An 18 year-old gives a 2 month history of intermittent, irregular bleeding.

Her last normal menstrual

period was 3 months ago. Before that, her cycle was regular at 28 weeks. It was normal. The next step in
the management should be

A pregnancy test

In patients with dysfunctional uterine bleeding, the lack of predictable ovulation results in the lack of the
cyclic effect of what luteal phase hormone

Progesterone

A patient with dysfunctional uterine bleeding is a greater risk for developing what type of cancer

Endometrial

Which of the following mimics the physiologic hormonal event that induces normal menstrual bleeding

Discontinuing progestin

Dysfunctional uterine bleeding is defined as

Irregular menstruation without anatomic lesions of the uterus

What is likely finding on endometrial biopsy of a patient with dysfunctional uterine bleeding (Chronic
anovulation)

Atrophic endometrium

Which of the following conditions is commonly associated with chronic anovulation also termed
dysfunctional uterine bleeding

PCOS

After successful; treatment of an acute episode of anovulatory bleeding in a 13 year-old, long term
treatment is best accomplished by

Cyclic oral contraceptives

A 37 year-old patient complained of menorrhagia for the past 8 months. The patient has no rash, but
her skin was dry. Endometrial biopsy showed proliferative endometrium. Which systemic disease most
likely to be associated with these findings

Hypothyroidism

Therapeutic agents that are efficatious in reducing mean menstrual blood loss include all of the
following EXCEPT

Methylergonovine maleate
The following are all pharmacologic actions of NSAIDs used in treating menorrhagia EXCEPT

Inhibition of fibrinolysis

A 20 year-old GO complains of heavy menstruation, which is now on its 7th day. The internal
examination was normal except for presence of clotted blood filling the posterior fornix. Pregnancy test
was negative and haemoglobin is 10.8g. the recognized management options include all the following
EXCEPT

Dilation and Curettage

A radical hysterectomy differs from a total abdominal hysterectomy in that it includes surgical removal
of the

Parametrium

A 36 – year – old comes to your clinic for her annual physical examination. She is married with two
children and she has no major medical illnesses. She reports a 10 year pack-year history of cigarette
smoking. She has had 10 heterosexual partners in her lifetime and denies a history of sexual transmitted
disease. All of her pap smears have been normal. Her physical examination including pelvic, is
unremarkable. A week later, you receive her pap result, which read “satisfactory for evaluation, ASCUS.”

Which of the following would be appropriate as initial management for this patient

All of the above

You perform a colposcopy and biopsy on the above patient and a histopath reads “CIN-2”. All of the
following are acceptable management plans for the patient exept

Perform conization

Clear cell carcinoma of the cervix is associated with intrauterine exposure to

Diethylstilbestrol

Often symptom of cervical cancer is

Abnormal bleeding or loss brownish discharge, no Hx of pap smear

All patients with cervical carcinoma with hydronophe or non-functioning kidney should be included in

III

In general, surgical therapy for cervical carcinoma is indicated for most patients with stage

I (IB & I A)
Which of the following is a complication noted after radiation therapy for cervical carcinoma

All of the above (radiation cystitis, radiation proctitis, dyspareunia, fistulae)

Which of the following human papilloma virus (HPV) types has low encogenic potential

The Bethesda classification, high grade squamous intraepithelial lesion(HSIL) sorresponds to

CIN II or III

After multiple directed cervical biopsies have resulted in a diagnosis of CIN II, best cryotherapy
technique with a patient in whom ECC results are negative is a

Double 3-minute freeze

The most common complication of conization is

Bleeding

31. a 52 year-old woman

She has a 25 smoking history

Coelomic epithelium tumors include

Serous

An example of gonadal stromal tumor

Dysgerminoma

Germ cells result in what ovarian neoplasm

teratoma

hyoerthyroidism is associated with what ovarian neoplasm

struma ovaril

granulosa-theca cell tumor characteristics include all of the following EXCEPT

produces androgenic components

sertoli-leydig cell tumor characteristics include

may contribute to hirsutism or virilizing symptoms

A unique ovarian fibroma is

What is the primary surgical approach involved in the treatment of ovarian carcinoma

Total abdominal hysterectomy

The presence of a signet-ring cell type in ovarian tumors is most characteristic of

Krukenberg tumors

Gonadoblastoma consist of

Germ cells and sex cord-stromal elements

Reinke crystalloids are found in

Bilar-cell (Leydi-cell) tumors

a 26 year-old nulliparous woman is seen in the emergency room for acute abdominal pain. Her vital
signs are BP: 90/50, HR: 120bpm, Temp: afebrile. Abdominal examination shows right lower quadrant
tenderness with rebound. Pelvic examination demonstrates a painful 10-cm right adexal mass. A serum
pregnancy test is negative. A hematocrit is 24% (normal, 35-40%). Exploratory laparotomy confirms a
hemoperitoneum. A smooth right ovarian tumor is bleeding from its ruptured capsule. Inspection of the
uterus, fallopian tubes, and left ovary is normal. A right salpingo-oophorectomy is performes. Frozen
section of the tumor shows primitive germ cells with intervening connective tissue infiltrated by
lymphocytes. The tumor is most likely a (an)

dysgerminoma

the BRCA-1 tumor suppressor gene is on chromosome

17

a type of family planning method where patient is advised to abstain from coitus on the days of
menstrual cycle when a woman is likely to conceive

calendar method

a method that uses changes in the cervical mucus with ovulation % a woman should be conscientious in
assessing her vaginal secretions

dilling method?

