Ob & Gyn 1201-1400 ចម្លើយពេញ

1270 Engagement is said to occur when....... A The fetal head is within the maternal pelvis B The biparietal diameter of the fetal head is through the plane of the inlet. C The presenting part is just above the level of ischial spines. D The vertex is in transverse position

B

1271 Engaging diameter, in fully extended head : A Mento occipital B Submentobregmatic C Biparietal D Mentovertica

B

1276 Female came to the ER with Bp 80/60 and pulse 125 with history of acute abdomen, next step is A laparotomy B iv fluids C CBC D PV examination

B

1281 The Arius-Stella reaction may be seen with all except : A Ectopic pregnancy B Birth control pills C Abortion D Trophoblastic disease

B

1283 What is the most common side effect with MTX therapy for ectopic pregnancy A Transient pelvic pain 3 - 7 days after starting treatment B Stomatitis C Bone marrow suppression D Gastritis

B

1289 Shock is out of proportion to the amount of bleeding in : A 1ry postpartum haemorrhage B Retained placenta C Acute puerperal inversion of uterus D Hypofibrinogenemia

B

1255 Female patient with history of endometriosis, menstrual disorders complaining from pain 1255 on right iliac fossa, on examination there was tenderness on right iliac fossa with no rebound pain no rigidity, on CBC it was normal, most likely : A peritonitis B appendicitis C follicular cyst D non of the above

C

1256 Considering a case of follicular cyst it need all of following except : A assurance follow up B OCP C usually surgical removal D repeated US

C

1257 Considering the follicular cyst all of following is true except : A associated with metropathia hemorrhagica B OCP indicated in ttt C the second common functional cyst D TAS is the gold standard diagnostic method

C

1260 A 29-year-old G4P4 is found to have an abnormal smear signed out as atypical glandular cells, favouring neoplasia. She undergoes a colposcopy with cervical biopsies. One of the ectocervical biopsies demonstrated adenocarcinima in the situ. The most appropriate next step is: A Vaginal hysterectomy B Radical hysterectomy/Radiotherapy C Cold-knife conization of the cervix D Loop excision of the cervical tranformation zone

C

1267 woman delivers a 9 lb baby with midline episiotomy & develops a 3rd degree tear. Inspection shows that the following structures are intact. A Anal sphincter B Perineal body C Rectal mucosa D Perineal muscles

C

1269 The following hormone is not produced by the placenta... A HCG B HPL C Prolactin D Estriol

C

1239 Diagnosis of stress incontinence coded by which of the following before taking the patient for surgery A History B Subjective demonstration of stress incontinence C Objective demonstration of stress incontinence D Urodynamic studies

D

1240 Bartholin's gland duct opens in..... A Upper third of labia majora B Middle third of labia majora C Upper third of labia minora D Middle third of labia minora

D

1242 Endometroid cyst, on examination: A adenexal tenderness B cyst felt in thin people C cyst fixed and tender D all of the above .

D

1243 Ovarian precursors of oestradiol include : A Oestrone B Androstenedione C Testosterone D All of the above

D

1248 Considering Brenner tumor all true except : A potential malignant is common B histologically has epithelial nests and coffee bean nuclei C vaginal bleeding reported with it D usually in childbearing women

D

1252 Considering endometroid cyst : A not uncommon B due to menstrual reaction C torsion is common D A & B

D

1253 Considering endometrial cyst ttt all true except : A GNRH is of benefit B laparosope idicated in small cyst C laparotomy is preferred D recurrence is not common

D

1258 Considering the endometroid cyst : A associated with dysmenorrhoea B associated with pelvic pain C associatd with pelvic endometriosis D All of the above

D

1285 Placenta previa, all true except : A Shock out of proportion of bleeding B Malpresentation C Head not engaged D Painless bleeding

A

1249 Considering malignant ovarian neoplasm histologically may be all except : A epithelial tumors B germ cells tumor C cystic and solid tumors D sex cord tumors .

