1.

The term of small for gestational age is generally used to designate newborn whose birth
weight is less than what percentile?
a. 3%
b. 5%
c. 10%/williams
d. 15%
e. 20%

2. The neonatal mortality rate is expected to be lowest for newborns born at which of the
following gestational ages?
a. 36 weeks 6 days
b. 37 weeks 4 days
c. 39 weeks 6 days/williams
d. 40 weeks 6 days
e. 41 weeks 2 days

3. Maternal stress may potentiate preterm labor by which of the following mechanisms
involving corticotrophin –releasing hormone (CRH)?
a. Increased production of maternal derived CRH
b. Decreased production of maternal derived CRH
c. Increased production of placental derived CRH/williams
d. Decreased production of placental derived CRH
e. Decreased production of fetal derived CRH

4. Which of the following lifestyle factors has NOT been identified as an antecedent for
preterm labor?
a. Frequent coitus
b. Illicit drug use
c. Young maternal age
d. Inadequate maternal weight gain
e. Heavy smoking

5. 17-Hydroxyrogesterone caproate has been demonstrated in randomized controlled trial to

decrease the preterm birth rate in women with which of the following characteristics?
a. Nulliparous
b. Carrying twins
c. Prior preterm birth
d. Breech presentation
 e. Preeclampsia

6. What is the only reliable indicator of clinical chorioamnionitis in women with preterm
rupture of the membrane?
a. Fever
b. Leukocytosis
c. Fetal tachycardia
d. Positive cervical or vaginal cultures
e. Non-reassuring cardiotocographic pattern

7. Which antibiotic should be avoided for preterm labor with an increased risk of necrotizing
enterocolitis
a. Ampicillin
b. Amoxicillin
c. Erythromycin
d. Amoxicillin- clavulanate
e. Cefotaxim

8. A 25 year-old primigravida at 34 weeks and 5 days gestation by certain dating criteria is

found to have preterm rupture of the membranes. What is the most appropriate
management?
a. Expedited delivery
b. Expectant management
c. Administer a course of corticosteroids followed by delivery
d. Expectant management unless fetal lung maturity is confirmed
e. Nifedipine to prevent uterine contraction

9. Corticosteroids administered to women at risk for preterm birth heve been demonstrated
to decrease rate of respiratory distress if the birth is delayed for at least what amount of
time after initiation of therapy?
a. 12 hours
b. 24 hours
c. 36 hours
d. 48 hours
e. 56 hours

10. The combination of nifedipine with what other tocolytic agent can potentially cause
dangerous neuromuscular blockade?
 a. Atosiban
b. Terbutaline
c. Indomethacin
d. Magnesium sulphate
e. Diazepam

Choose the correct answer:

1. Ultrasound resolution has been dramatically improved in newer ultrasound machines by:
A. An increase in the number of ultrasound crystals
B. Decrease in array aperture
C. Implementation of analog instead of digital algorithms for focusing on the received
ultrasound beam
D. Implementation of a single focus over multiple ultrasound bram focuses
E. Implementation of pulsed Doppler

2. Essential elements of the fetal anatomic ultrasound survey are all of the following except :
A. Cisterna magna
B. Cavum septi pellucid
C. Four-chamber heart view
D. Fetal hands
E. Umbilical cord insertion site into the fetal abdomen

3. Indications for ultrasound examination in the first trimester of pregnancy are all of the following
except:
A. To confirm the presence of an intrauterine pregnancy
B. To evaluate pelvic pain
C. To estimate gestational age in a patient who had an embryo transfer (IVF)
D. To confirm cardiac activity
E. To evaluate suspected hydatidiform mole

4. The term mild ventriculomegaly is commonly used to indicate cases with an atrial width of:
A. 10-12 mm
B. 10-15 mm
C. 10-18 mm
D. 15-20 mm
E. > 20 mm

5. Demonstration of the bulb-like brain stem bulging inside the fluid-filled intracranial cavity is
typical of:
 A. Alobar holoprosencephaly
B. Porencephaly
C. Hydranencephaly
D. None of the above
E. All of the above

