Vaginal examination

Culdocentesis

hCG urine pregnancy test

Laparoscopy

Answer: E* Laparoscopy

***) Which of the following can be a definite diagnosis of intrauterine pregnancy to rule out ectopic pregnancy:

Decidual reaction at D&C pathology specimen

Aria-stellaphenomen at D&C pathology specimen

Chorionic villi at D&C pathology specimen

Positive pregnancy test

Positive β-hCG assay

Answer: C* Chorionic villi at D&C pathology specimen

***) Differential diagnoses of ectopic pregnancy are the following, except:

Acute salpingitis

Acute appendicitis

Acute red degeneration of fibroid

Rupture ovarian cyst

Vesicular mole

Answer: E* Vesicular mole

***) Differential diagnoses of ectopic pregnancy are the following, except:

Rupture of a corpus luteum cyst

Uterine abortion

Torsion of fallopian tube

Acute appendicitis

Spasmodic dysmenorrhea

Answer: E* Spasmodic dysmenorrhea

***) Of the following, which woman is at greater risk for ectopic pregnancy:

Healthy woman on birth control pills

A woman with a past history of three incidents of pelvic inflammatory disease

Woman with a history of endometriosis

Woman with irregular menses

Woman with a past history of several attacks of UTI

Answer: B* A woman with a past history of three incidents of pelvic inflammatory disease

***) The most common implantation site for ectopic pregnancy is the:

Abdominal cavity

The ovarian surface

The cervix

Ampulla of the fallopian tube

The interstitial portion of the fallopian tube

Answer: D* Ampulla of the fallopian tube

***) A 24 year old patient married since 2 years. She is having 6 weeks amenorrhea and unilateral anneal pain, acute abdomen, rapidly falling hematocrit, hypertensive and positive pregnancy test. The most likely diagnosis is:

Endometriosis

Appendicitis

Urinary tract infection

Threatened abortion

Ectopic pregnancy

Answer: E* Ectopic pregnancy

Placenta ob26-ob29.

The Placenta.

***) Where does fertilization take place:

In the ovary

In the fimbrial end of the fallopian tube

In the ampullary region of the fallopian tube

In the uterus

In the isthmic region of tube

Answer: C* In the ampullary region of the fallopian tube

***) Implantation of the blastocyte occurs after:

1-2 days

3-5 days

6-8-days

9-10 days

12-14 days

Answer: C* 6-8-days

***) The method of choice of placental localization is:

Ultrasonography

Angiography

Soft tissue placentography

Use of radioactive isotopes

Amniography

Answer: A* Ultrasonography

***) All of the following are placental hormones, except:

Follicular stimulating hormone

Human placental lactogen

Progesterone

Estrogen

Somatotropine (growth hormone)

Answer: A* Follicular stimulating hormone

***) Human Placental Lactogen (hPL) can be elevated in all of the following, except:

Diabetes

Twins

Hypertension

Erythroblastosis

Bronchogenic carcinoma

Answer: C* Hypertension

Abnormalities of the Placenta.

***) Placental abnormality characterized by an accessory lobe is termed:

Placenta membranacea

Placenta circumvallate

Placenta succenturiata

Placenta fenestrata

Placenta increta

Answer: C* Placenta succenturiata

***) One of the following is true concerning placenta succenturiata:

The placenta is surrounded by a fibrous ring

The placenta contains fenestration in its center

The placenta is connected to an accessory lobe by a small vessels and membrane

The chorionic plate is surrounded by a membranous structure

The placenta is horse-shaped in appearance

Answer: C* The placenta is connected to an accessory lobe by a small vessels and membrane