C

1250 For endometrial cyst all true except : A chocolate cyst on TVS B laparoscope is indicated C C125 is a specific test D associated with dysmenoorrhoea .

C

1236 The uterus is held in anteflexed position by : A The ventral pull of round ligament B The dorsal pull of uterosacral ligaments C Its weight D All of the above

D

1237 What are the signs of ovulation on Ultrasonography : A Irregular follicle wall B Collapse of follicle C Fluid in cul de sac D All of the above

D

1294 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

E

1298 Pyogenic infections of genital tract usually spread via : A Mucous membrane B Veins C Lymphatics D Fistulous tracts E B+C

E

1231 Subnuclear vaculoes in the endometrial mucosa are evidence of activity of: a. Cholesterol A Progesterone B Pregnendiol C Androstenendione D Oestrogen សំណួរខុស យក B តាមគេ សិនទៅ

B

1235 Magnesium sulphate toxicity include all EXCEPT: A CNS depression B This drug acts only on motor end plate C Respiratory depression D muscle relaxant

B

1241 Female patient with endometrial hyperplasia could be all of these except: A thecoma B fibroma C Brenner tumor D follicular cyst .

B

1244 Considering epithelial neoplasm of the ovaries all true except : A the commonest B mucinous cystadenoma lined by tubal epithelium C Brenner tumor lined by urinary tract epithelium D embryologically arise from wolffian epithelium .

B

1245 The Commonest ovarian neoplasm complicated with torsion during pregnancy: A fibroma B teratoma C simple serous cyst D thecoma .

B

1251 Female patient with history of induction of ovulation present with tender lower abdominal pain and discomfort, TVS show cyst , Next step is : A assurance sending home B hold ovarian stimulation drug C laparotomy D non of the above

B

1254 Considering the follicular cyst it is rarely associated with : A endometrial hyperplasia B acute abdomen C polycystic ovary D On PV in obese patient it may rupture .

B

1233 Non-neoplastic ovarian cysts include all of the following except: a. follicular cyst A theca lutein cyst B dermoid cyst C corpus luteum cyst D endmetroid cyst សំណួរខុស យក C តាមគេ សិនទៅ

C

1234 Which of the following ovarian tumor is most prone to undergo torsion during pregnancy? A Serous cystadenoma B Mucinous cystadenoma C Dermoid cyst D Theca lutein cyst

C

1284 A primigravida presents to casualty at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by; A Immediate cesarean section B Immediate induction of labor C Tocolytic therapy D Magnesium sulphate therapy

A

1203 Extensive bleeding into the myometrium & beneath the uterine serosa in severe cases of abruption placenta may result in : A A Couvelaire uterus. B Active uterus C Placental perfusion D Normal fetal heart rate

A

1205 One of the following contraindications for the use of amnio-hook : A Placental previa B Abruptio placenta C Breech presentation D IUGR

A

1212 In Placenta previa, all help in the diagnosis, EXCEPT: A Constant lower abdominal pain B Mal presentation C Painless vaginal bleeding D US

A

1218 Lady with infertility with bilateral tubal block at cornua. Best method of management is : A Laparoscopy & Hysteroscopy B Hydrotubation C IVF D Tuboplasty

A

1229 Which of the following statements is incorrect regarding levonorgestrel releasing intrauterine system: A There is increased incidence of menorrhagia B This system can be used as hormone replacement therapy C This method is useful for the treatment of endometerial hyperplasia D Irregular uterine bleeding can be problem initially

A

1238 Perforation of the uterus while doing endometrial biopsy in non pregnant uterus, needs A Laparoscopy B Observation C Immediate laparotomy D Hysterectomy

A

1246 Female patient with acute abdomen, CBC normal, B-HCG size, No vaginal bleeding, Mostly is : A hemorrhagic teratoma B disturbed ectopic pregnancy C appendicitis D Peritonitis

