| Kulin Arit, Edess Lim and Delsie Vicente

SESSION 1: January 7, 2019 3. Linea alba, which normally measures 10 to 15 mm wide

below the umbilicus
Quiz 1.1: Anterior abdominal wall to external 4. abnormally wide separation: diastasis recti or hernia
5. external oblique, internal oblique, and transversus
generative organs; page 16 to 19 only
abdominis muscles
1. T10 dermatome is at the level of?
6. Low transverse incisions
2. This nerve supplies the skin of mons pubis, upper labia
7. Intercostal and subcoastal nerves
major and medial upper thigh?
3. Nerve that provide sensation to the suprapubic area Quiz 1.3 Answers
4. Homologous to the male scrotum 1. Frenulum of the clitoris
5. Homologous to the ventral shaft of the penis 2. Prepuce
6. Homologous to the penis 3. Scarpa’s fascia
4. Colle’s fascia
Quiz 1.2: Anterior abdominal wall 5. Hesselbach’s triangle
1. Difference between direct and indirect inguinal hernia
2. Rationale behind perineal infection or hemorrhage
superficial to Colles fascia to extend upward to involve the
Quiz 2.1: External generative organs
superficial layers of the abdominal wall.
1. Labia minora is numerous in what gland?
3. Measure of linea alba (how wide below umbilicus)
2. Principal female erogenous organ
4. Diastasis recti or hernia results when linea alba
3. 6 openings of the vestibule
_________?
4. Largest paraurethral glands
5. What anterior abdominal muscles form fibrous
5. The bartholin’s gland ducts opens distal to the hymeneal
aponeurosis?
ring on what position
6. What is Pfannenstiel incision?
7. These nerve branches may be severed during a
Pfannenstiel incision at the point in which the overlying Quiz 2.2: External generative organs
anterior rectus sheath is separated from the rectus For 1 and 2, choose labia majora or minora:
muscles. 1. During pregnancy, the rich venous plexus in _______
commonly develops varicosities, especially in parous
Quiz 1.3: External generative organs women
2. Structurally, the ____ are composed of connective tissue
1. Formed thru fusion of lower lamellae of labia minora?
with numerous vessels, elastin fibers, and very few smooth
2. Formed from merging of upper lamellae of labia minora.
muscle fibers. They are supplied with many nerve endings
3. What fascia of abdominal wall thah extends contiously
and are extremely sensitive
onto the perineum
3. What is Hart line?
4. New name of scarpas fascia after it descends inferiorly
4. Clitoral blood supply?
onto the perineum
5. inflammation and duct obstruction of any of the
5. Direct inguinal hernia is hernia protuding through what
paraurethral glands can lead to__________.
abdominal wall triangle

Quiz 2.3 External generative organs

Quiz 1.1 Answers 1. Septum that separates the vagina and the bladder
1. Umbilicus 2. Upper fourth of the vagina is separated from the rectum
2. Ilioinguinal nerve by the --?
3. Iliohypogastric nerve 3. Vaginal length: Choose only one question
4. Labia majora A. Anterior wall measures?
5. Labia minora B. Posterior vaginal wall measures?
6. Clitoris 4. Provides access to the peritoneal cavity
5. Vagina vascular supply: choose only one question
Quiz 1.2 Answers A. Proximal portion supplied by
1. Hernias that protrude through the abdominal wall in B. Posterior vaginal wall supplied by
Hesselbach triangle are termed direct inguinal hernias. In C. Distal wall supplies by?
contrast, indirect inguinal hernias do so through the deep
inguinal ring, which lies lateral to this triangle, and then
may exit out the superficial inguinal ring.
Quiz 2.1 Answers
1. Sebaceous glands
2. Scarpa fascia continues inferiorly onto the perineum as
2. Clitoris
Colles fascia
3. the urethra, the vagina, two Bartholin gland ducts, and
 | Kulin Arit, Edess Lim and Delsie Vicente

two ducts of largest paraurethral glands—the Skene glands. 2. Membrane that divides the the Anterior triangle into
4. Skene’s gland superficial and deep spaces
5. 5 and 7’o clock position 3. These muscles constrict vaginal lumen, aid in release of
bartholin secretions, contribute to clitoral erections
4. Corresponds to the corpora spongiosa of the penis
Quiz 2.2 Answers 5. Line taht serves as a landmark in the anal canal between
1. Labia majora columnar epithelium and simple stratified epithelium
2. Labia minora 6. Landmark for pudendal nerve block
3. lateral boundary that enclose the vestibule 7. Difference between external hemorrhoids and internal
4. Internal pudendal artery hemorrhoids
5. Urethral diverticulum 8. Major blood supply of the perineum

