruding out from behind the placenta. Which of the following is the best
next step in management of this patient?
a. Begin intravenous oxytocin infusion
b. call for immediate assistance from other mecical personnel
c. Continue to remove the placenta manually
d. Have the anesthesiologist administer magnesium sulfate
e. Shove the placenta bac into the uterus

51. A 40-year-old G4P3A0 at 39 weeks gestation has progressed rapidly in labor

with a reasurring fetal heart rate pattern. She has had an ncoplicated
pregnancy with normal prenatal labs, including an amniocentesis for
advanced maternal age. The patient begins the second stage of labor and
after 15 minutes of pushing starts to demonstrate deep variablee heart rate
accelerations. You suspect that she may have a fetus with a nuchal cord. You
expedientlly deliver the baby by low-outlet forceps and hand the baby over
to the neonatologist called to attend the delivery. As soon as the baby is
handed off to the pediatric teat, it lets out a strong spontaneous cry. The
infant is pink with slightly blue extremites that are actively moving and
kicking. The heart rate is noted to be 110 on auscultation. What Apgar score
should the pediatricians assign to this baby at 1 minnutee of life?
a. 10
b. 9
c. 8
d. 7
e. 6

52. You are making rounds on a 29-year-old P1A0 who underwent an

uncomplicated vaginal delivery at term on the previous day. The patient is
still very confused about whether she wants to breast feed. She is a very
busy awyer and is planning on going back to work in 4 weeks, and she does
not think that she has the time and dedication that breast feeding requires.
She asks you what you thin is best for her to do/ Which of the following is an
accurate statement regarding breast-feeding?
a. Breast-feeding decreases the time to return of normal menstrual cycle.
b. Breast-feeding is associated with a decreased incidence of sudden infant
death syndrome
c. Breast-feeding is a poor source of nutrients for required infant growth
 10
d. Breast-feeding is associated with an increased incidence of childhood
obesity
e. Breast-feeding is associated with a decrased incidence of childhood
attention deficit disorders.

53. A 22-years old P1A0 who is postpartum day 2 and is botttle-feeding

complains that her breasts are very engorged and tender. She wants you to
give her something to ake the engorgement go away. Which of the following
is recommended to relieve her symptoms?
a. Breast binder
b. Bromocriptine
c. Estrogen-containing contraceptive pills
d. Pump her breast
e. Use oral antibiotics.

54. A 36-year-old P1A0 comes to see you for a routine postpartum examinations
6 weeks after an uncomplicated vaginal delivery She is currently nursing her
baby without any major problems and wants to continue to do so for at least
9 months. She is ready to resume sexual activity and wants to know what her
options are for birth control. She does not have any medical problems. She
is a nonsmoker and is not taking any medicationss except for her prenatal
vitamins. Which of the following methods may decrease her milk supply?
a. Intrauterine device
b. Progestin-only pil
c. Depo-provera
d. Combination oral contraceptive
e. Foam and condoms.

55. A 21-year-old P2A0 calls her physician 7 days postpartum because she is
concerned that she is still bleeding from the vagina. She describes the
bleeding is light pink to bright red and less heavy than the first few days
postdelivery. She denies fever or any cramping pain. On examination she is
afebrile and has an appropriately sized, nontender uterus. The vagina
contains about 10 cc of old, dark blood. The cervix is closed. Which of the
following is the most appropriate treatment?
a. antibiotics for endometritis
b. high-dose oral-estrogen for placental subinvolultion
c. Oxytocin for uterine atony
d. suction dilation and curettage for retained placenta
e. reassurance

56. A 28-year-old P2A0 presents to the hospital 2 weeks after vaginal delivery
with the complaint of heavy vaginal bleeding that soaks a sanitary napkins
every hour. Her pulse is 89 beats per minute, blood pressure 120/76 mm Hg
and temperature 37,1⁰C. Her abdomen is non tender and her fundus is
located above the symphysis pubis. On pelvic examination, her vagina
contained small blood clots and no active bleeding is noted from the cervix.
Her uterus is aboutr 12 to 14 weeks size and non tender. Her cervix is closed.
An ultrasound reveals an 8-mm endometrial stripe. Her hemoglobin is 10.9,
unchanged from the one at her vaginal delivery Beta hcG is negative. Which
of the following potential treatments would be contrandicated?
 11
a. Methylergometine maleat
b. Oxytocin injection
c. Ergonovine maleate
d. Prostaglandin
e. Dilatation and curettage.

