GYNECOLOGY

1. What percentage of fetal blood passes from the umbilical vein to right atrium through the
ductus venosus?

a. 20%
b. 30%
c. 40%
d. 50%
e. 60%

2. The most common isolated organism in mastitis is:

a. Streptococcus agalactiae
b. Klebsiella
c. Staphylococcus epidermis
d. Streptococcus progenies
e. Staphylococcus aureus

3. Rhesus disease is most communion:

a. Middle East
b. Italy
c. UK
d. Russia
e. United States

4. Fetal indications for cesarean delivery are:

a. Malpresentation (eg. Fixed transverse lie, compound presentation)

b. Feta distress (eg. Presumed fatal jeopardy, non reassuring fatal monitoring)
c. Cerebral aneurysms or arteriovenous malformations connective tissue disorders (eg. Marfans
syndrome, ehlrers-danlos syndrome)
d. Uterine rupture
e. Prior cesarean delivery

5. Is it true about abruptio placentae:

a. Represents the separation of the placenta from the uterine wall> 20th week of gestation
b. May manifest severe haemorrhage depending on the degree of separation
c. Fetal prognosis is good regards the blood loss and gestational age
d. Management involves a good control of the blood loss
e. Vaginal delivery is indicated
6. Human milk contains the following:

a. Vitamin K
b. Antibodies
c. Fatty acids
d. Lactalbumin
e. Immunoglobulin A

7. Regarding cervical intraepithelial dysplasia, the following are false:

a. The term dysplasia refers to the abnormal appearance of the cells when viewed under the
microscope
b. The term dysplasia refers to the normal appearance of the cells when viewed under the
microscope
c. The term dysplasia refers to the abnormal appearance of the cells when viewed
macroscopically
d. Intraepithelial refers to the fact that these cells are present in the lining tissue of the cervix
e. Intraepithelial refers to the fact that this cells are present in the lining tissue of the uterine
fundus

8. Difficult/dangerous forceps application can be seen in:

a. Vertex presentation
b. Engaged presentation
c. Posterior presentation
d. Asynclitism
e. Rupture of amniotic membranes

9. Differential diagnosis of ectopic pregnancy is done with:

a. Adnexal torsion
b. Cholecystitis
c. PID
d. Endometriosis
e. Ovarian cyst

10. Risk factors for fetal compromise in labour are:

a. Multiple pregnancies
b. Maternal age above 35
c. Prolonged labour
d. Augmentation with oxytocin/hyperstimulation
e. Precipitate labour
11. Anesthesiologic evaluation for a Caesarean delivery assesses:

a. Pregnancy related hypertension

b. Chronic medication
c. Congenital cardiac diseases
d. Fetal biophysical profile
e. Fetal weight

12. Pelvic inflammatory disease is caused by all except

a. Mycoplasma
b. Chlamydia
c. Escherichia coli
d. Helicobacter pylori
e. Haemophylus influenza

13. SGA (small for gestational age) means that the weight of the foetus is less than:

a. 10th centile
b. 20th centile
c. 30th centile
d. 40th centile
e. 50th centile

14. Maternal risks in prolonged pregnancy include, except:

a. Infection
b. Haemorrhage
c. Operative delivery
d. Fetal distress
e. Anxiety

15. Dietary therapy for the gestational diabetes consists of approximately

a. 10 kcal/kg/day
b. 30 kcal/kg/day
c. 50 kcal/kg/day
d. 70 kcal/kg/day
e. 100 kcal/kg/day

16. Prevalence of D-Rhesus sensitivity in the caucasian population is:

a. 5%
b. 10%
c. 15%
d. 20%
e. 25%
17. Rhesus system consists of:

a. C, D, E antigens
b. C, D antigens only
c. C, E antigens only
d. A and B antigens only
e. A and D antigens only

18. Hypertension in pregnancy – one or more episodes of high blood pressure is found
approximately in

a. 1 in 10 women
b. 1 in 20 women
c. 1 in 50 women
d. 1 in 100 women
e. 1 in 1000 women

19. Which risk factors for placenta praevia are wrong

a. Smoke cigarettes or use cocaine

b. Have had a c-section before
c. Maternal age of 30 or younger
d. Multiple pregnancies
e. Have had any type of surgery on your uterus

20. Placenta praevia refers to

a. Implantation of placenta over or near the internal ostium of the cervix

b. Premature detachment of the placenta from the uterine wall
c. The umbilical cord vessels have a lower implantation side on the placenta
d. A subchorionic hematoma that forms near the placenta
e. Implantation of the placenta at more than 2 cm from the cervical internal osmium

21. Maternal injuries during a breech presentation delivery include, except

a. Maternal infection
b. Uterine rapture, cervical laceration
c. Extension of episiotomy, deep perineal tears
d. Uterine atony with postpartum haemorrhage
e. Ord prolapse

22. In screening for gestational diabetes to balance sensitivity and specificity with adequate
treatment duration, you should screen women at:

a. 8 weeks
b. 12 weeks
c. 11-14 weeks
d. 24-28 weeks
e. 32 weeks
23. Causes of uterine distension that can cause preterm delivery include, except:

a. Polyhydramnios
b. Cervical insufficiency
c. Multiple gestation
d. Fetal macrosomia
e. In pregnancy

24. For placenta Previa diagnosis, which investigation method is indicated:

a. Colposcopy
b. Transvaginal ultrasound
c. Hysteroscopy
d. Cone biopsy of the cervix
e. Abdominal radiography, with uterine lead uterine protection

25. Incidence of gestational diabetes with two-step screening and Carper-Coustan criteria is:

a. 2%
b. 3%
c. 7%
d. 10%
e. 20%

26. The Manning score of fetal well-being include, except:

a. Cardiography
b. Fetal breathing movements
c. Doppler flow in the umbilical artery
d. Fetal muscle tone
e. Amniotic fluid

27. In ultrasound diagnosis of twin pregnancies, the false statement is:

a. ‘’Lambda sign’’ is characteristic of dichorionic pregnancies

b. ‘’T sign’’ is characteristic in monochorionic pregnancies
c. ‘’Lambda sign’’ is characteristic of monochorionic pregnancies
d. If no membrane is seen in between the foetuses is characteristic for monochorionic mono-
amniotic pregnancy
e. Lambda sign is thickened chorionic tissue between 2 layers of intertwine membrane at the
placental origin

28. The clinical pelvic examination includes, except:

a. Bimanual examination
b. Ultrasound transvaginal examination
c. External examination
d. Speculum examination
e. Rectal examination
29. Contraindications for oxytocin usage include, except:

a. Non-reassuring fetal testing

b. Malpresentation
c. Oblique lie
d. Longitudinal lie
e. Previous uterine scar after myomectomy