Quiz 2.3 Answers Quiz 3.1 Answers

1. Vesicovaginal septum 1. Intersphincteric groove
2. Pouch of Douglas 2. Greater sciatic foramen
3. A. Anterior wall: 6- 8 cm 3. Perineal, dorsal nerve of clitoris and inferior rectal
B. Posterior vaginal wall: 7-10 cm branch
4. Posterior fornix 4. Haemorrhoids
5. A. Proximal portion: Uterine artery + Vaginal artery 5. Anterolaterally therefore Anterior
B. Posterior vaginal wall: Middle rectal artery
C. Distal wall: Internal pudendal artery
Quiz 3.2 Answer
1. Vaginal birth
2. Pubovisceral muscle
3. hematoma formation
Quiz 3.1 4. True
1. Distal site at which IAS and EAS overlap ends is called? 5. Read Book
2. Pudendal nerve exits into what foramen?
3. 3 terminal branches of pudendal nerve? Quiz 3.3 Answers:
4. Damage to anal cushion is popularly known as? 1. Perineal body
5. We know that arbitrary line is formed by 2 ischial 2. Perineal membrane
tuberosities but where these tuberosities specifically belong 3. Bilateral bulbocavernous muscles
to? Anterior or posterior? 4. Vestibular bulb
5. Dentate or pectinate line
Quiz 3.2 6. Ischial spine
For 1 and 2: Evidence supports that injuries to these 7. Read the book hahah mahaba eh
muscles may predispose women to greater risk of pelvic 8. Internal pudendal artery
organ prolapse or urinary incontinence. For this reason,
current research efforts are aimed at minimizing these
injuries.
1. ___ conveys significant risk for damage to the levator ani Quiz 4.1
or to its innervation. 1. If the uterine artery is accidentally resected, what artery
2. Of the levator ani muscles, the ____ is more commonly will compensate to prevent uterine ischemia or postpartum
damaged. hemorrhage.
3. Injury to the vessels in the posterior triangle can lead to - 2. 3 terminal branches of uterine artery
_____ in the ischioanal fossa, and the potential for large 3. Peritoneum around the round ligament is called?
accumulation in these easily distensible spaces. 4. T or F. Round and broad ligament provide no substantial
4. True or false: The two ischioanal fossae communicate support
dorsally, behind the anal canal. An episiotomy infection or 5. Chadwick sign is seen in what Female reproductive
hematoma may extend from one fossa into the other. system structure?
5. Differentiate EAS and IAS. 6. Softening of the isthmus
7. Given that the px underwent NSD, and if you'll examine
Quiz 3.3 her external cervical OS the shape is expected to be?
1. Central tendon of the perineum
Quiz 4.2 Uterus, pg 25 to 29
 | Kulin Arit, Edess Lim and Delsie Vicente