Intrauterine device (IUD) is advised in the following patients

After her menstrual period

the first functioning organ system in the embryo is the

cardiovascular system

a 26 y/o woman complains of vaginal discharge associated with itching and burning. The pH of the
discharge is 5.5. the best likely diagnosis is

bacterial vaginosis

pregnant woman w/ Hodgkin hymphoma are inordinately susceptible to w/c of the following
complications

infection and sepsis

a 17 y/o nulligravida has been amenorrheic for 12 weeks. She took 8 tabs of misoprostol to induce
menstruation. After 3 days she had spotting then she asked a hilot to massage her hypogastrium area.
One week later she had chills and fever. The most probable diagnosis is

septic abortion

a patient who is 36 weeks pregnant reports to labor and delivery room complaining of vaginal bleeding,
contraction and very tender abdomen. In this situation, which would be

fetal heart rate deceleration

a 28 y/o female GP 28 wks AOG came to the clinic w/ cough and wheezing associated w/ on and off
lumbosacral pain

pregnancy uterine full term with asthma

during pregnancy maternal blood volume increase by

45 – 50%

During normal vaginal delivery there is usually a blood loss approximately

500 ml

A 26 y/o G1P1 nonbreastfeeding 6 weeks postpartum woman had bright red bleeding after 4 weeks
without bleeding. Most likely diagnosis is

Normal menstruation

A multigravida whose internal examination finding is 8 cm with marked moulding of the head has a
rising suprapubic depression

Pathologic ring
A woman who was on contraceptive pills for two years consults because she did not menstruate for 6
weeks after getting off the pills. You will

Do a pregnancy test

Management of nuchal cord include which of the following

All of the above (if more than one cut clamping both coils and deliver the baby, if tight cut between the
2 clamps prior to delivery, if loose it can be slipped over the shoulder or over head)

A 32 y/o G3P3 Jehovah’s witness begins to bleed heavily two days after CS

Let her die giving supportive care

A pregnancy of approximately 10 weeks gestation is confirmed in a 30 y/o woman G5P5 with and IUD
place. The patient expresses a strong desirefor the pregnancy to continue. On examination, the string of
the IUD is protruding from the cervical os. The most appropriate course of action would be to

Remove the IUD immediately

A 22 y/o G1P0 has just delivered spontaneously. As the placenta is being delivered, an inverted uterus
prolapsed out of the vagina. All of the following steps are appropriate EXCEPT

Apply pressure to the fundus with the palm of the hand and finger in the direction of the long axis of the
vagina

A pregnant woman is discovered to be an asymptomatic carrier of gonorrhea

Ampicillin

A 27 y/o G2P1 with an otherwise normal pregnancy complains

Biophysical profile

A 19 y/o female

Tra USG (basta yung maikli na USG)

A female patient at 17 weeks gestation is diagnosed as having intrauterine fetal

Consumptive (yung mahaba)

A 27 y/o woman G3P2 comes to the delivery room at 37 weeks gestation. She had prenatal check up.

Abruption placenta
A woman develops endometritis after CS. She is treated with penicillins and gentamicin but fails to
respond. Which of the following bacteria is resistant to the above antibiotics and is likely responsible for
this woman’s infection

Bacteriodes fragilis

A 24 year old primigravid who intends to breastfeed decided on home delivery

Hemochromatosis

Received DES during pregnancy

All of the above

Nausea and vomiting are common in pregnancy

Abc(hypolamia, jaundice, weight loss)

A woman had vaginal delivery. She had catheterization once on the ward due to urinary retension

Urinary tract infection

Which of the following need not be reported immediately as a potential danger signal in a pregnant
woman

Escape of fluid from the vagina

6hrs

An abnormal findings during normal pregnancy

Real time USG evidence of fetal heart motion 4 weeks after the last menstruation

A 30 year old woman whose last menstruation were 8 weeks ago presents with heavy vaginal bleeding
and lower left quadrant pain. Serum B HCG levels are low for dates

None of the above

A 30 year old G1P0 38 weeks AOG came to the clinic because of headache and blurring of vision

Pre-eclampsia

Yourmanagement would be

All of the above is correct (admit the patient, antihypertensice, put her on bed rest)
A 25 year old G3P2

She is having an impending rupture of the uterus

Immediate management in this patient is

Stat CS

An 18 year old single, obese, female, G1P0 is first seen by you for prenatal check up at 16 weeks AOG

Folic acid supplementation

A pregnant patient at 28 weeks gestation complained of increasingly severe abdominal pain of 5 weeks
duration

Fetal skeleton overlapping the maternal spine

Your diagnosis in the above patient is

Erythroblastosis fetalis

A 22 year old patient at 40 weeks AOG develop vesicular lesions

Herpetic vulvitis

In the above patient other than specific culture which of the following diagnostic steps is most likely
indicated

Smear of the lesions