30. Maneuvers used in a breech presentation delivery may include, except:

a. Bracht maneuver
b. Mauriceau maneuver
c. Leopold maneuver
d. Loveset maneuver
e. Prague maneuver

31. About cesarean operation is true:

a. Haemostats is achieved by clamping the edges of the histerotomy using Kelly or Kocher
forceps
b. Intravenous oxytocin is administered for uterine contraction further improving homeostasis
c. Closures of muscle fascia is optional
d. The examination of the adnexa is not mandatory
e. If chorioamnionitis was not a clinical diagnosis preoperatively and if the myometrial suture
line is dry, the vesicouterine fold is not routinely reapproximated

32. Signs and symptoms of uterine leiomyomas:

a. Bleeding
b. Nausea
c. Pelvic discomfort
d. Epistaxis
e. Constipation

33. The following are true about breastfeeding and ovulation:

a. Ovulation can occur without bleeding

b. Bleeding can be anovulatory
c. Ovulation is not possible during breastfeeding
d. Contraception is not needed during breastfeeding
e. Resumption of ovulation was frequently marked by return of normal menstrual bleeding
34. Women considered to be at high risk of preeclampsia include women with:

a. Hypertensive disease during previous pregnancy

b. Chronic kidney disease
c. Thyroid disease
d. Autoimmune disease such as systemic lupus erythematosus or antiphospholipid syndrome
e. Type 1 or type 2 diabetes

35. Pregnancies at risk for FGR are

a. Multiple pregnancies
b. History of FGR
c. Heavy smokers
d. Primigravidae
e. Current drug users

36. Cervical polyps:

a. The most common type of cervical cancer

b. Endocervical polyps are the most common type; they usually occur in premenopausal
women. They typically arise from the cervical glands in the endocervix
c. The ectocervical polyps are more common in postmenopausal women and arise from the
outer space layer cells of the cervix within the act ectocervix
d. Most polyps are about 10 to 20 cm long
e. Asymptomatic polyps usually warrant removal

37. Potential contributors for pregnancy-induced hypertension (PIH) are:

a. Endothelial damage
b. Decreased platelet activation and consumption
c. Decreased NO
d. Decreased TXA2 and PGI 2
e. Increased NO

38. Ultrasound features of fetal anaemia are:

a. Polyhydramnios
b. Oligohydramnios
c. Enlarged fetal heart
d. Ascites
e. Pericardial effusion
39. The following are true about malignant ovarian tumours

a. Usually are bilateral-due to multifocal growth or metastasis from the other ovary
b. Epithelial tumor markers are - CA 19-9 and CEA
c. Mucinous tumour markers are - CA 125 and OCAA
d. The clinical symptoms: persistent pelvic/abdominal pain, abdominal distention/bloating,
early satiety, abnormal uterine bleeding, ascites and other effusions
e. Direct spread to para-aortic lymph nodes, lungs and brain

40. The following are true for antibioprophylaxis for cesarean delivery

a. Reduces the risk of endometritis, wound infection etc

b. 30 minutes after the procedure
c. 30 minutes before the procedure
d. Increases the risk of endometritis, wound infection etc
e. Reduces the risk of thromboembolic events

41. Surveillance of foetuses with fetal growth restriction is down using

a. Fetal ultrasound monitoring

b. Fetal cardiotocography
c. Umbilical doppler wave assessment
d. Amniocentesis
e. Routine blood tests

42. Maternal indications for Caesarean delivery are

a. Obstruction of the birth canal by a pelvic mass invasive carcinoma of the cervix
b. Suspected placenta accreta/increta/parcreta
c. Fetal thrombocytopenia
d. Fetal anomalies (eg. Neural tube defect, conjoined twins)
e. Antepartum hemorrhage (eg. Placenta previa, abruptio placentae, vaso previa)

43. Cervical intraepithelial dysplasia

a. The abnormal growth of cells on the surface of the cervix that always lead to cervical cancer
b. Risk factors: HPV infections, early onset sexual activity, multiple sexual partners, history of
sexually transmitted infection, immunosuppression, multiparity, cigarette smoking, using oral
contra
c. CIN 1 refers to the presence of dysplasia confined to the basal and third of the cervical
lining, or epithelium. This is a high grade lesion
d. CIN 3 is considered a high grade lesion. Refers to preconceived changes in the cells
encompassing greater than two-thirds of the cervical lining thickness
e. Is usually seen on a pelvic examination
44. The main indication for the Caesarean delivery is except one

a. Obstruction of the birth canal by a pelvic mass

b. Invasive carcinoma of the cervix
c. Suspected placenta accreta/increta/parcreta
d. Malpresentation
e. Premature rupture of membranes

45. Circumstances under which a trial of VBAC should not be attempted:

a. Previous T-shaped CS, or extensive transfúndalo uterine surgery

b. Previous uterine rupture
c. One prior uterine scars & no vaginal delivery
d. Medial or obstetric complications that precludes vaginal delivery
e. Lack of anaesthesia, facility or personnel for an emergency CD

46. Additional risk factors for cervical intraepithelial dysplasia are:

a. Early ones sexual activity

b. Late onset sexual activity
c. Smoking cigarettes
d. Giving birth to many children
e. Giving birth to a single child

47. Internal podalic presentation - maternal complications:

a. Shock
b. Premature separation of the placenta
c. Uterine rupture
d. Cervical lacerations
e. Gestational hypertension

48. Placental functions are:

a. respiratory, nutritive and excretory function

b. endocrine and enzymatic function
c. barrier function
d. immunological function
e. nonimmunological function

49. Risk factors for polyhydramnios are:

a. fetal anomalies
b. skeletal malformations
c. race (white people have a higher risk)
d. obstruction of the gastro-intestinal tract
e. caesarean section
50. Fetal heart rate:

a. can be evaluated with a fetal stethoscope

b. can be detected using ultrasound technique at approx. 4 weeks of gestation
c. normal frequency is below 120 beats per min
d. failure in detection of the fetal heart rate may be due to the presence of oligoamnios
e. failure in detection of the fetal heart rate may be due to intrauterine fetal death

51. Every prenatal consultation monitors:

a. blood pressure
b. weight
c. fetal heart beats
d. evaluates the perception of fetal movements (for the second and third trimester)
e. height