1. Pregnancy stimulates uterine growth due to muscle? 5. 10%

2. Cervical edema leads to softening known as?
3. Endometrium layer that serves as a regeneration site
following each menses?
4. Ligament that aids in fallopian tube identification? Quiz 5.1 Lympathics and Innervation
5. Branch of uterine artery that runs within the round
ligament? 1. Lymphatics from the cervix terminate mainly in the __
6. Ligament that houses the ovarian vessels? which are situated near the bifurcation of the common iliac
7. Supply the functionalis layer and is responsive to vessels.
hormonal action. 2. Pelvic visceral innervation is predominantly?
8. Inferior hypogastric plexus divides into three plexus. 3. Beginning below the aortic bifurcation and extending
Name each and their innervations downward retroperitoneally, presacral nerve/hypogastric
plexus (sympathetic innervation to pelvic viscera) is formed
Quiz 4.3 by sympathetic fibers arising from spinal levels?
1. Peritoneum of what pouch is sharply incised during CS 4. In contrast, parasympathetic innervation to the pelvic vis-
delivery? cera derives from neurons at spinal levels?
2. What layer of uterine cavity epithelium sloughs off with 5. Blending of the two hypogastric nerves (sympathetic) and
menses? the two pelvic splanchnic nerves (parasympathetic) gives
3. And 4. Most of the uterus is composed of endo- or rise to the inferior hypogastric plexus, also termed the
myometrium? this anatomy is integral to hemostasis at the pelvic plexus. This retroperitoneal plaque of nerves lies at
placental site during the what stage of labor? the ___ level.
5. Myometrial muscle fiber level progressively diminish
caudally such that, in the cervix, muscle makes up only how
many percent of the tissue mass?
Quiz 5.2 Musculoskeletal pelvic anatomy pg 31
1. important in childbearing and can be described as an
obliquely truncated, bent cylinder with its greatest height
posteriorly: true pelvis or false pelvis?
2. Which serves as superior border and inferior margin-
Quiz 4.1 Answers linea terminalis, pelvic outlet (matching type)
1. Ovarian artery 3. serve as valuable landmarks in assessing the level to
2. Tubal, Ovarian and Fundal branch which the presenting part of the fetus has descended into
3. Mesoteres the true pelvis; and also aid pudendal nerve block
4. True placement.
5. Cervix 4. upper anterior margin of __ corresponds to the
6. Hegar sign promontory that may be felt during bimanual pelvic
7. Transverse slit examination in women with a small or large pelvis? It can
also provide a landmark for clinical pelvimetry
Quiz 4.2 Answers 5. Anteriorly, the pelvic bones are joined together by the
1. Hypertrophy
2. Goodel sign Quiz 5.3 Pelvic anatomy pg. 32 and 33
3. Basalis layer 1. Structure in the pelvic wall that divides false from true
4. Round ligament pelvis
5. Sampson artery 2. Anterior and posterior pelvis are used to classify the
6. Infundibulopelvic or suspensory ligament of the ovary pelvis into different pelvic shapes, which segment
7. Spiral arteries
determines the type of pelvis.
8. Vesical plexus: bladder
3. Used to mark zero station
Middle rectal: rectum
4. Distance from the fingertip to the point at which the
Uterovaginal: (Frankenhauser) proximal fallopian tube,
lowest margin of symphysis strikes the same finger's base
uterus and vagina
is?
5. Superior plane of the true pelvis is AKA as
Quiz 4.3 Answer
1. Vesicouterine pouch
Quiz 5.4 Pelvic anatomy pg. 33 to 34
2. Functionalis layer
1. The smallest pelvic diameter
3. Myometrium
2. Determines the pelvic tendency
4. 3rd stage
3. Pelvic shape suited for most delivery of the fetuses
 | Kulin Arit, Edess Lim and Delsie Vicente

4. Obstetrical conjugate is estimated indirectly by

subtracting -- cm from the diagonal conjugate
5. Diagonal conjugate is the distance from -- to the --?

Quiz 5.1 Answers

1. Internal Iliac nodes
2. Autonomic
3. T10 through L2
4. S2 through S4
5. S4 and S5

Quiz 5.2 Answers

1. True pelvis
2. Superior border: Linea terminalis;
Inferior margin: Pelvic outlet
3. Ischial spine
4. Sacrum
5. pubis symphysis

Quiz 5.3 Answers

1.Linea terminalis
2. Posterior segment
3. Midpelvis and ischial spines
4. Diagonal conjugate
5. Pelvic inlet

Quiz 5.4 Answers

1. Interspinous diameter
2. Anterior segment
3. Gynecoid
4. 1.5 cm to 2 cm
5. lowest margin of Pubis symphysis to sacral promontory