57. A 20-year-old G1P0A0 at 41 weeks has been pushing for 2 ½ hours. The fetal
head is at the introitus and beginning to crown. It is necessary to cut an
episiotomy. The tear extends through the sphincter of the rectum, but the
rectal mucosa is intact. How shold you classify this type of episiotomy?
a. First-degree
b. Second-degree
c. Third-degree
d. Fourth-degree
e. Mediolateral episiotomy.

58. A primipara is in labor and an episiotomy is about to be cut. Compared with

a midline episiotomy which of the following is an advantage of mediolateral
episiotomy?
a. Ease of repair
b. Fewer breakdown
c. Less blood loss
d. less dyspareunia
e. Less extension of the incision.

59. All of the following agents are used for emergency contraception, except :
a. Danazol
b. Levonogestrelp
c. Misoprostol
d. Mifepristone

60. Emergency contraceptives are effective if administered within following period

after unprotected coitus?
a. 24 hours
b. 48 hours
c. 72 hours
d. 1 week

61. Which one of the following is the ideal contraceptive for a patient with heart
disease?
a IUD
b Depoprovera
c Diaphragm
d Oral contraceptive pills

62. Contraceptive of choice of lactating women is :

a IUCD
b Barrier
c Lactational amenorrhoea
d Depo Provera
 12

63. CuT-380 IUCD should be replaced once in ?

a. 4 years
b. 5 years
c. 8 years
d. 10 years

Seorang ibu datang kepada SpOG dengan keluhan sebagai berikut : Sudah
menikah selama lima tahun tetapi belum mempunyai anak. Si Ibu berharap bahwa
SpOG tersebut bisa melayaninya secara profesional agar keinginanya terkabul.

Apa yang disebut profesional itu?

64. Dokter profesional adalah mereka yang telah :
a. Mengikuti pendidikan yang intensif dan bekerja diranah publik.
b. Menguasai ilmu dan bioteknologi yang mutakhir dan ketrampilan
yang sesuai dengan yang sesusai dengan standar prosedur.
c. Mempunyai niat dan, sikap dan perilaku yang etis.
d. Menguasai ilmu dan bioteknologi yang mutakhir, ketrampilan yang
sesuai dengan
standar prosedur serta niat, sikap dan perilaku yang etis.
e. Mempunyai organisasi profesi dengan AD/ART yang mantap.

Seorang PPDS, disuruh oleh Konsulenya untuk memeriksa Ibu Hamil. Konsulen
tersebut mewanti-wanti agar si PPDS tersebut bersikap Etis. Apa yang dimaksud
dengan dokter yang Etis itu?
65. Salah satu ciri-2 dokter yang bersifat etis adalah mereka yang:
a. Ramah dan jujur.
b. Bisa dan mau menjaga rahasia pasien.
c. Bisa melakukan Informed Consent dengan benar.
d. Bersikap penuh empati.
e. Tidak melakukan sesuatu yang merugiRan pasien.

66. Definisi Etika Profesi menurut Beauchamp & Childress adalah sebagai
berikut:
a. Beneficence
b. Non Malficence
c. Autonomy
d. Justice

Apa yang disebut dengan Autonomy itu ?

67. Autonomy adalah Hak pasien untuk mendapat :
a. Informasi dan pelayanan yang baik dan diikutsertakan dalam
pengambilan keputusan klinik.
b. Informasi yang benar tentang penyakitnya
c. Pelayanan kesehatan yang baik
d. Mendapat pembebasan dari biaya pelayanan
e. Informasi dan pelayanan kesehatan yang baik dan diikutsertakan dalam
pengambilan keputusan klinik dalam kedudukan yang setara.
 13

Mrs Dora 30 years old G3P2A0 , came to emergency room with chief complain :
labor pain. The doctor in charge has examined and made the partograf like above.
Questions :
68. What is the phase of labor in this case ?
A. Pasive labor
B. Active labor
C. Prolonged latent phase
D. Not in labor
E. Prolonged labor

69. How is the uterine contraction during labor ?

A. Appropriate
B. Hyperstimulation
C. Inappropiate
D. Normal in the latent phase
E. Normal in the active phase

70. Descend of the presenting part at admission :

A. Head has been engaged
B. The large of the head has descent to pelvic inlet
C. There is a CPD ( Cephalo Pelvic Disproportion)
D. It is the normal condition
E. There is malposition of the head
71. Uterine Contraction at admission :
A. 3 times in 10 minutes , < 20 mmH20
B. 3 times in 10 minutes, 20-40 mmH2O
C. 3 times in 10 minutes , > 40 mmH2O
D. 4 times in 10 minutes , 20 -40 mmH2O
E. 4 times in 10 minutes, > 40 mmH2O