6. Sonography prenatal diagnosis may improve the prognosis of which of the following cardiac
anomalies?
A. Ebstein’s anomaly of the tricuspid valve with atrioventricular insuffiency
B. Corrected transposition of the great arteries
C. Complete transposition of the great arteries
D. Ventricular septal defect
E. Univentricular heart

7. Mild hydronephrosis is defined by the presence of:

A. An anteroposterior diameter of the pelvis greater than 7 mm at mid-gestation
B. An anteroposterior diameter of the pelvis greater than 5 mm at mid-gestation
C. An anteroposterior diameter of the pelvis greater than 4 mm at mid-gestation
D. An anteroposterior diameter of the pelvis greater than 10 mm at mid-gestation
E. None of the above

8. In urethral level obstruction :

A. Obstruction may have a genetic association
B. Obstruction may be caused by two semicircular membranous plicae
C. Urethral valves cannot be detected by ultrasound
D. All of the above
E. None of the above

9. Examination of the fetus at risk for skeletal dysplasias includes:

A. Measurements of all long bones
B. Evaluation of the degree of bone mineralization
C. Evaluation of the degree of long bone curvature
D. Evaluation of fractures
E. All of the above

10. All but one of the following are integral components of the algorithm for first-trimester risk of
Down syndrome:
A. The patients’ age
B. The crown-rump length of the fetus
C. The fetal heart rate
 D. The NT thickness in millimeters
E. The Nasal Bone

11. There is an increased risk of multifetal pregnancies in each of the following settings except:
A. The use of assisted reproductive technologies (ART)
B. Women with collagen vascular diseases
C. Women of advanced maternal age
D. The use of ovulation-inducing agents
E. Higher baseline levels of gonadotropins

12. Which of the following statements about zygosity is most correct?

A. The rate of zygotic splitting is increased following all ART procedures
B. Early zygotic splitting will always result in conjoined twins
C. The highest risk for perinatal morbidity and mortality occurs in dizygotic as opposed to
monozygotic twins
D. Monozygotic twins will always have a monochorionic placenta
E. Monozygotic twins will never have diamnotic , dichorionic

13. Twin-to-twin transfusion syndrome:

A. Monozygotic twins
B. Dizygotic twins
C. Both
D. Neither
E. Conjoined twins

14. Monochorionicity in a twin pregnancy can be suspected by the presence of all of the following
ultrasound features except:
A. Separate placental disks
B. T-shaped junction of amnion into chorion
C. Fetuses of the same gender
D. Very thin intertwine membrane
E. Conjoined twins

15. Which of the following statements about twins prematurity is most correct?
A. Preterm labor occurs more frequently in twins than in triplets
B. Preterm labor in triplet gestations occurs more frequently than fetal anomalies
C. Tocolysis is contraindicated for preterm labor in triplets because of a uniform maternal
contraindication
D. Preterm labor in multifetal gestations is commonly associated with acute fatty liver of
pregnancy
E. Preterm labor in multifetal gestations is commonly due to anemia
16. Which of the following statements about anomalies in twins is most correct?
A. Acardiac twins are dizygotic
B. Conjoined twins are dizygotic
C. Conjoined twins are the most common anomaly in multifetal gestations
D. The rate of anomalies in twin pregnancies is the same as in singleton pregnancies
E. Anomalies occur more frequently in monozygotic twins than in dizygotic twins

17. The etiology of chronic twin-to-twin transfusion syndrome:

A. Is based on the dizygotic nature of the conceptuses
B. Is undoubtedly due to the associated reserved arterial perfusion sequence in the acardiac
twin
C. Produces hypovolemia and anemia in the recipient and hypervolemia and polycythemia in
the donor
D. Is based on unbalanced arterial to venous anastomotic connections between the twins in
the placenta
E. Unknown