SESSION 2: January 8-9, 2019
TOPIC 6: Cardiovascular changes and Fetal circulation
Quiz 6.1
1. In respiration, which remains unchanged?
2. Heart is displaced to what position?
3. Uterine blood flow percentage: ___% to placenta; ___%
supports myometrium
4. Which cannot cross placental membrane? Coumadin,
isoflurane, succinylcholine or lidocaine?
5. Prolonged maternal hypotension for more than 10-
15mins decreases uterine blood flow which will lead to
what complication of the fetus?
Quiz 6.2
1. How many percent decrease in blood flow would classify
Maternal Hypotension?
2. Cardiac Output decreases to _ to_% during aortocaval
compression 3. What causes maternal edema?
4. What maternal component causes the doubling of serum
ALP?
5. At term, how many percent of uterine blood flow goes to
the placenta?
Quiz.6.3
1. Renal calyces, pelvis and ureter dilate after 3rd month of
gestation due to?
2. Increase progesterone with stomach and pylori
displacement leads to --- gastric emptying time
3. -- positioning is avoided during regional anesthesia
4. Nonpathologic glucosuria levels and proteinuria levels
5. Plasma protein albumin is -- in pregnancy
Quiz 6.1 Answers
1. Vital capacity
2. Anteriorly and leftward
3. 80% to placenta; 20% supports myometrium
4. succinylcholine
5. progressive fetal acidosis
Quiz 6.2 Answers
1. Greater than 25% decrease in blood flow
2. CO Decreases by 10-20%
3. Aldosterone (sodium and water retention)
4. Placental production
5. 80%
| Kulin Arit, Edess Lim and Delsie Vicente
Quiz 6.3 Answers
1. progesterone production which causes atony of the
calyces and ureters
2. delayed
3. supine
4. 1-10 g/day glucosuria; <300 mg/day proteinuria
5. decreased which lead an increase free blood level of
high-protein bound drugs
TOPIC 7: Labor Analgesia and anesthesia
Quiz 7.1
1. Systemic meds which side effect is nausea, vomiting,
pruritus, prolonged gastric emptying time and used for early
stage of labor.
2. General anestheisa for CS with “bad dreams” effects
3. Local anestheisa block nerve transmission by reversibly
binding with intracellular _ channel
4. ______ is catheter based, uses Tuoly needle to be
inserted between ___ interspace.
5. ______ used in advanced stage of labor
Quiz 7.2
1. Fetus can metabolize drugs as early as
2. Represent most effective form of anelgesia and achieve
the highest rate of maternal satisfaction
3. What enzymes metabolizes ester-linked and amide-
linked anesthetics.
4. Used to provide continuous pain relief during labor in
epidural anesthesia
5. It is usuallt used to decrease shivering caused by
neuroaxial anesthesia
6. Most common complication of neuroaxial blockade for
labor anelgesia
7. Epidural anesthesia is normally inserted in the epidural
space bt
8. Propofol can lead to neonatal depression at dose _
9. Pudendal nerve block blocks sensation of
10. Rapid improvement of the neonate is expect in this
modality.
11. Volatile anesthesics are ionized or non-ionized
12. Usual drug used to restore BP to normal state
13. Critical time period of the which will require immediate
delivery of the baby
Quiz 7.3
1. Most common complication of neuraxial blockade for
labor analgesia
 | Kulin Arit, Edess Lim and Delsie Vicente

2. Drug used for decreasing shivering by lowering the 5. It is a decapeptide that drives menstruation 6. Ovarian
body's shivering threshold and kappa opioid receptor hormone that triggers ovulation
activity
3. Drug use to restore BP to normal state Quiz 8.2
4. Alternative to succinylcholine because of rapid onset of 1. In ovarian cycle increased levels of LH are due to:
action. Providing adequate intubation conditions in less a. Increased Progesterone
than 90 s; b. Increased Estrogen
5. Highly lipid soluble drug with rapid onset, short duration c. Increased FSH
and makes px unconscious at 30 s; d. Increased Androgens

2. In 40 days of menstrual cycle the ovulation occurs at:

Quiz 7.1 Answers a. 14th day
1. Opioids b. 20th day
2. Ketamine c. 26th day
3. Volted-g Na+ channels d. 30th day
4. Epidural anes; L2-L4 insterspaces
5. Spinal anes. 3. The ovarian cycle is initiated by:
a. FSH
Quiz 7.2 Answers b. Estrogen
1. 14th week AOG c. LH
2. Neuroaxial techniques d. Progesterone
3. Plasma cholinesterase and P450 liver enzymes
respectively 4. The corpus luteum secretes:
4. Epidural anesthesia a. Estrogens
5. Meperidine b. Progesterone
6. Hypotension c. Both
7. L2-L4 d. None
8. 9mg/kg
9. Lower vagina and perineum 5. When there is no fertilization of the ovum, the
10. Inhalational anesthesia endometrial cells die because:
11. Ephedrine a. The involution of corpus luteum causes estradiol
12. 4 minutes and progesterone levels to fall dramatically
b. LH levels rise after ovulation
Quiz 7.3 Answers c. Estradiol levels are not involved in the LH surge
phenomenon
1. Hypotension
d. Estradiol inhibits the induction of the
2. Meperidine
progesterone receptor in the endometrium
3. Ephedrine
4. Rocuronium
5. Propofol Quiz 8.3
Matching type:
1-4. LH, FSH, Estrogen, Progesterone= egg maturation,
pregnancy, ovulation, follicular maturation
TOPIC 8: Physiology of menstrual Cycle 5. Luteal, follicular= secretory, mentrual and proliferative