72. The progression of labor

A. Normal
B. Secondary inertia uterine contraction
C. Primary inertia uterine contraction
D. We have to give augmentation
E. Augmented the contraction by given amniotomi and oxytocin infusion
 14

73. What are the cardinal movements of labor (in order) ?

A. Descent, engagement, flexion, internal rotation, extention, external
rotation, expulsion.
B. Descent, flexion, engagement, internal rotation, extension, external
rotation, expulsion.
C. Engagement, descent, flexion, internal rotation, extension, external
rotation, expulsion
D. Engagement, flexion, descent, internal rotation, extension, external
rotation, expulsion.
E. Flexion, Engagement, descent, internal rotation, extension, external
rotation, expulsion

74. Which of the following is true regarding use of episiotomy ?

A. Decrease the risk of anal sphincter laceration
B. Increase the risk of anal sphincter laceration
C. Decrease the risk of urethral lacerations
D. Increase the risk of urethral lacerations
E. Decrease the risk of vaginal laceration

75. 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
E. After the uterine relaxation

76. Intrauterine contraceptive device :

A. Controls the menorrhagia
B. Contraindicated in Fluor albus
C. Replaced every 5 years
D. Can cause an ectopic pregnancy
E. Insertion at 7 – 10 days after delivery

77. Which is the narrow diameter of the pelvic inlet through the fetal head must
pass ?
A. True conjugate
B. Diagonal conjugate
C. Transverse diameter
D. Obstetrical conjugate
E. Anteroposterior diameter

78. Engagement occurs when the biparietal diameter of the fetal head descends until
Station 0 or as level as ?
A. Ischial spine
B. Ramus inferior symphysis Pubis
C. Ala sacrum
D. ischial tuberosities
E. Sacro spinososus
 15

79. The following statement about combined oral contraceptive pill is false :
A. Consists of 21 days of ethinyloestradiol and progestogen and a 7 day pill
free period
B. Treratment for both menorrhagia and dysmenorrhoea
C. Lowers risk of ovarian and endometrial cancer
D. Lowers risk of developing functional ovarian cyst
E. Lowers absolute risk of myocardial infarction

80. In the menstrual cycle :

A. Ovulation follows the luteinizing hormone surge by 48 hours
B. Progesterone stimulates endometrial cell proliferation in the proliferative
phase
C. Oestrogen in the secretory phase , produce vocuolation of the cell with
the nuclei displaced toward the gland lumen
D. Early production of trophoblastic HCG maintain the corpus luteum and
prevent the withdrawal bleed
E. The bleed is caused by failure of implantation and cessation of oestrogen
production

81. Primordial germ cells first appear at an early stage of development amon
endoderm cells in the wall of the yolk sac and migrate by amoeboid movement
to the gonads They will differentiate into specific cells. Which one of the
following cells follows the path stated above?
A. Follicle cell
B. Leydig cell
C. Oogonia
D. Epithelial cell
E. Sertoli cell

82. In a normal, healthy 25-year-old woman:

A. The plasma LH is at its lowest concentration during the 2 days before
ovulation
B. The plasma FSH is at its lowest concentration during the 2 days before
ovulation
C. The plasma estrogen is at its lowest concentration during the 2 days before
ovulation
D. Ovulation is followed by a decline in plasma estradiol
E. Ovulation is followed by a decline in plasma progesterone

83. In a normal, healthy young woman with a menstrual cycle of 28 days:

A. The proliferative phase of the uterus is caused by estrogen produced by
the Graafian follicle
B. Menstruation is caused by progesterone from the corpus luteum
C. Oral estrogen and / or progesterone will cause an enlargement of the
ovary and an increase in production of mature Graafian follicle
D. The concentration of estradiol in the plasma begin to fall at ovulation
and continues to decrease until menstruation
 16
E. The concentration of progesterone in the plasma begins to fall at
ovulation and continues to decrease until menstruation

84.During most of pregnancy, the maintenance of human gestation is dependent

upon the
secretions of
A. Corpus luteum of the ovary
B. Anterior pituitary
C. Corpus luteum and anterior pituitary
D. Placenta
E. Adrenal cortex