18. Fetal demise:

A. Complicates 4-8% of twin pregnancies
B. Complicates 11-17% of triplet pregnancies
C. Is associated with an increased risk of preterm delivery in the survivor
D. Is seen at least twice the rate in monozygotic twins as in dizygotic twins
E. All of the above

19. Maternal complications that are increased in multifetal gestations include all of the following
except:
A. Hyperemesis gravidarum
B. Preeclampsia
C. Cholestasis of pregnancy
D. Uterine rupture
E. Gestational diabetes

20. Interlocking twins:

A. Twin A vertex, twin b vertex
B. Twin A vertex, twin B nonvertex
C. Twin A nonvertex
D. Monozygotic twin
E. Dizygotic twin

21. Each of the following statements about toxoplasmosis is true except:

A. The likelihood of transmission of infection increases with gestational age
B. Most infants with congenital toxoplasmosis are asymptomatic in the newborn period
 C. Toxoplasmosis-specific IgG detected preconceptionally indicates protection from
subsequent fetal infection
D. The severity of congenital infection increases with gestational age
E. With an acute infection, toxoplasmosis-specific IgM may be present for up to 8 monts with
an ELISA test

22. Congenital abnormalities typical of rubella infection include all of the following except:
A. Cataracts
B. Blueberry muffin rash
C. Valvular pulmonic stenosis
D. Sensorineural deafness
E. Hepatomegaly

23. Which of the following medications has been shown to be effective in the treatment of
cytomegalovirus (CMV) infection?
A. Acyclovir
B. Leukocyte interferon
C. Adenosine arabinoside
D. Idoxuridine
E. None of the above

24. Transmission of hepatitis B infection from the mother to the fetus/infant occurs in 80-90% of
cases when:
A. Mother is HBsAg positive but HBeAg negative
B. Mother is HBeAg positive
C. Mother’s infection was in the third semester
D. Mother has persistent asymptomatic disease
E. Asian women with HBsAg positive

25. Infants born to women who are HBsAg positive should be:
A. Observed for development of hepatitis
B. Given hepatitis B immuneglobulin (HBIG) only
C. Vaccinated with hepatitis B vaccine only
D. Tested for HBeAg status only
E. Given both HBIG and vaccine

26. All of the following are approved for use throughout HIV infection in pregnancy except:
A. Efavirenz
B. Zidovudine
C. Nelvinavir
D. Lamivudine
E. Combivir
 27. Which of the following statements are true about Cesarean sections for the prevention of
MTCT?
A. They should be performed at 39 weeks
B. They should be preceded by an amniocentesis for maturity if done at 38 weeks
C. There should a vertical incision in the uterus
D. The patient should be given prophylactic antibiotics
E. All of the above

28. Urinary tract infection:

A. Should be prevented in women with an indwelling catheter by theprescription of antibiotics
B. With an indwelling catheter, a urine culture of > 100. 000 E.coli is better treated by
removal of cathether than by antibiotics
C. Intermittent clean self cathetrerization results in more morbidity than suprapubic
catheterization
D. Post-operative catheterization is obligatory after vaginal hysterectomy for menorrhagia
E. The presence of lactobacilli is treated with ampicillin

29. A pregnant women with a history of recurrent genital herpes:

A. Should be assessed early in labor for lesions
B. Should have weekly culture of the cervix
C. Should have cesarean section
D. Should have acyclovir during pregnancy
E. Neonatal infections is 50%

30. All these statements are in Group B streptococcal infections, except:

A. Causes serious effects in about 30% colonized babies
B. Prophylactic penicillin to neonates leads to higher mortality
C. Maternal treatment reduces neonatal morbidity only if continued throughout labor
D. Is commoner in infants < 2500 g
E. A rapid diagnostic screening test for preterm labour would helps reduce neonatal morbidity

1. You would generally select a high frequency transducer to get:

a. Better tissue penetration.

b. Better image detail.

c. Faster imaging.

d. Decreased attenuation.
 2. While doing an ultrasound scan you notice that the echoes at a depth of 4 - 6 cm appear
relatively weak. The appropriate action to increase their brightness in the image would
be to adjust the:

a. Frequency.

b. Focusing.

c. Time Gain Compensation

d. Beam intensity.