Quiz 8.1
1. What ovarian hormone rises during secretory phase of
Quiz 8.1 Answers
endomerial cycle
1. Progesterone
2. T or F Follicular phase of ovarian cycle corresponds to
2. False. Proliferative dapat
secretory phase of endometrial cycle
3. Luteal phase
3. Basal body temp increases at what phase of ovarian
4. Estrogen and prolactin
cycle
5. Estrogen
4. These 2 hormones are excess in PMS
 | Kulin Arit, Edess Lim and Delsie Vicente

Quiz 8.2 Answers Quiz 9.3

1. B. Increased estrogen 1. Dysmenorrhea is due to endogenous --?
2. C. 40 - 14: 26th day 2. Latest sign of puberty?
3. A. FSH 3. __ causes delay in menarche
4. C. Both 4. PMS is due to -- excess
5. A. 5. Not menstruated within 5 years of breast development if
telarche occured by age 10
Quiz 8.3 Answers 6. Microadenomas secrete what hormone?
1. LH= ovulation 7. What is Oligomenorrhea?
2. FSH= Follicular maturation
3. Estrogen= Egg maturation
4. Progesterone= Pregnancy Quiz 9.1 Answers
5. Luteal phase= secretory; follicular phase= menstrual and 1. Average age is 26y/o
proliferative 2. Telarche
3. PGF2a
4. Luteal Phase
5. True
TOPIC 9: Abnormalities of the menstrual cycle + 6. Breast Development
Anovulation 7. Functional Hypothalamic amenorrhea
8. Trabecular bone loss
9. 2.5% per year and 1.5% before and after menopause
Quiz 9.1 10. Irregular and absent menses
1. Average age of onset of PMS
2. Earliest sign of puberty Quiz 9.2 Answers
3. What type of prostaglandin is elevated in the 1. Progesterone
endometrium when having dysmenorrhea? 2. Delayed
4. Depression in PMS occurs in what phase of ovarian cycle 3. Supine
5. T or F px with High BMI are at risk of PMS 4. Glucosuria: 1-10g/day and proteinuria <300 mg/day
6. Biomarker of estrogen production 5. Decrease
estrogen production
7. Cessation of menses and ovulation w/o identifiable Quiz 9.3 Answers
organic cause 1. Prostaglandin
8. Which bone loss is greater in menopause? (Trabecular or 2. Menachem
cortical) 3. Malnutrition
4. Estrogen
9. Spinal bone density decrease by _ per year and _ before
5. Primary amenorrhea
and after menopause 6. Prolactin
10. Cardinal sign of anovulation 7. Menstruation cycle of >36 or <8 cycles per year

Quiz 9.2
1. Incidence of dysmenorrhea
2. Precursor of prostaglandin
3. effective in decreasing prostaglandin in secretory
endometrium
4. T or F. Lamaze can also be used to alleviate
dysmenorrhea
5. T or F. Increased TSH can cause PMS
6. In macroadenoma, _____ hormone is secreted which
inhibits gonadonadotropins
7. Chronic NSAID usage can lead to ___
8. In CKD, LH is increased or decreased
9. Depletion of primordial ovarian follicles ___
10. In menopause, which hormone is increased?
 | Kulin Arit, Edess Lim and Delsie Vicente