85. The only one of the following hormones that is produced by other than the
placenta is:
A. Human chorionic gonadotropin
B. Oxytocin
C. Human chorionic somatomammotropin
D. Estrogen
E. Progesterone

86. Which of the following is the best explanation for the mechanism of the action of
intra uterine device?
A. Stimulation of Fallopian tubes peristaltic movement
B. A chronic bacterial endometritis interferes with implantation
C. Excess Endometrial sloughing causes abortion
D. A sterile inflammatory response result in implantation failure
E. Antibody development
87. The overall effect of combined oral pill containing synthetic estrogen and
progestins
is :
A. Direct inhibition of oocyte maturation
B. Inhibition of ovulation
C. Production of uterine secretion that are toxic to developing embryo
D. Impairment of implantation due to hyperplastic changes of endometrium
E. Impairment of sperm transport due to tubal obstruction

88. Which one of the following statements about fluid resuscitation in obstetrical
hemorrhage ?
A. The volume of fluid given should exceed the blood loss, about 4 - 5 times as
much.
B. Urine production level does not reflect improvement of blood distribution.
C. Packed red cell is more effective than whole blood.
D. Crystalloid is a preferred intravenous replacement solution than glucose
solution.
E. Colloid solution can be used to prevent over expansion of intravascular
volume

89. The Trendelenburg position helped the case in one of the following mechanism:
 17
A. Prevention of fluid redistribution from intravascular to interstitial
space
B. Assuring optimal venous return
C. Prevention of blood overflow to the head
D. Reduction of blood flow to the uterus
E. Prevention of increasing heart rate

. The curve below is showing the changes in endometrial thickness during a normal
28- days menstrual cycle.
Please answer question number 90 - 93

( mm )
5-

3-

1-

4 8 12 16 20 24 28 day

Days of menstrual cycle

90. The event designated by the dotted line corresponds most closely to :
A. The menstrual phase
B. The maturation of the corpus luteum
C. The early prolipherative phase
D. The secretory phase
E. Ovulation

91. The period designated by coincides with one of the following events :
A. The follicular phase of the ovarian cycle
B. The proliferative phase of the endometrium
C. The menstrual phase
D. The most likely time for fertilization and implantation
E. The secretory phase of endometrium

92. The period designated by coincides with one of the following events :
A. The increasing level of progesteron
B. The secretory phase of the endometrium
C. The estrogen reaches the lowest level
D. Maturation of the dominant follicle
E. The maturation of the corpus luteum

93. The curve shows that on the fourth day of the cycle the endometrial thickness
is minimum. Which one of the following statements is correct about this
condition?
A. All of the endometrial layers are sheded
B. The basal layer of endometrium is still capable of responding to estrogen
stimulation.
 18
C. The formation of progesterone receptors in the endometrium
predominates.
D. The spiral arteries are recoiling
E. None of the answers in A, B, C or D is correct.

94. Which one of the following method is the most certain to determine ovulation ?
A. Cervical mucus
B. Basal body temperature
C. Endometrial biopsy
D. Pregnancy
E. Vaginal cytology

95. The ovarian follicles which is capable of releasing an oocyte is :

A. Primordial follicle
B. Secondary follicle
C. Graafian follicle
D. Primary follicle
E. Granulosa lutein cells

96. The oocyte are transported down the oviduct by :

A. Contraction of uterus
B. The sweeping movement of the cilia on the tubal epithelial cells.
C. Hormonal factors
D. Contraction of vagina
E. Contraction of fimbriae

97. The remainder of the graafian follicle immediately after ovulation is :

A. Corpus luteum
B. Primary follicle
C. Corpus albicans
D. Tertiary follicle
E. Atretic follicle

98. “Spinnbarkeit” is a term which means :

A. Crystallization of the cervical mucus
B. Threading of cervical mucus
C. Mucus secretion of the cervix
D. Mucus secretion of the Bartholin glands
E. Thinning of the cervical mucus

99. Immediately after delivery:

a. The uterine fundus is between the umbilicus & the symphysis pubis.
b. The uterus weighs about 500 gm.
c. The lochia is yellowish in color.
d. There is decreased venous return to the heart.
e. There is increased diuresis.
 19

100. Immediately after the completion of a normal labor, the uterus should be :
a. Firm & contracted at the level of the umbilicus.
At the level of the symphysis pubis.
b. Immobile.
c. Atonic.
d. Boggy