1. A. B. C. D. E. 2. A. B. C. D. E.

Which of the following is LEAST likely to be associated with preterm delivery? Incompetent cervix Polyhydramnios Uterine fibroids Abdominal pregnancy Previous preterm delivery Each of the following is a risk factor of puerperial infection EXCEPT: Caesarean section Premature rupture of membranes (PROM) Multiple vaginal examinations during labor Long labor multiparity

3. Regarding the features of the Proliferative Phase, which of the following is WRONG? A. At the beginning of the proliferative phase of uterine cycle, the endometrium is thin, about 12mm. B. During the proliferative phase of uterine cycle, the predominant change is evolution of the initially straight, narrow, and short endometrial glands into longer, tortuous structures. C. Throughout the proliferative phase of uterine cycle, the stroma is a dense compact layer, and vascular structures are infrequently. D. Histologically, during proliferative phase of uterine cycle, the glands have multiple mitotic cells and their organization changes from a low columnar pattern in the early period to a pseudostratified pattern before ovulation. E. The proliferative phase of the menstrual cycle is characterized by the cellular effects of progesterone. 4. A. B. C. D. E. Using the NST tracing in Figure 1, which of the following is TRUE? A fetus with this pattern is at risk for fetal death in utero within the next week The pattern demonstrates no fetal movement presented. The tracing meet the criteria for reactivity The pattern is common during the sleep cycle of the fetus The tracing shows the regular uterine contractions which demonstrates parturition initiated

Figure 1.

5. A 45-year-old patient with uterine leiomyomata found on pelvic examination complains of excessive uterine bleeding. Which of the following should be the next step in the management of this patient? A. myomectomy B. hysterectomy C. ultrasonography D. endometrial biopsy E. hysterosalpingography 6. The majority of deaths from cervical carcinoma are due to which of the following? A. local spread obstructing the ureters, causing renal failure B. brain metastasis with resultant cerebral hemorrhage C. hemorrhage into the pelvis from erosion of vessels by the tumor D. pulmonary failure secondary to metastatic disease filling the lungs E. bone metastasis causing crush injuries to the central nervous system. 7. A 26-year-old patient is found to have an 8-week size, irregular uterus. She does not complain of pain or excessive menstrual bleeding. Her Pap smear is normal and a pregnancy test is negative. Which of the following is the best step in the management of this patient? A. continued observation B. endometrial biopsy C. cervical conization D. hysterectomy E. pelvic ultrasonography 8. Which of the following is the best therapy for secondary dysmenorrheal thought to be due to adenomyosis? A. cervical dilation B. cyclic OCs C. analgesics

D. hysterectomy E. testosterone injections 9. Which of the following is the most common pelvic mass associated with amenorrhea in a reproductive-age woman? A. follicular cyst B. corpus luteum cyst C. benign cystic teratoma D. leiomyoma E. pregnancy 10. A 21-year-old woman has amenorrhea, mild vaginal spotting, and pelvic pain. Her vital signs are blood pressure, 100/50mmHg; pulse, 110bpm; and temperature 98.60F. Abdominal examination shows left lower quadrant tenderness with rebound. Pelvic examination demonstrates a painful 4-cm left adnexal mass. A serum pregnancy test is positive. A hematocrit is 22%(normal, 35 to 45%). Which of the following is the best next step? A. observation B. estrogen therapy C. progesterone therapy D. methotrexate therapy E. surgery

11. The human pelvis is a complex structure. Which option includes all of the bones that make it up? A. Trochanter, hip socket, ischium, sacrum, and pubis B. Illium, ischium, pubis, sacrum, and coccyx. C. Illium, ischium, and pubis D. Sacrum, ischium, ilium, and pubis E. Trochanter, sacrum, coccyx, ilium, and pubis
12. Which of the following is the most important prognostic indicator of survival from advanced ovarian carcinoma? A. stage of disease B. grade of tumor differentiation C. nutritional status D. body mass index E. presence of sec steroid receptors 13. A 54-year-old healthy woman comes for an annual examination. Her last menstrual period(LMP) was 4 years ago. The physical examination is normal. Palvic examination shows vaginal atrophy and a small, mobile uterus. The right ovary is 2.5X4.5 cm in diameter. The left ovary is nonpalpable. Vaginal ultrasonography shows that the right ovary is similar in size to that of a premenopausal ovary. How do you advise this patient?