52. Oligohydramnios:

a. is defined as amniotic fluid is less than 800 ml at term

b. is defined as amniotic fluid is less than 200 ml at term
c. renal agenesis or obstruction of the urinary is a cause
d. is defined as amniotic fluid index (AFI) is < 5 cm
e. is defined as amniotic fluid index (AFI) is < 10 cm

53. In the third trimester the fetal heart rate can be detected:

a. close to the median line in the cephalic presentations

b. lateral to the median line in transversal presentations
c. flanked in posterior occipital presentations
d. above the umbilical scar in the transversal presentation
e. above the umbilical scar in the pelvic presentation

54. Presumptive (possible) signs of pregnancy:

a. amenorrhea
b. neurovegetative disorders – nausea, vomiting, insomnia, psychiatric lability, sialorrhoea,
fatigue
c. decreased bone density
d. breast changes: hyperpigmentation of mammary areoles, the appearance of Montgomery
tubers, the appearance of colostrum
e. pigmentation of the skin: increased face pigmentation named chloasma
55. Risk factors for placental abruption include:

a. pre-eclampsia
b. chronic hypertension
c. long umbilical cord
d. prolonged rupture of membranes (>24 hours)
e. gonorrhea

56. Signs and symptoms of ectopic pregnancy include:

a. increased hCG
b. sudden lower abdominal pain
c. diarrhea
d. an adnexal mass
e. vaginal bleeding

57. The following affirmations about the placenta Praevia are true:

a. ultrasound can be used for diagnosis

b. multiparity is a risk factor
c. pelvic examination is permitted
d. blood transfusion may be required
e. caesarean section is indicated

58. The umbilical cord:

a. is a connecting link between fetus and the chorionic/amniotic membranes

b. has a spiral disposition
c. is approximately 100 cm in length at term
d. has two umbilical veins and one umbilical artery
e. is surrounded by Wharton jelly

59. Which of the following are classified as barrier contraception:

a. progestin implants
b. male condoms
c. contraceptive patch
d. intravaginal devices – diaphragm, cervical cap, female condom
e. spermicides (foam, cream, suppositories)

60. Non stress test:

a. it is used to evaluate the fetal heart rate

b. variability and acceleration appears abnormally in response to fetal activity
c. suspicion of intrauterine growth restriction is an indication
d. can be performed on any pregnant woman regardless of gestational age
e. is a non-invasive test
61. Hyperemesis gravidarum:

a. etiopathogenesis is likely multifactorial

b. antiemetics are the only treatment accepted
c. sometimes, it is severe and unresponsive to simple dietary modification and antiemetics
d. is characterized by severe nausea, vomiting, weight loss, and possibly dehydration
e. diagnosis is usually made based on the observed signs and symptoms

62. Signs and symptoms of placenta praevia are:

a. bright red vaginal bleeding

b. bleeding before delivery
c. headache
d. occurs around 32 weeks of gestation
e. varicose veins

63. Abruptio placentae:

a. the majority of placental abruptions occur before 37 weeks gestation

b. is the only cause of vaginal bleeding in the later part of pregnancy
c. there may be risk factors such as pre-eclampsia, chronic hypertension
d. is suspected when a pregnant mother has sudden localized abdominal pain with bleeding
e. sometimes, emergency hysterectomy may become necessary

64. Ectopic pregnancy:

a. 97% are located in a fallopian tube

b. the most common complication is rupture with internal bleeding
c. transvaginal ultrasonography has a great sensitivity
d. measuring beta-human chorionic gonadotropin (beta-hCG) levels may aid in the diagnosis
e. laparoscopy or laparotomy is the only way to confirm an ectopic pregnancy

65. Preeclampsia:

a. the etiologic agent is known

b. can affect virtually every organ system
c. there is no risk to the mother
d. the diagnosis may be suspected also in the presence of hypertension
e. patients may receive intravenous magnesium sulfate
66. Gestational diabetes:

a. is an uncommon problem
b. it involves maternal and fetal risks: birth trauma, shoulder dystocia, macrosomia
c. screening should be performed between weeks 24 and 28 of gestation
d. macrosomia is a rare complication
e. children from diabetic mothers may have an increased risk for obesity/diabetes in childhood/
adolescence

67. Terminology:

a. gravida – number of pregnancies

b. primigravida – pregnant for third time
c. multiparous – has had one or more deliveries that were carried to viability
d. nulligesta – never have been pregnant before
e. nulliparous – never carried a pregnancy to viability

68. Regarding ectropion treatment the following are false:

a. treatment is always recommended

b. medical treatment is represented by boric acid vaginal suppositories
c. medical treatment is represented by estrogen vaginal suppositories
d. hysterectomy is the elective treatment
e. cryotherapy and electrotherapy are ablative maneuvers which can be used

69. Edocervical polyps:

a. can be asymptomatic
b. abnormal vaginal bleeding can occur
c. hysterectomy is the elective treatment
d. they never require anatomopatholgical examination because they are always benign
e. they are frequent in young women 10-20 years old

70. Uterine leiomyomas are classified as:

a. submucous
b. intramural
c. fallopian leiomyomas
d. ovarian leiomyomas
e. subserous

71. Mayer-rokitansky-kuster-hauser syndrome is represented by:

a. absence of the uterus

b. unicorn uterus
c. absence of the vagina
d. septate uterus
e. bicorn uterus
72. Uterine malformations can be diagnosed using:

a. cardiotocography
b. MRI
c. hysterosalpingography
d. Rx scan
e. ultrasound scans

73. Adenomyosis:

a. represents the presence of endometrial tissue in the ovaries

b. represents the presence of endometrial tissue in the fallopian tubes
c. represents the presence of endometrial tissue in the uterine wall
d. thickened and spongy appearing of the myometrium is typical for adenomyosis
e. thickened and spongy appearing of the myosalpinx is typical for adenomyosis

74. Endometriosis:

a. is never associated with infertility

b. can cause dysmenorrhea
c. represents the presence of endometrial tissue outside the uterus
d. endometriosis is always treated surgically
e. CT can be used to diagnose the intestinal endometriosis

75. Oral contraception:

a. can contain both estrogen and progestogen

b. are 100% effective
c. the primary mechanism is inhibition of ovulation by suppressing spermatogenesis
d. they decrease the risk of endometrial and ovarian cancer
e. no side effects were discovered in women who have taken oral contraception

76. The lipid triad in the menopausal metabolic syndrome consists of:

a. hypertriglyceridemia
b. increased LDL cholesterol
c. decreased LDL cholesterol
d. decreased HDL cholesterol
e. increased HDL cholesterol