A

1261 The severity of CIN is graded A 3-Jan B 1a-4a C I-III+ I-IV D A-C

A

1263 The cysts in Polycystic Ovarian syndrome are formed by: A Failure of atretic follicles to undergo apoptosis B Oocyte proliferation C Multiple corpus lutea D Cystic degeneration of ovarian cortex

A

1264 Functional ovarian cysts include: A Follicular cysts. B Endometriomas. C Dermoid cysts. D fibromas.

A

1266 Mechanism of labor in abortion stick (use of stick to induce abortion) is due to A Necrosis of uterine endometrium and stimulation of uterine contraction B Oxytocin present in the stick C Prostaglandins present in the stick D All of the above

A

1277 A 40-years-old female with history of fibroid on investigation showed CIN-2 changes. Treatment of choice in this case is : A Hysterectomy B Conization C Cryotherapy D Laser ablation

A

1278 Post menopausal bleeding does not occur in.... A Use of combined OCP's B Atrophic vaginitis C Endometrial hyperplasia D CA-Endometrium

A

1280 The most dangerous symptom during pregnancy is: A PV bleeding B Ankle swelling C Hyperemesis D Cramps

A

1286 A 34wk GA lady presented with vaginal bleeding of an amount more of that of her normal cycle. O/E uterine contracts every 4 min, bulged membrane, the cervix is 3 cm dilated, fetus is in a high transverse lie and the placenta is on the posterior fundus. US showed translucency behind the placenta and the CTG (Cardiotocography) showed FHR of 170, the best line of management is: A C/S immediately. B give oxytocin. C do rupture of the membrane. D amniocentisis

A

1290 Fetal hyperinsulinemia leads to: A Fetal macrosomia causes difficult vaginal delivery B Inhibition of pulmonary surfactant causing Intrauterine asphyxia C Decrease serum K causing respiratory distress syndrome D Neonatal hypoglycemia with myocardial injury

A

1291 Glycogen is seen in the lumina of endometrial glands : A During the luteal phase B During pregnancy only C During pre and post ovulatory D During proliferative phase only E At the time of ovulation only

A

1259 Female patient with history of hydatiform and complaining of lower abdominal pain , on examination there was tenderness on palpation and the lab result show high level of HCG , most likely to be : A follicular cyst B theca lutein cyst C corpus luteum cyst D non of the above .

B

1247 Considering mucinous cystadenoma : A the commonest neoplasm B usually bilateral C sometimes fill the entire abdominal cavity D lined by tubal epithelium .

C

1268 Engagement is said to occur when....... A The fetal head is within the maternal pelvis B The biparietal diameter of the fetal head is through the plane of the inlet. C The presenting part is just above the level of ischial spines. D The vertex is in transverse position.

B

1201 Management of placental abruption includes all of the following EXCEPT: A Coagulation studies B Tocolytic drugs if the baby is premature C Augmentation of labor D Artificial rupture of amniotic membrane

B

1211 The following may be signs of abruptio placenta, EXCEPT : A Vaginal bleeding. B Absence of uterine contractions. C Blood stained amniotic fluid. D Abnormal fetal heart rate.

B

1213 33 year female at 37 weeks gestation confirmed by early sonography presents with moderate severe vaginal bleeding, she is noted to have placenta previa, which of the following is the best management for her : A Induction of labor B C-Section. C Expectant management D Artificial rupture of membrane

B

1221 Sub urethral diverticula may occur as a sequelae to infection of: A Bartholin's gland B Skene's gland C Clitoral gland D Vulvovaginal gland

B

1223 The function of round ligament is : A Vestigial with no apparent function B To prevent retrodisplacement of the uterus C To prevent uterine prolapse D To provide nerve supply of the upper vagina

B

1226 The cyclic production of pituitary hormones is dependant upon: A Normal menstruation B An intact pituitary- portal system C An adult anterior pituitary gland D All of the above