SESSION 2: January 10, 2019 3. Of the four phases of parturition, phase 2 is

characterized by which of the following?
TOPIC 10: PHYSIOLOGY OF LABOR (CHAPTER 21, a. Uterine activation, cervical ripening
WILLIAMS 24th Ed) b. Uterine quiescence, cervical softening
c. Uterine involution, cervical remodeling
Quiz 10.1 (Williams, p. 408-413) d. Uterine contraction, cervical dilatation
1. Cervix begins an early remodeling termed as ____
4. Which phase of parturition corresponds to the clinical
2. Remains the major contributor to neonatal mortality and
stages of labor?
morbidity in developed countries is _____
a. Phase 1
3. Defined as bringing forth of young
b. Phase 2
4. Contraction of this type become more commom toward
c. Phase 3
the end of pregnancy, other term for this is False Labor
d. Phase 4
4. Differentiate the consistency of cervix of a nonpregnant
women to a women by the end of pregnancy
5. During which of the stages of labor is the fetus
5. Main structural protein in the cervix
delivered?
6. Uterine awakening or activation is in what phases of
a. Stage 1
parturition
b. Stage 2
7. The fetal heas often descends to or even through the
c. Stage 3
pelvic inlet so called as______
d. Stage 4
8. What types of collagen is present in the matrix of the
cervix
6. The umbilical arteries carry which of the following?
9. Tx to promote cervical ripening for labor induction
a. Oxygenated blood to the placenta
includes direct application of what type of prostaglandins?
b. Oxygenated blood from the placenta
(2 answers)
c. Deoxygenated blood to the placenta
10. Cervical thinning is also called as cervical ___
d. Deoxygenated blood from the placenta
11 Extrusiom of the mucus plus that had previously filled
the cervical canal during pregmamcy is referred to as
7. Cervix is dilated fully, the most important force in fetal
"_______"
expulsion is?
12. T or F Neural blockade from epidural anelgesia does
A. Uterine contraction
not diminish frequency and intensist of labor pains
B. Maternal intra-abdominal pressure
13. What happens in the cervix during Ferguson reflex
C. Forcep pressure
14. T or F interval between contractions increases gradually
D. All of the above
from 1st stage to 2nd stage of labor.
15. MCQ: Uterine upper segment is ______ while the lower
8. Schultz mechanism?
segment is ___ ( a. Firm during contrations b. Softer,
9. Duncan mechanism?
distended and more passive)
10. Reinstitution of ovulation happens within 4-6 weeks
16. Identification: When thinning of the lower uterine
after birth. True or false
segment is extreme as in obstructed labor, this ring is
prominent and forms pathological retraction ring known as
Quiz 10.3 (Physio of Labor and biochemical
Quiz 10.2 processes)
1. Phase of parturition that comprises 95% of pregnancy 1. There are unique characteristics of smooth muscle,
myometrium, compared with those of skeletal muscle that
and is characterized by uterine smooth muscle tranquility
may confer advantages for uterine contraction efficiency
with maintenance of cervical structural integrity. and fetal delivery. All are true except:
A. Phase 2 a. The degree of smooth-muscle cell shortening
B. Phase 3 with contractions may be one order of magnitude
C. Phase 1 greater than that attained in striated muscle cells.
D. Phase 4 b. Forces can be exerted in smooth muscle cells in
multiple directions.
c. Smooth muscle is not organized in the same
2. True or false. Maintenance of the cervix and it's integrity manner as skeletal muscle. The plexiform
is essential for the continuation of pregnancy to term. arrangement aids greater shortening and force-
generating capacity.
 | Kulin Arit, Edess Lim and Delsie Vicente

d. Greater multidirectional force generation in the 7. B. Maternal intra-abdominal pressure

uterine fundus compared with that of the lower 8. Schultze mechanism of placental expulsion, blood from
uterine segment permits versatility in expulsive the placental site pours into the membrane sac and does
force directionality. not escape externally until after extrusion of the placenta.
e. None of the above 9. Duncan mechanism: placenta separates first at the
periphery and blood collects between the membranes
2. Fill in the blanks. Agents that promote contraction act on and the uterine wall and escapes from the vagina.
myometrial cells to increase __________. Or, they allow an 10. True
influx of____________ through___________.
(ligand- or voltage-regulated calcium channels; intracellular Quiz 10. 3 Answers
cytosolic calcium concentration—[Ca2+]; extracellular 1. E. None of the above
calcium) 2. intracellular cytosolic calcium concentration—[Ca2+];
extracellular calcium); ligand- or voltage-regulated calcium
3. The transmembrane channels that make up the gap channels;
junctions in myometrium consist of two protein “hemi- 3. Connexons
channels”. These _____ are each composed of six connexin 4. G-protein linked, enzyme-linked and ion-channel linked
subunit proteins. These pairs establish a conduit between 5. IL-8
coupled cells for the exchange of small molecules that can
be nutrients, waste, metabolites, second messengers, or
ions.
1. Prostaglandin
4. There are various cell surface receptors that can directly 2. Menache
regulate myocyte contractile state. Three major classes are: 3. Malnutrition
___________. 4. Estrogen
5. Primary amenorrhea
5. There is a large influx of leukocytes into the cervical 6. Prolactin
stroma with cervical dilatation during labor. Cervical tissue 7. Menstruation cycle of >36 or <8 cycles per year
levels of leukocyte chemoattractants such as _____ are
increased just after delivery, as are their receptor levels.
TOPIC 11: Normal Labor (Williams, Chapter 22)