77. Cervical dysplasia removal procedures are represented by:

a. loop electrosurgical excision procedure

b. cryocautery
c. hysterectomy
d. conization
e. large loop excision of the transformation zone
78. Which affirmation regarding contraception is true:

a. they prevent from pregnancy

b. contraceptive are 100% effective
c. there are no side-effects during administration
d. combined oral contraceptives contain both estrogen and progestogen
e. the primary mechanism of oral contraceptive is inhibition of ovulation

79. Health benefits of oral contraception administration are:

a. reduced menstrual blood loss and anemia

b. decreased bone density
c. improved dysmenorrhea from endometriosis
d. reduction in various benign breast diseases
e. improvement of acne

80. Side effects of oral contraception administration are:

a. thrombosis and embolism

b. stroke
c. weight loss
d. hypertension
e. myocardial infarction

81. Patient selection criteria for IVF (in vitro fertilization) are:

a. tubal factor infertility

b. reduced fertility with advancing maternal age
c. women with diminished ovarian reserve
d. endometriosis
e. patient with unexplained infertility

82. Indications of fetal non-stress test are:

a. suspicion of intrauterine growth restriction

b. preeclampsia
c. maternal diabetes
d. pregnancy over 41 weeks of gestation
e. maternal history of intrauterine fetal death

83. The following affirmations about the placenta Praevia are true:

a. multiparity is a risk factor

b. ultrasound can be used for diagnosis
c. pelvic examination is permitted
d. blood transfusion may be required
e. caesarean section is not indicated
84. Ectopic pregnancy:

a. is defined as implantation of pregnancy outside the uterine cavity usually in fallopian tubes,
ovaries, cervix, abdominal cavity
b. gonorrhea is not a risk factor for ectopic pregnancy
c. can be a leading cause of maternal death
d. weak pulse and maternal shock can be part of the symptomatology
e. methotrexate can be an alternative treatment if there is a rupture of the tube

85. HELLP syndrome:

a. it may cause disseminated intravascular coagulation

b. hemolysis leads to jaundice, weakness
c. target organ is the heart
d. vasospasms cause vasoconstriction leading to reduction of the blood flow in the uterus/other
organs
e. anemia is not a common symptom

86. Cervical intraepithelial neoplasia (CIN):

a. is classified as CIN I (HSIL, high-risk squamous intraepithelial lesion) and CIN II, III,
(LSIL, low-risk squamous intraepithelial lesion)
b. is one of the leading causes of cancer deaths in women
c. HPV is a risk factor
d. precancerous lesions may exist for 20 years before invasive carcinoma develops
e. in CIN I two thirds of the epithelium show nuclear changes and mitotic activity

87. The following affirmations regarding leiomyoma are true:

a. is a benign uterine tumor

b. the incidence is much higher in white women
c. positive family history is a risk factor
d. the tumor is not well circumscribed
e. the development is uncommon in patients after 20 years of age

88. Uterine agenesis:

a. is an extreme mullerian duct anomaly

b. clinical presentation is characterized by primary amenorrhea
c. normal hormonal levels and fully functional gonads are present
d. there is complete absence of uterine tissue above the vagina
e. associations include renal tract anomalies (renal agenesis) and vertebral anomalies
89. Effects of fibroids on pregnancy are:

a. distortion of uterine cavity

b. affection of the decidual development
c. retention of urine
d. constipation
e. non-engagement of presenting part

90. Clinical presentation of fetal hemolytic anemia include:

a. ascites
b. pleural effusion
c. pericardial effusion
d. hepatosplenomegaly
e. hydrops fetalis

91. Causes for intrauterine growth restriction (IUGR) are:

a. assisted reproductive technology

b. low socioeconomic status
c. placental hyperfunction
d. preeclampsia
e. placental infection

92. Perineal care during puerperium requires:

a. cleaning of the vulva from posterior to anterior

b. an ice bag applied to the perineum which may help reduce edema
c. tub bathing after uncomplicated delivery is not allowed
d. careful inspection and palpation if a severe discomfort is present
e. beginning at approximately 24 hours after delivery

93. Postpartum uterine infection:

a. involves the decidua

b. involves the myometrium
c. involves the parametrial tissues
d. it is very common after vaginal delivery
e. manual removal of the placenta decreases the puerperal uterine infection rate

94. Complication of the pelvic infections are:

a. peritonitis
b. wound dehiscence
c. necrotizing fasciitis
d. parametrial phlegmon
e. adnexal infections
95. Pelvic inflammatory disease:

a. represents the inflammation of the upper genital tract characterized primarily by salpingitis
b. may extend along the paracolic gutters to the liver
c. may coexist with oophoritis
d. the infection usually starts as an asymptomatic cervicitis
e. decrease the risk of ectopic pregnancy

96. Tubal sterilization may be can be approached via:

a. colposcopy
b. laparotomy
c. laparoscopy
d. colpotomy
e. hysteroscopy

97. Risk factors for ovarian cancer are:

a. age (less than 25 years old)

b. family history
c. peutz-jeghers syndrome
d. fits-hugh curtis syndrome
e. lynch syndrome

98. The following conditions represents causes and contributing factors for pelvic genital static
disorders, but not:

a. race (white people have a higher risk)

b. anatomy (congenitally long vagina)
c. successive vaginal deliveries
d. small fetuses
e. trauma

99. In case of pelvic genital static disorders, the clinical examination can be diagnostic for:

a. bulging of the posterior vaginal wall in case of cystocele

b. bulging of the anterior and lower 1/3 of vagina in case of cystourethrocele
c. bulging of the posterior vaginal wall in case of rectocele and enterocele
d. rectal prolapse
e. urinary incontinence

100. Which of the following affirmations regarding breast biopsy are true:

a. it should be performed before an imaging test

b. includes fine-needle aspiration biopsy
c. includes core-needle biopsy
d. resulting tissue trauma can produce image artifacts
e. needle biopsy of solid masses is generally not preferred prior to excision
101. Phyllodes tumors:

a. histologically are similar to fibroadenomas

b. are classified as benign
c. are classified as intermediate
d. are classified as malignant
e. treatment consists in wide local excision with a minimum 1 cm margin

102. Spermatogenesis:

a. describes the production of spermatozoa (sperm) in the seminiferous tubules of the testes
b. first, the germline epithelium of the seminiferous tubules divides by mitosis in 2
spermatocytes
c. the process begins at puberty
d. spermatogonia cells undertake a process of differentiation in order to become functional
sperm cells
e. spermatocytes undergo two meiotic divisions to form 4 haploid daughter cells