A. The ovaries of a postmenopausal woman are usually papable. B. The right ovary of a postmenopausal woman is usually palpable by right-handed examiners. C. A palpable ovary in a postmenopausal woman is suspicious for malignancy. D. The right ovary is still producing significant amounts of estrogen. E. The vaginal ultrasound is an unnecessary diagnositic test.

14. During normal delivery, an infant must pass through the maternal true pelvis. Which of the following most accurately describes the characteristics of the true pelvis? A. It has an oval outlet. B. It has three defining planes: an inlet, a midplane, and an outlet. C. It has an inlet made up of a double triangle. D. It is completely formed by two fused bones. E. It lies between the wings of the paired ileum.

15. During clinical pelvimetry, which of the following is routinely measured for evaluate the OUTLET? A. True conjugate B. Interspinal diameter C. Bispinous diameter D. Angle of pubic arch E. Intercristal diameter 16. Engagement is best defined as which of the following? A. when the greatest biparietal diameter of the head is level with the ischial spines B. when the greatest diameter of the fetal presenting part passes through the narrowest and lowest part of the maternal pelvis. C. when the presenting part goes through the pelvic inlet D. when the presenting part is below the ischial spines E. when the greatest biparietal diameter of the fetal head passes the pelvic inlet

17. A 32-year-old (G2P0) at term is admitted in labor with an initial cervical examination of 6cm dilatation, complete effacement, and the vertex at -1 station. Estimated fetal weight is 3.8kg, and her first pregnancy resulted in an uncomplicated vaginal delivery of a 3.0kg infant. After 2 hours, there is no cervical change. An intrauterine pressure catheter is placed. This shows two contractions in a 10-minute period, each with a strength of 30 mmHg. What is this abnormality of labor termed? A. prolonged latent phase B. active-phase arrest C. failure of decent D. protraction of descent E. arrest of latent phase

18. A patient calls your office complaining of continued heavy vaginal bleeding. She had an uncomplicated vaginal birth 2 weeks ago of her second child. The most likely diagnosis from the following differential is which of the following? A. uterine atony B. uterine rupture C. vaginal lacerations D. coagulopathies E. retained placental fragments 19. Fundal height, part of the obstetric examination, which of the information below is WRONG? A. Measurement should start at the variable point (the fundus) and continue to the fixed point (the clitoris) B. In centimeters, approximating the weeks of gestation beyond 18-20 weeks C. Is used to indirectly measure fetal growth in relation to gestational age D. A discrepancy between fundal height and gestation may indicate a fetus small or large for gestational age and should be investigated E. Fundal height is measured and recorded at each visit from second trimester, on an empty bladder, by using a non-elastic tape measure. 20. A. B. C. D. E. Which of the following factors is NOT measured as part of a biophysical profile (BPP) amniotic fluid volume a contraction stress test (CST) a nonstress test (NST) fetal breathing motion fetal limb movements

21.Signs and symptoms that should alert you to the possibility of gestational trophoblastic disease include which of the following? A. persistent titer of hCG after pregnancy B. hematuria C. weight loss D. persistent postpartum anovulation E. nocturnal fever 22.Which of the following is the most common pelvic mass in postmenopausal woman? F. follicular cyst G. corpus luteum cyst H. germ cell tumor I. leiomyoma J. endometrioma 23.An 18-year-old woman presents for care because a condom broke during sexual

intercourse. Coitus occurred 1 day ago when she was at midcycle. She does not wish to be pregnant and will terminate the pregnancy if menses does not occur. Regarding her fear of pregnancy, which is the most appropriate next step in her management? K. advise her that unprotected midcycle coitus has a 5% risk of pregnancy L. prescribe intravaginal misoprostol M. advise immediate douching N. prescribe postcoital a brief course of oral contraception O. advise her to await her next menses before taking any action 24.The following methods are all hormonal contraception EXCEPT: P. condom Q. oral contracepative pill R. transdermal patch S. vaginal ring T. progesterone-only methods U. emergency contraception with RU486 25.Which of the following best describes a missed abortion? V. It is the death of the fetus that the patient does not realize has occurred. W. It is the death of the fetus in which the products of conception are retained after the embryo or fetus has died. X. It is the death of the fetus in which the products of conception are partially expelled. Y. It is the death of the fetus in which the products of conception cause bleeding and there is an open cervical os. Z. It is the death of the fetus in which the products of conception are no longer recognizable.