***) One of the following is true concerning a battledore placenta:

The umbilical cord is attached to its central part

The umbilical cord is attached to the central membranes

The umbilical cord is attached to the margin of the placenta

The umbilical cord is attached to an accessory lobe of the placenta

The umbilical cord is attached to two lobes of placenta

Answer: C* The umbilical cord is attached to the margin of the placenta

***) All of the following are common causes of placental insufficiency, except:

Prolonged hypertension disease in pregnancy

Obesity

Chronic renal disease

Severe anemia

Prolonged pregnancy

Answer: B* Obesity

***) Placental insufficiency is caused by the following, except:

Smoking in pregnancy

Dieting in pregnancy

Hypertensive disorders in pregnancy

Post maturity

Multiple pregnancy

Answer: B* Dieting in pregnancy

***) All of the following are causes of large placenta, except:

Multiple pregnancy

Chronic renal disease

Syphilis

Diabetes mellitus

Hydropsfetalis

Answer: B* Chronic renal disease

Placenta Previa.

***) In placenta previa all of the following statements are true, except:

Causes painless vaginal bleeding

Vaginal examination is contraindicated

Is managed by caesarian section if covering the cervical os

Presents with a woody hard uterus

Predisposes to postpartum hemorrhage

Answer: D* Presents with a woody hard uterus

***) All of the following are commonly associated with placenta previa, except:

Sudden onset of fresh bleeding

Abnormal presentation

Unengaged head

Absence of fetal heart

Soft abdomen

Answer: D* Absence of fetal heart

***) Vaginal examination is contraindicated in one of the following situations during pregnancy:

Carcinoma of the cervix

Gonorrhea

Prolapsed cord

Placenta previa

Active labor

Answer: D* Placenta previa

Abruptio Placenta.

***) Concerning abruptio placenta, all the following are true except:

It is a premature separation of normally implanted placenta

The uterus is tender

In severe cases a central venous pressure line should be inserted

The vaginal bleeding is painless

The management of choice is termination of pregnancy

Answer: D* The vaginal bleeding is painless

***) Abruptio placenta can be secondary to all of the following, except:

Hypertensive disorders

Following delivery of first twin

In severe car accident

After rupture of membrane in oligohydramnios

External cephalic version

Answer: D* After rupture of membrane in oligohydramnios

***) In abruptio placenta, all of the following may occur, except:

Shock

Vaginal bleeding

Uterine tenderness

Convulsions

Fetal distress

Answer: C* Uterine tenderness

***) The most common complication of abruptio placenta is:

Hepatic failure

Heart failure

Post partum hemorrhage

Adrenal failure

Cerebral edema

Answer: C* Post partum hemorrhage

***) The following are complications of placental abruption, except:

Renal cortical necrosis

Eclampsia

Afibrinogenemia

DIC (Disseminated Intravascular Coagulopathy)

Intrauterine growth retardation

Answer: B* Eclampsia

***) The most consistent factor predisposing to abruption placenta is:

Maternal hypertension

Trauma

Uterine decompression

Maternal parity

Maternal age

Answer: A* Maternal hypertension

***) Treatment for severe placental abruption at term with 3cm dilated cervix is:

Heparin

Blood transfusion

Steroid therapy for fetal lung maturity

Tocolytic therapy

Urgent CS

Answer: E* Urgent CS

Placental Tumors.

***) Choriocarcinoma is a primary tumor of:

Decidua

Undifferentiated gonadal cells

Myometrium

Trophoblast

Ovaries

Answer: D* Trophoblast

***) Choriocarcinoma may result from all of the following, except:

Hydatidiform mole

Endometriosis

Term pregnancies

Ectopic pregnancies

Abortions

Answer: B* Endometriosis

***) The following are clinical features of choriocarcinoma, except:

Irregular vaginal bleeding after pregnancy

Metastases may present as lumps in the vagina

Choriocarcinoma is self-limited disease

May cause intraperitoneal hemorrhage

May cause amenorrhea

Answer: C* Choriocarcinoma is self-limited disease

***) Choriocarcinoma is treated by:

Surgery

Chemotherapy

Antibiotics

Hormones

Radiotherapy

Answer: B* Chemotherapy