103. Risk factors for premature birth are:

a. multiple pregnancy
b. pathology of uterus
c. good nutrition status
d. multiple miscarriages
e. an interval of less than six months between pregnancies

104. Maternal complications of prolonged pregnancies are:

a. fourth-degree perineal lesions

b. postpartum hemorrhages
c. meconium staining in utero
d. oligohydramnios
e. increased perinatal mortality

105. Possible signs of pregnancy are:

a. presence of hCG in urine

b. uterine growth
c. early breast changes
d. morning sickness
e. bladder irritability
106. Gestational diabetes involves maternal and fetal risks such as:

a. macrosomia
b. intrauterine fetal death
c. birth trauma
d. polyhydramnios
e. shoulder dystocia

107. For prolonged pregnancies- what are the ways to induce delivery:

a. amniocentesis
b. stripping (also called sweeping) the membranes
c. oxytocin administration
d. prostaglandins
e. mounting an intracervical Foley catheter

108. Fibroadenomas:

a. involute spontaneously in premenopausal women

b. often present in adolescence and menopause women
c. a shrinking fibroadenoma should be excised
d. large fibroadenomas are often indistinguishable from benign phylloides tumors by imaging
and needle biopsy
e. fibroadenomas are comprised of glandular and cystic epithelial structures, with malignant
characteristics

109. Indications for performing hysteroscopy:

a. normal menstruation
b. postcoital bleeding
c. normal pelvic ultrasound findings
d. previous term pregnancy
e. cesarean section history

110. ASC-US refers to:

a. this abbreviation stands for atypical squamous cells of undetermined significance

b. this abbreviation stands for low grade squamous intraepithelial lesion
c. this abbreviation stands for high grade squamous intraepithelial lesion
d. this abbreviation stands negative for intraepithelial or malignancy
e. this abbreviation stands for atypical sarcomatous cells of undetermined significance
111. Which of the next statements are not true about the amniotic fluid:

a. the quantity can be approached by ultrasound

b. amniotic fluid index is defined as the amount of fluid in the four quadrants of amniotic
cavity
c. a disadvantage is that it does not act as a shock absorber to protect the fetus from external
injury
d. maintains the fetal temperature
e. allows free fetal movements

112. Is true about Couvelaire's uterus, except:

a. also called as utero-placental apoplexy

b. first described by couvelaire in 1900
c. demonstrated al laparotomy
d. extravasation of blood into uterine musculature and beneath uterine serosa
e. is not a life-threatening condition

113. About uterine sarcomas is true, except:

a. relative rare tumors, mesodermal origin – 2-6% of uterine neoplasia

b. incidence rises after pelvic radiotherapy for cervical cancer treatment
c. this is the most aggressive type of uterine neoplasia
d. stage I and II – hysterectomy with bilateral anexectomy and lymph node removal
e. stage IV – hysterectomy with bilateral anexectomy and lymph node removal

114. The ultrasound evaluation at 18-22 weeks of gestation include, except:

a. fetal biometry
b. detection of major fetal abnormalities
c. measurements of cervical length
d. placenta location
e. fetal presentation

115. It is true about infertility, except:

a. infertility is defined as 12-18 months of unprotected intercourse without conception

b. the first step in the evaluation of infertility is a thorough medical history and physical
examination
c. risk factors for tubal factor infertility – pelvic inflammatory disease, history of sexually
transmitted diseases
d. uterine factors: uterine leiomyoma, polyp, adhesions, adeniomyosis, malformations
e. sperm abnormalities account for only 5% to 10% of infertility
116. Pelvic inflammatory disease may cause :

a. Salpingitis
b. Peritonitis
c. Parametrises
d. Endometritis
e. All of the above

117. Ultrasonography is useful in a twin pregnancy for:

a. Chorionicity, mostly in the third trimester

b. Fetal malformations, in the first 10 weeks of gestation
c. Cervical length, at term
d. Differential diagnosis with cervical cancer
e. Twin to twin transfusion syndrome assessment

118. Regarding the closure of the muscle fascia, the following is true:

a. It is optional
b. It is most important
c. It is performed before fetal extraction to minimise blood loss
d. It is performed before placental extraction to minimise blood loss
e. It is performed after skin suture to minimise the risk for an eventuation

119. Avantages of prostaglandins include, except:

a. Increase successful vaginal delivery within 24 hours

b. Decrease incidence of c-section
c. Reduce epidural usage
d. Nausea and vomiting
e. Usage for induction of labor in prolonged pregnancy

120. Preeclampsia is defined as:

a. Hypertension of at least 140/90 mmHg recorded on at least two separate occasions and at
least 4 hours apart
b. The presence of at least 300 mg protein in a 24-hour collection of urine
c. Arising de novo after the 20th week of pregnancy in a previously normotensive woman
d. Resolves completely by the sixth postpartum week
e. All of the above
121. About gestational diabetes is true, except:

a. Is defined as carbohydrate intolerance of variable severity first recognised during the present
pregnancy
b. This pathology does not have complications in neonatal period
c. Diagnosis is established using one hour 50mg glucose screening test of 3-hour GTT
d. Complications: preeclampsia, fetal macrosomia, intrauterine growth restriction, stillbirth
(IUFD)
e. During pregnancy the goals are to prevent macrosomia, fetal death

122. The technique for an episiotomy includes:

a. After perineal anaesthesia, an expulsive effort is expected and when the perineum is
stretched the scissors are inserted between the branches
b. The direction of the scissors is vertical or oblique towards the anus
c. The other hand protects the presentation
d. Section 10-12 cm
e. After expulsion of the foetus and placenta, the softs parts are checked

123. The following are contraindications for transvaginal ultrasound examination

a. Virgo patient
b. Vaginism
c. Cervical cancer
d. Ovarian cancer
e. Pediatric patient

124. The conditions for an instrumental delivery are:

a. Vertex presentation
b. Empty bladder
c. Rupture of the amniotic membranes
d. Breech presentation
e. Engaged presentation

125. Complications of transverse presentation:

a. Cord or hand prolapse

b. Preeclampsia
c. Birth trauma
d. Difficult intraoperative delivery
e. Polyhydramnios
126. The following are false regarding thromboprophylaxis for cesarean delivery

a. Reduces the risk of thromboembolic events

b. Increases the risk of thromboembolic events
c. Reduces the risk of endometritis, wound infection etc
d. Increases the risk of endometritis, wound infection etc
e. It can be performed with the aid of compressive socks, hydration or low molecular weight
heparin

127. Complications of the fourth stage of labor include:

a. Postpartum haemorrhage
b. Retained placenta
c. Uterine inversion
d. Fetal cephalhematoma
e. Placenta accretta