Discussion: The time-gain compensation (TGC) is the control which can be used to
selectively amplify the echoes from any specific depth.

3. One or more ghost-images of a body structure displayed at different depths within an

ultrasound image are signs of:

a. Shadowing.

b. Reverberation.

c. Refraction.

d. Enhancement.

1.Principal ventilator use on lung edema complication in preeclampsia management

a. Ventilator setting soon starts after cesarean
b. When acceptable ventilator setting of FiO2<50%, PEEP<8, PaO2>75,pH>7.25 as
indication for extubation
c. Resolution/stabilization of the disease process and hemodinamically stable are
important for weaning
d. All of the above
2. Management of laboring women with well treated mitral stenosis should include the
following, except ;
a. Epidural analgesia
b. Elective cesarean section
c. Endocarditis prophylaxis
d. Beta-blockers to slow heart rate
3. Recurrent Pregnancy Loss (RPL)
 a. Uterine fibroid, Diabetes and PCO are possible cause
b. Pra-conceptional care to provide optimal preparation for healthy pregnancy setting
c. The new concept including the role of micronutrition in the day 20-24 window of
implantation
d. All description are right
4. Which of the following is not characteristic regarding spiral artery remodelling as the
etiopathogenesis of preeclampsia
a. Invasion by Extravillous Cytotrophoblast intersitially and endovascularly
b. Decidual NK cells regulate the invasion
c. Vasodilatated vascular as indication of its failure
d. Replacement of smoothmuscle and endothelium with trophoblasts

5. Which of the following is wrong when the woman with Rheumatic Heart Disease (RHD)
becoming pregnant
a. It is not classified into congenitally heart disease
b. PTMC should be considered after the hospitalized patient being improved and steady
in medicinal treatment
c. Mitral stenosis type has better prognosis rather than mitral insufficiency type
d. Vaginally delivery with painless labor must be obtained for the aterm,well treated
patient
6. The management of lung edema complication in severe preeclampsia
a. They often develop in early onset type of preeclampsia
b. The decreased serum albumin < 3 g% mostly found in her laboratory finding
c. Furosemide and respirator in the Obstetric Intensive Care are not needed largely
d. It is influenced greatly by maternal nutrition pre-gestational state
7. Here comparing between early and late onset type of preeclampsia
a. Late onset type is characterized by remodelling decidual spiral artery
b. Urinary tract infection strongly activates early onset type
c. Early onset type is also called as placental preeclampsia
d. IUGR is most often occured at late onset type

8. All of the following statement are maternal adaptation as increased cardiac out put in
normal pregnancy due to, except:
a. Decreased peripheral vascular resistance
b. Decreased blood volume
c. Increased stroke volume
d. Rise in resting pulse late in gestation
 9. The woman with congenitally ventricular septal defect who becoming pregnant would
provide the abnormally scanning of fetal cardiac four chamber view

a. 1 to 3 %

b. 5 to 10%

c. 12 to 18%

10. It is not true for explanation of lung edema on severe preeclampsia complication
a. Plasma oncotic pressure decreases appreciably in normal term pregnancy
b.Both decreased extravascular fluid oncotic pressure and decreased capillary permeability
have occured in preeclampsia
c. Decreased serum albumin concentration because increased blood volume of maternal
adaptation
d. Oncotic pressure falls even more with preeclampsia