B

1300 The most common symptom associated with adenomyosis is : A Infertility B Menorrhagia C Haematometra D Dyspareunia E Metrorrhagia

B

1207 24 -year- old patient ( G2 P1 + 0 ). At 34 weeks of gestation presented to emergency with vaginal bleeding. Which one of the following is NOT TRUE ? A Admit the patient B Resuscitate the patient C Do digital examination immediately D Cross-match blood

C

1210 An 18 year old woman is noted to have a marginal placenta previa on an US at 24 weeks gestation. Which of the following is the most appropriate management? A Schedule cesarean delivery at 38 weeks. B Schedule an amniocentesis at 36 weeks & delivery by C-section if the fetal lung is mature. C Reassessplacentalpositionat33-34weeks. D Recommend termination of pregnancy.

C

1217 In placenta previa: A Common in primigravida. B Presents with vaginal bleeding with abdominal pain. C Hx. Of repeated C-section is a risk factor. D Characterized by bleeding at 10weeks gestation.

C

1219 Women with postmenopausal bleeding need endometrial sampling if endometrial on US is thicker than A 1mm B 2mm C 5mm D 8mm

C

1222 Large amount of alkaline phosphatase may be demonstrated in the endometrium of : a. Decidua A Secretory phase B Proliferative phase C All of the above D None of the above សំណួរខុស យក C តាមគេទៅ

C

1224 The definitive epithelium of vagina is derived from : A Wolfian duct B Mullerian duct C Urogenital epithelium D Coelomic epithelium

C

1227 The clots passed with menorrhagia perhaps indicate A No endometrial regeneration B No terminal arteriolar spasm C Large amount of bleeding D All of the above

C

1272 Following a vaginal delivery, a woman develops a fever, lower abdominal pain anduterine tenderness. She is alert, and her blood pressure and urine output are good. Large gram positive rods suggestive of clostridia are seen in a smear of cervix. management should include all except : A Immediate radiographic examination for gas in uterus B High dose antibiotic therapy C Hysterectomy D close observation for renal failure or hemolysis

C

1273 A multiparous woman aged 40 years, presents with menorahagia and progressively increasing dysmenorrhoea. Most probable diagnosis is: A Ca Cervix B Ca Endometrium C Adenomyosis D DUB

C

1274 Considering dysgerminoma all true except : A the commonest germ cell tumor B usually in young females C lymphatic spread is so late D elevate lactic dehydrogenase level .

C

1275 Ordering accord to the commonest cancers in female genital tract the right is: A cervical, endometrial, ovarian B ovarian, cervical, endometrial C endometrial, cervical, ovarian D endometrial, ovarian, cervical .

C

1279 Dysfunctional uterine bleeding is said to present when there is bleeding due to: A Endometriosis B Irregular ripening and irregular shedding C Chronic endometritis D Fibroid

C

1287 Most important cause of immediate post partum hemorrhage: A laceration of cervix B laceration of vagina C uterine atony D placental fragment retention

C

1293 Oxytocin and vasopressin are transferred from hypothalamus to neurohypophysis through: A Venous channels B Lymphatics C Nerve axons D All of the above E None of the above

C

1296 The preferred treatment of ruptured tubo-ovarian abscess is : A Cul-de-sac drainage B Removal of uterus , tubes and involved ovary C Removal of uterus , tubes and ovaries D Removal of ruptured tube and ovary E Removal of adenexae and drainage

C

1297 The cysts of Stein -Leventhal ovary or PCOD are of which kind? A Lutein B Germinal inclusion C Follicular D Theca lutein E Endometrial

C

1202 The followings are causes of Antepartum hemorrhage EXCEPT: A Abruptio placenta. B Placenta brevia. C Cervical polyp. D Rhisoimmunization.