128. The types of cervical biopsy are:

a. Punch biopsy with dedicated forceps

b. Loop electrosurgical excision procedure
c. Cone biopsy
d. Hysterectomy
e. Endometrial curettage biopsy

129. Preoperative for c-section evaluation includes:

a. Complete blood count

b. Blood type & RH
c. Coagulation
d. EEG
e. Pulmonary radiography

130. Types of cephalic presentation are:

a. Vertex presentation
b. Breech presentation
c. Brow presentation
d. Face presentation
e. Forehead presentation
131. Placenta praaevia management:

a. Emergency Caesarean delivery: if maternal pr fetal jeopardy is president after stabilisation

of the mother
b. Vaginal delivery: this may be attempted if the lower placental edge is <2 cm from the
internal cervical osmium
c. Scheduled Caesarean delivery: if the mother has been stable after fetal lung maturity has
been confirmed by amniocentesis, usually at 24 weeks of gestation
d. Schedule Caesarean delivery: is the mother has been stable after fetal lung maturity has been
confirmed by amniocentesis, usually at 36 weeks of gestation
e. Emergency Caesarean delivery if the mother and the fetus are stable

132. The double test

a. It's done in the second trimester

b. Includes the evaluation of the fetal nasal bone
c. Includes fetal blood test of estriol and PAPP-A
d. Generates the risk for Patau, Edwards and Down’s syndromes
e. Includes maternal blood test of PAPP-A and free BHCG

133. Ultrasound can be used for:

a. Evaluation of fetal well-being

b. Evaluation of the Bishop score
c. Examination of the vagina discharge
d. Estimation of fetal weight
e. Evaluation of fetal presentation

134. Complications of PID include:

a. Hydroslpinx
b. Tubal abscess
c. Tubo-ovarian abscess
d. Fitz-Hugh-Curtis syndrome (perihepatitis)
e. Fitz-Hugh-Curtis syndrome (endometritis)

135. Pelvic inflammatory disease:

a. It's caused by sexually transmitted organism such as N. gonorrhoea and C.trachomatis

b. Symptoms: lower abdominal and pelvic pain, and use a vagina discharge that may have a
foul order, painful sexual intercourse, irregular menstrual bleeding, pain during a pelvic exam
c. Culdocentesis may be very helpful in diagnosis of suspected pelvic infection
d. Laparoscopy usually does not provide any information about PID
e. PID cannot be cured with antibiotics only
136. The following affirmations about dermoid cyst are true:

a. Represent 70 - 80% of overall tumours

b. Ovarian cystectomy is never possible; a total adnexectomy is recommended because of the
high risk of malignant transformation
c. May contain teeth, bone, cartilage bone nerves, hair
d. Almost always benign
e. Malignant change accuse in 1 - 3%

137. Monitoring fetal complications of preeclampsia can be done by:

a. Ultrasound assessment of fetal size

b. Ultrasound assessment of amniotic fluid
c. Ultrasound assessment of fetal Dopplers
d. Ultrasound assessment of the maternal renal arteries
e. Antenatal CTG

138. About cervical cancer is true:

a. Asymptomatic in early stages, usually diagnosed with an abnormal Babes-Papanicolaou test

b. Signs and symptoms: abnormal vaginal bleeding, vaginal discomfort, malodorous discharge,
dysuria
c. The most common symptom is dyspareunia
d. Estrogen use is the most important risk factor
e. HPV infection is the most important risk factor

139. What are the risk factors for ovarian tumours:

a. Nulliparity
b. Late menopause
c. Hysterectomy
d. Oral contraceptive usage
e. Endometriosis

140. Endometriosis represents:

a. Presence of endometrial glands or stroma in abnormal locations outside the uterus

b. The main method of diagnosis when talking about endometriosis is by transvaginal
ultrasound
c. Adenomyosis - the endometrium grows into the adjacent myometrium
d. Is always symptomatic
e. No symptoms are a chronic pelvic pain dysmenorrhoea, infertility, dyspareunia
141. The main types of fetal lie include:

a. Vertex
b. Breech
c. Longitudinal
d. Oblique
e. Transverse

142. Differential diagnosis of malignant ovarian tumours is done with:

a. Benign ovarian tumour or cyst

b. Inflammatory lymphadenopathy
c. Menstruation
d. Bowel mass or primary peritoneal carcinoma
e. Secondary carcinoma: breast, gastrointestinal tract, lymphomas and pelvic organ tumours

143. The following affirmations are true:

a. Mastitis is almost invariably bilateral

b. Women diagnosed with mastitis develop frequently an abscess
c. Symptoms of mastitis include chills or actual rigor followed by fever and tachycardia
d. The breast becomes hard and there is severe pain
e. Mastitis can develop up to a third of breastfeeding women

144. Conditions for trial of VBAC include:

a. ONE previous low-transverse CS

b. TWO previous low-transverse CS
c. The availability of a 24-hour blood bank
d. Intermittent electronic fetal heart rate monitoring
e. A physician capable of performing a cesarean delivery

145. Management of gestational diabetes – following statements are true:

a. Exercising three times a week for 20 to 45 minutes is beneficial for women with GDM and
those at risk for GDM
b. Diet or exercise for both, during pregnancy can reduce the risk of excessive gestational
weight gain and decreases maternal hypertension
c. Diet or exercise, combined, during pregnancy have been shown to decrease neonatal
respiratory morbidity
d. Diet or exercise during pregnancy have not been shown to decrease neonatal respiratory
morbidity
e. With the glucometer, fasting and two-hour (or one-hour) post-prandial glucose levels should
be followed daily
146. About vaginal cancer is true

a. Vagina cancer is a rare type of cancer most common in women of 30 and younger
b. Invasive vagina cancer is treated mainly with radiation therapy and surgery
c. HPV infection is not a risk factor
d. Usually, affect women 60 and older
e. It can be transmitted during sexual intercourse

147. Risk factors for superimposed preeclampsia in patients with pre-existing hypertension:

a. Renal disease
b. Maternal age < 20 years
c. Pre-existing diabetes
d. Prepregnancy BMI < 35
e. Antiphospholipid syndrome

148. Adnexal conditions, detectable by US

a. Cysts
b. Solid tumours
c. Hyperstimulation syndrome
d. Ovarian torsion
e. Uterine fibromas

149. Granulosa cell tumor produces estrogens, which can cause:

a. Late puberty
b. Irregular bleeding
c. Post-menopausal bleeding
d. Endometrial hyperplasia
e. Cervical cancer