11. The nonvisualized stomach with severepolyhydramniosin 24 weeks gestation during

transverse scanning of fetus abdomen may alert to presence of
a. The big fetus of maternal diabetes
b. Early indication of large placenta
c. The suspect of fetus with tracheoesophagealfistula {TEF}
d. The suspect of fetus renal agenesis bilateral
12. The characteristic of early onset type of Preeclampsia can be described as
a. Glucose intolerance of maternal blood
b. Maternal urinary tract infection as the predisposing factor
c. Spiral artery remodeling failure
d. It occurs at 37 weeks of gestation
13. Regarding congenitally toxoplasmosis, all these explanation are right except:
a. It will be most dangerous when transmission vertically from maternal to the
fetusoccurring in the third trimester
b. Prevention step as keeping away from both Toxoplasma gondii ‘s cyst and oocyst
infection look important
c. The majority of clinically affected baby is asymptomatic appearance
d. Acute infection stage becomes determinant on pregnancy
14. Which of the following is not true concerning risk factor in preeclampsia?
a. Autoimmune disease
b. PCO
c. Malignancy
d. Obese
15. Cardiac four chamber view scanning should not include into which of the following?
a. Anterior and to the closer of the spine is the aorta and the right atrium
b. Size of the heart occupies about one third of thorax
c. Ventricular septum at angle of 45 ® to midline
d. Two equal ventricles when you look on analysis of structure

16. When lupus woman becoming pregnant at clinically serving should be done :
a. Her pregnancy is soon planned to terminate as the main measurement
b. History taking may not be helpful to upholding diagnosis of lupus on pregnant among
well educated patient
c. Firstly to determine whether she is in state of flash lupus.
d. The ultrasound examination as the priority to identify the possible congenital fetus.
17. Hepatitis B infection on pregnancy
a. Occurrence of vertical transmission to the fetus predicted to become the threat of late
complication as cirrhosis hepatis and hepatoma
b. Vaccination program is most effective step
c. China’s studies had already just proven in recent years that transmission transplacental
of the virus to fetusbecoming potentially way
d. All description are right
18. Which of the wrong description in fetal brain imaging ultrasound serve?
a. The best scanning time is 18 -24 weeks of pregnancy
b. Trans cerebellar diameter may indicate age of gestation weeks
d. Banana like appearance of cerebellum may think suspect fetus with chromosomal
abnormality
d. Normal posterior horn of lateral ventricle is >20 mm widein assesment

19. Etiopathogenesis of Lupus on pregnant

a. Aautoimmune disease where pregnancy as trigerring factor being flare state
b. Transmitted SSA and SSB autoantibody type leading arrytmia fetal heart rate of 2-4 %
c. Increased estrogen activating maternal T cells directs B cells to produce much more
autoantibody
d. All of the above
20. Here the description is not true about Epigenetic
a. One phenomena of epigenetic is placental methylation at promoter domain of VEGF
(Vascular Endothelial Growth Factor)coding gene in its transcription stage
b. Preeclampsia etiopathogenesis can also be explained now by epigenetic
c. Epigenetic is abnormal Genetic which preceded by abnormal genotype producing
finally abnormal phenotype
d. Foetus’s Intra uterine life may provide epigenetic for some abnormal changing
 3.1A twin pregnancy is identified at 12 weeks' gestation on antenatal ultrasound. One placenta
and one separate amniotic sac are identified. In which ONE of the following scenarios is this is
MOST LIKELY to arise?

a. Ovulation induction

b. ICSI with single embryo transfer

c. Natural conception

d. Family history of multiple pregnancy in sister

e. Maternal age 35-39 years.

Which one of the following pregnancies carries the highest risk of adverse outcome?

a. Singletone pregnancy
b. DCDA twins
c. MCDA twins
d. MCMA twins
e. Dissappearing twins

Which one of the following is true of congenital abnormalities seen in the newborn baby?