D

1204 Which of the following is NOT a complication of abruption placenta ? A Postpartum hemorrhage B Consumptive hemorrhage C Fetal demise D Subsequent ectopic

D

1206 Which of the following signs is most useful in predicting the absence of placental abruption following trauma : A Absence of uterine contraction B Absence of vaginal bleeding C Presence of normal fetal heart tones D Absence of tense, painful uterus

D

1208 In the management of placenta previa centralis : A Once diagnosis is made, the treatment should urgent caesarean section B Patient may stay at home if she is living near the hospital C Vaginal examination should be done carefully to confirm diagnosis D Ifthepregnancyhasadvancedto37weeks,itisusuallybesttoperform C/S

D

1209 The condition of placental abruption is associated with : A External cephalic version B Nulliparus women, among whom it is more common C Direct trauma which may be the main cause D A clinical diagnosis

D

1214 Routine pelvic examination is contraindicated in which of the following situations during pregnancy: A Carcinoma of the cervix. B Gonorrhea. C Prolapsed cord. D Placenta previa.

D

1215 Which of the following is NOT a complication of abruptio placenta: A Postpartum hemorrhage. B Consumptive hemorrhage. C Fetal demise. D Subsequent ectopic.

D

1216 Placenta previa is more likely to be found in a pregnancy associated with: A Multiple pregnancy. B Previous manual removal of placenta. C Pyometra. D Previous C-section.

D

1220 Which of the following change in puberty is influenced by the estrogen: A Growth of the acinar buds of the breast B Epiphyseal fusion C Proliferatve phase D All of the above

D

1225 Causes of post partum amenorrhoea may be : A Anorexia nervosa B Cervical atresia C Chlorpromazaine therapy D Any of the above

D

1228 Monilial vagintis occurs frquently during pregnancy because : A Glycosuria is commoner B The vagina contains more glycogen C Higher vaginal acidity suppresses other organisms D All of the above

D

1230 Myxoma peritonei may occur as a consequence of rupture of which ovarian cyst ? a. Dermoid A Struma ovarii B Serous cystadenoma C Mucinous cystadenoma D Cystadenofibroma សំណួរខុស យក D តាម គេសិនទៅ

D

1232 Clinical findings of PCOD include all except : A Obesity B Olgomenorrhoea C Infertility D Tall stature

D

1262 A 42-year-old G4P4 has had postcoital bleeding for the past four months. She has not had a Pap test since the delivery of her last child 7 years ago. Speculum examination shows a vaginal discharge and a 1 cm exophytic lesion of the posterior cervical lip. The most appropriate next step is: A Perform a Pap smear B Perform a cold-knife conization C Give the patient a course of intravaginal Metronidazole gel followed by re-examination in 6 weeks D Perform a punch biopsy of the lesion

D

1265 Following changes occur in urinary system during normal pregnancy: A Increase in renal blood flow B Increase in glomerular filtration rate C Increase in capacity of kidney pelvis D All of the above

D

1282 The passage of decidual cast in cases of ectopic pregnancy usually means : A Impending tubal rupture B Reabsorption of embryo C Pregnancy was intrauterine D Death of embryo

D

1288 Factors favoring long anterior rotation include all except A Correction of the deflexion B Adequate pelvis C good pelvic floor D rupture of membranes

D

1292 The Wolfian duct in the female : A Develops into the fallopian tube B Forms the ovary C Forms the round ligament D Regresses and becomes vestigial E None of the above

D

1295 Physical exam reveals the uterus to be about 6 wk size. Vaginal bleeding is scanty with no discernible tissue in the cervical os. There are no palpable adnexal masses. The uterus is mildly tender. Ultrasonographic exam does not reveal a gestational sac. Which of the following should be recommended? A Dilatation & curettage. B Culdocentesis. C Observation followed by serial B-HCG determinations. D Diagnostic laparoscopy. E Laparotomy

D

1299 Presence of pyometra in a post menopausal females strongly suggests: A Diabetes mellitus B Degenerating myoma C Senile endometritis D Malignancy E Sexual promiscuity

D