150. Congenital infections that cause placentomegaly include:

a. Rubella
b. Toxoplasmosis
c. Parvovirus
d. Syphilis
e. Hepatitis B

151. Imminent eclampsia:

a. Blood pressure lower than 160/110 mmHg

b. Hyperreflexia
c. Severe continuous headache
d. Blurring of vision
e. Epigastric pain
152. The following signs are associated with PID:

a. Lower abdominal tenderness

b. Adnexal tenderness on bimanual vaginal examination
c. Cervical motion tenderness on bimanual vaginal examination
d. Fever (>38 C)
e. Left upper quadrant abdominal tenderness

153. Etiology of breech presentation:

a. Previous cesarean delivery

b. Uterine anomalies
c. Placenta praaevia
d. Single foetus
e. Polyhydramnios

154. The definitions are true:

a. Low-birth-weight refers to neonates less than 2500 g

b. Very low birthweight refers to go is less than 1500 g
c. Extremely low birthweight refers to those less than 1000 g
d. Very low birthweight first of those less than 1000 g
e. Extremely low birthweight refers to those less than 1500 g

155. The general contraindications for an instrument delivery are:

a. Unknown presentation
b. Cephalo-pelvic disproportion
c. Frontal presentation
d. Empty bladder
e. Vertex presentation

156. Is true about biophysical score:

a. All biophysical parameters involve the clinical evaluation of the cervix

b. If the parameter is fulfilled, a score of 2 points will be assigned
c. If there is an abnormal Parameter, the score of 0 points will be assigned
d. Total score between 8 to 10 is considered normal, 6 is equivocal and 4 or less is an abnormal
score
e. It is the score used to predict the likelihood of a woman entering labour naturally in the near
future
157. Select the correct affirmations about you uterine rapture:

a. Most cases of uterine rupture occur at the side of a prior vagina delivery
b. With complete rupture and fetal expulsion into the abdomen, fetal mortality is 10 to 15%
c. Partial rupture/uterine dehiscence - if the peritoneum remained intact
d. Cesarean delivery is imperative to ensure neonatal survival and decrease maternal morbidity
e. Most cases of uterine rupture occur at the site of a prior Caesarean delivery

158. Fetal growth restriction can lead to:

a. Asphyxia in labour
b. Haematological changes in the fetus
c. Respiratory acidemia
d. Metabolic acidemia
e. Larger birth weight

159. Monoamniotic twins have the highest perinatal morbidity and mortality. The causes of
multiple, with one exception:

a. The presence of ‘’T sing’’ on ultrasound examination

b. Cord entanglement
c. Congenital anomaly (genetics)
d. Preterm birth
e. Twin to twin transfusion syndrome

160. Differential diagnosis of increase your uterine fundal height is done with the following, except:

a. Full bladder
b. Cervical cancer with pregnancy
c. Macrosomia
d. Fibroid with pregnancy
e. Molar pregnancy

161. The pathology of the fetal adnexa includes, except:

a. Placental anomalies
b. Anomalies of the umbilical cord
c. Amniotic membrane abnormalities
d. Amniotic fluid anomalies
e. Cystic hygroma
162. The mechanism of birth in breech presentation include, except:

a. The denominator is the vertex

b. The denominator is the sacrum
c. The engagement diameter of the pelvis is the bitrochanteric diameter (10 cm)
d. The engagement diameter of the pelvis is the bitrochanteric diameter (11 cm)
e. The engagement diameter of the head is the suboccipitobregmatic

163. The partogram includes information about, except:

a. Labor progress
b. Cervical dilation
c. Fetal heart rate
d. Fetal weight
e. Blood pressure of the mother

164. The treatment options in ectopic pregnancy are:

a. Surgery is the only option

b. Medical (with methotrexate) and surgical
c. Hysterectomy is the most used surgical option
d. Surgical: salpingostomy, salpingectomy, oophorectomy
e. Curettage

165. Obstetrical conditions for ventouse delivery:

a. Complete dilatation
b. Vertex presentation
c. Rupture of the amniotic membranes
d. The position of the fetal skull in relation to the maternal pelvis: orientation, degree of
flexion and asinclitism
e. Full bladder

166. Complications of eclampsia are:

a. Maternal abruption 7% - 10%

b. HELLP 60% - 70%
c. HELLP 10% - 15%
d. Pulmonary edema 3% - 5%
e. Renal failure 5% - 9%

167. Etiology of malpresentation:

a. Contacted/small pelvis
b. Small baby
c. Polyhydramnios
d. Abrtuptio placenta
e. Low lying placenta
168. Gestational diabetes - following statements are true:

a. When hyperglycaemia is first recognised in pregnancy

b. If hyperglycaemia is detected before 20 weeks, pregestational diabetes is probably present
c. If hyperglycaemia is detected after 20 weeks, pregestational diabetes is probably present
d. The importance of screening for gestational diabetes and treatment to optimise glycaemic
control to reduce hyperglycaemia – associated complications has been established
e. Screening for gestational diabetes is done 24 - 28 weeks

169. Prognosis of foetuses with fetal growth restriction – following statements are true:

a. Highly dependent upon the cause

b. Of babies with FGR secondary to uteroplacental insufficiency, someone will suffer
morbidity or mortality as a result of prematurity
c. A link between FGR and the adult onset of hypertension and diabetes has been established
d. Most infant demonstrate ‘’catch up growth’’ after delivery when feeding is established
e. Is independent of birth weight

170. Regarding the chromosomal anomaly assessment, the following are false:

a. The first-trimester screening should include NT (nuchal translucency) measurement

b. The second-trimester screening should include NT (nuchal translucency) measurement
c. The third-trimester screening should include NT (nuchal translucency) measurement
d. Its performance is improved by the addition of three beta or total human chorionic
gonadotropin
e. Its performance is improved by the addition of glucose oral tolerance test

171. Maternal indications for an episiotomy:

a. Multiparty
b. Vulvo-vaginal hypoplasia
c. Obstetrical manoeuvres (ex.forceps)
d. Gestational hypertension
e. Associated diseases - heart disease, TB

172. The fetal heart rate:

a. Normal frequency is between 100 to 180 beats per minute

b. Failure in detection of the fetal heart rate may be due to the presence of polyhydramnios
c. It can be detected using ultrasound techniques at approximately 6 to 7 weeks of gestation
d. It can be evaluated with a fetal stethoscope in the first trimester
e. In the third trimester the fetal heart rate can be detected above the umbilical scar in the
pelvic presentation
173. Methods for induction of labour:

a. Amniotomy
b. Calcium-blocants
c. Magnesium sulphate
d. Oxytocin
e. Prostaglandins