a. Deformations are typically due to an insult in the first trimester whereas malformations occur
due to insults in the second or third trimester.
b. Congenital anomaly registers allow researchers to identify clusters of abnormality and may
allow earlier identification of a teratogenic source.
c. Deformities of the skull bones are extremely rare and need urgent neurosurgical referral.
d. An abnormal uterus or breech position does not cause limb abnormalities to occur.
e. Talipes equinovarus responds best to early corrective surgery by an orthopaedic surgeon.
20 random questions for MCQ
Explanation
Question: The following definitions are correct
In a 33 year old woman who presents with pyrexia 3 days after giving birth, the following are
important symptoms indicative of sepsis , EXCEPT:
a. Sorethroats
b. Vomiting
c. Diarrhoea
d. Painful swollen left leg
The following are typical features in a woman with severe pelvic sepsis:
a. Hypercapnia
b. Metabolic acidosis
c. Respiratory acidosis
d. Hypolactataemia

Viral infections in pregnancy: which four of the following is NOT true?

a. Approximately 35% of pregnant women in the UK have previously had a CMV infection.
b. Vertical transmission of CMV occurs in > 1%.
c. Immunity to rubella, once vaccinated/ exposed, is usually lifelong
d. Toxoplasmosis results from a viral infection.
e. Parvovirus can cause fetal anaemia

Which one of the following is NOT a potentially teratogenic infection if contracted in

pregnancy?

a. Cytomegalovirus
b. Rubella
c. Toxoplasmosis
d. Syphillis
e. Herpes simpleks virus

Which of the following is NOT risk factor for vertical transmission of group B streptococcus?

a. Intrapartum fever >38°C

b. Current preterm labour
c. Rupture of membranes >18 hours
d. Previous history
e. Family history of infection

HIV in pregnancy: which of the following are true?

a. Pregnancy hastens the progression of HIV to AIDS.

b. The incidence of pre-eclampsia may be decreased by antiretroviral therapy.
c. Stillbirth and IUGR appear to be more common in HIV-affected individuals.
d. Breast feeding decreases the rate of vertical transmission.
e. Caesarean section is mandatory

1. Histologically, which of the following best describes the villi found at placenta increta sites?
a. Invade into the myometrium
b. Attached to the myometrium
c. Attached to the endometrium
d. Penetrate to the myometrium
e. Invade to the endometrium

2. Management of placenta accreta tipically requires which of the following procedures?

a. Classical cesarean; hysterectomy
b. Low transverse cesarean; hysterectomy
c. Classical cesarean ; myometrial resection
d. Low vertical cesarean; myometrial resection
e. Low transverse cesarean; myometrial resection

3. Which obstetrical conditions can lead to significant consumptive coagulation?

a. Placental abruption ( A sampai D benar / All of above)
b. ITP
c. Hemolytic disease
d. Placenta previa
e. Polyhydramnios

4. One of the most important vital signs with obstetrical hemorrhage is which of the
following?
a. Urine output
b. Oxygen saturation
c. Hematocrit
d. Heart rate
 e. Respiration rate

5. Above which threshold are serum fibrinogen levels considered adequate to promote
coagulation?
a. 50 mg%
b. 150 mg%
c. 250 mg%
d. 300 mg%
e. 400 mg%

6. Acute resuscitation of hypovolemia is preferably done with which of the following?

a. Colloids and ephedrine
b. Crystalloids and ephedrine
c. Crystalloids and packed red blood cells
d. Colloid solutions and packed red blood cells
e. Colloid solutions only

7. With ongoing obstetrical hemorrhage, rapid blood transfusion is typically initiated at which
hematocrit threshold?
a. 20%
b. 25%
c. 30%
d. 35%
e. 40%

8. The ideal treatment of hypovolemia from catastrophic hemorrhage is which of the

following?
a. Whole blood
b. Packed red blood cells
c. Whole blood and platelets
d. Packed red blood cells and plasma
e. Plasma concentrate

9. Morbidity from volume replacement with only packed red blood cells and crystalloid
infusion would be one of the following?
a. Thrombocytosis (All of above, ABCD)
b. Hyperfibrinogenemia
c. Dilutional coagulopathy
 d. Leukoocytosis
e. Hemolytic anemia

10. Each unit of packed red blood cells raise the hematocrit by what amount?
a. 2-3%
b. 3-4%/willims
c. 3-5%
d. 5-6%
e. 6-7%