174. The 3 principles for an instrumental delivery are:

a. High-experienced doctor
b. Correct indication
c. Vertex presentation
d. Correct instrument
e. The delivery of a healthy fetus with minimal maternal consequences

175. Treatment for hypertension in pregnancy uses:

a. Methyldopa
b. Labetalol
c. Nifedipine
d. Intrauterine transfusion
e. Insulin

176. Differential diagnosis of PID is done with:

a. Acute cholecystitis
b. Ectopic pregnancy
c. Endometrial cancer
d. Diverticulitis
e. Torsion of an adnexal mass

177. Certain factors are related with the post-maturity:

a. Inaccurate dating – according to the last day of menstruation (most common cause)
b. Biological variability hormonal factors and genetic predisposition
c. Maternal factors: primiparity, previous prolonged pregnancy, sedentary habit, elderly
multiparae, maternal obesity
d. Fetal factors: congenital anomalies: anencephaly, abnormal fetal HPA (hypothalamic-
pituitary-adrenal) axis and adrenal hyperplasia diminished fetal cortisol response
e. Female foetuses

178. Hospital admission in cases of PID is full

a. Diagnostic uncertainty
b. Failure of oral therapy
c. Presence of a tube ovarian abscess
d. All cases of PID
e. PID in pregnancy
179. About ectopic tubal pregnancy is true:

a. Lead to tubal rupture massive intra-abdominal haemorrhage - > death

b. Transvaginal ultrasound – rules out the presence of an intrauterine pregnancy
c. Usually has higher HCG levels that are not detected in the urine test
d. Causes: loss of fimbria, lumen and ciliated mucosa integrity, pelvic inflammatory disease,
tubal surgery, cigarette smoking
e. Usually occurred in women with multiple sexual partners

180. It is true about HPV:

a. Is the most common sexually transmitted infection

b. Doesn’t cause symptoms, and many people with the virus don’t know they have it
c. Less than 10% of all new HPV infections become undetectable within two years
d. Some HPV infections can stay in the body and lead to complications, including genital warts
and cervical cancer
e. Only 2 types - 70 and 72 cause the majority of HPV - related cancers

181. Is false about amniocentesis:

a. Is a non-invasive procedure
b. Is the first trimester screening test
c. Is the procedure where amniotic fluid is extracted from the uterine cavity
d. Chromosomal evaluation cannot be done using this procedure
e. Determination of fetal maturity can be established using this procedure

182. Hypertension in pregnancy that the following statements are true:

a. Approximately one and 10 women will have one or more episodes of raised blood pressure
prior to delivery
b. The majority have a benign condition called gestational hypertension, which is not
associated with adverse outcomes. However, about one-third of these women (3% overall) will
develop pre-eclampsia
c. Pre-eclampsia is a leading cause of maternal death
d. Pre-eclampsia is frequently accompanied by fetal growth restriction which is responsible for
considerable perinatal morbidity and mortality
e. Approximately one and 20 women will have one or more episodes of raised blood pressure
prior to delivery

183. About the first prenatal consultation is true:

a. Should be scheduled as soon as the pregnancy diagnosis was formulated early in the first-
trimester
b. It does not involve the recommendation of blood tests
c. It should assess the mother's health and the risk factors
d. It helps to establish the gestational age
e. It is not recommended to be done in the first trimester
184. After you examine a pregnant woman you should answer the following questions:

a. The morphology of the fetus

b. Lie of the fetus
c. Attitude of the fetus
d. Presentation of the fetus
e. Position of the fetus

185. Is false about ultrasound examination:

a. Pelvic ultrasound usually includes two components - transabdominal evaluation and

transvaginal/endovaginal evaluation
b. Transabdominal scan is not used in gynaecological pathology
c. Transvaginal scan, because of the higher resolution of the transvaginal probe, is very helpful
for an evaluation of the pelvic structures
d. A full bladder is used as an acoustic window to achieve better imaging of the uterus and
adnexa in the transvaginal evaluation
e. Bleeding associated with known placenta previa represents a contraindication for
transvaginal evaluation

186. Circumstances under which a trial of VBAC should not be attempted:

a. Previous T-shaped CS, or extensive transfundal uterine surgery

b. Previous uterine rupture
c. One prior uterine scars and no vagina delivery
d. Medical or obstetric complications that precludes vagina delivery
e. Lack of anaesthesia, facility or personnel for an emergency CD

187. About serous cystadenoma is true:

a. Represents 50% of all epithelial tutors

b. Are bilateral in 40%
c. Represent 1 - 2% of all ovarian tumours
d. Macroscopic appearance: smooth, shiny, greyish white, with exuberant papillary projections
e. Associated fibrosis may lead to ‘’cystadenofibroma’’

188. The following statements regarding CIN 1 are true:

a. Refers to the presence of dysplasia confined to the basal third of the cervical lining
b. Refers to the dysplastic cellular change confined to the basal two third of the lining tissue
c. Refers to precancerous changes in the cells encompassing greater than two third of the
cervical lining thickness
d. Formerly called moderate dysplasia
e. Formerly called mild dysplasia
189. The technique for an artificial rupture of membranes includes:

a. The operator with sterile gloves, after previous asepsia of the genitals, insert the index and
the middle finger of the right hand into the vagina to fill the amniotic sac
b. With the left hand the amniotome is inserted
c. The amniotome is guided by the transvaginal ultrasound probe
d. Perforates the membranes with a small opening to stop the prolabation of umbilical cord
e. Perforation is done during a contraction

190. Factors that influence the visibility during an ultrasound investigation:

a. Obesity
b. Barium inside the bowels
c. Filling of the bladder
d. Liver enlargement
e. Tattoos

191. About PCOS is true:

a. Ovaries are enlarged, stroma is increased, capsule is thickened with pearly white appearance
b. Hormonal investigations - blood tests can be used to measure the levels of FSH, LH and
circular male hormones
c. 0.5 - 4%, infertile women, young reproductive age
d. 50-70%, infertile women, young reproductive age
e. The patient has amenorrhea, hirsutism, obesity

192. Fetal heart rate:

a. it can be evaluated with a fetal stethoscope (fetuscope) under 20 weeks of gestation

b. can be detected using ultrasound techniques at approx. 6-7 weeks of gestation
c. failure in detection of the fetal heart rate may be due to the presence of oligoamnios
d. normal frequency is between 120-160 beats per min
e. normal frequency is below 120 beats per min