Quiz 10.1 Answers Quiz 11.1

1. Softening 1. Differentiation between head and breech is made using
2. Preterm Labor what Leopold's Maneuver?
3. Parturition 2. As preparation to an OB px next week, your groupmates
assigned you to assess fetal position using Leopold's
4. Braxton Hicks Contraction
Maneuver. What is the very first thing you'll assess?
5. Nasal cartilage and oral cavity respectively 3. Shoulder presentations are what type of Fetal lie?
6. Phase 2 of Labor: Preparation for Labor 4. Partially flexed neck what Cephalic presentation
7. Lightening 5. Partially extended neck, what cephalic presentation
8. Type 1, 3, 4 6. Pregnant mom having a hyrocephalus baby inside, at
9. PgE2 and PGF2a what uterine location you'll likely find the head of the fetus?
( Cephalic pole or podalic pole)
10. Effacement
7. Situations that will entail difficulty to examine the
11. Show or bloody show pregnant mom using Leopold's maneuver except
12. True A. Obese
13. Mechanical stretching B. Decreased amniotic fluid volume
14. False C. Placenta is anteriorly implanted
15. A and B respectively D. None of the above
16. Bandl ring
Quiz 11.2A
1.The relation of the fetal long axis to that of the
Quiz 10.2 Answers mother is termed which of the following?
1. C. Phase 1 a. Fetal lie
2. True b. Fetal angle
3. A. Uterine activation, cervical ripening c. Fetal position
4. C. Phase 3 d. Fetal polarity
5. B. Stage 2
6. C. Deoxygenated blood to the placenta 2. Which of the following is not a predisposing factor
 | Kulin Arit, Edess Lim and Delsie Vicente

for transverse fetal lie? d. A normal-sized head usually engages with its
a. Multiparity sagittal suture directed anteroposteriorly.
b. Oligohydramnios
c. Placenta previa 10. On palpation of the fetal head during vaginal
d. Uterine anomalies examination, you note that the sagittal suture is
transverse and close to the pubic symphysis. The
3. Which of the following fetal presentations is the least posterior ear can be easily palpated. Which of the
common? following best describes this orientation?
a. Breech a. Anterior asynclitism
b. Cephalic b. Posterior asynclitism
c. Compound c. Mento-anterior position
d. Transverse lie d. Mento-posterior position

4. What percentage of fetuses are breech at 28 weeks’ 11. Of the cardinal movements of labor, internal
gestation? rotation achieves what goal?
a. 1% a. Flexes the fetal neck
b. 10% b. Brings the occiput to an anterior position
c. 25% c. Brings the anterior fontanel through the pelvic
d. 50% inlet
d. None of the above
5. When the anterior fontanel is the presenting part,
which term is used? 12. In what percentage of labors does the fetus enter the
a. Brow pelvis in an occiput posterior position?
b. Face a. 0.5%
c. Vertex b. 5%
d. Sinciput c. 20%
d. 33%
6. In shoulder presentations, the portion of the fetus
chosen for orientation with the maternal pelvis is 13. Which of the following is not a risk factor for
which of the following? incomplete rotation of the posterior occiput?
a. Head a. Macrosomia
b. Breech b. Poor contractions
c. Scapula c. Lack of analgesia
d. Umbilicus d. Inadequate head flexion

7. Which of the following could inhibit performance of
Leopold maneuvers?
a. Oligohydramnios
b. Maternal obesity
c. Posterior placenta
d. Supine maternal positioning
8. Which of the following is the correct order for the
cardinal movements of labor?
a. Descent, engagement, internal fixation, flexion,
extension, external rotation, expulsion
b. Descent, flexion, engagement, external fixation,
extension, internal rotation, expulsion
c. Engagement, descent, flexion, internal rotation,
extension, external rotation, and expulsion
d. Engagement, flexion, descent, internal rotation,
straightening, extension, and expulsion
9. Regarding engagement of the fetal head, which of
the following statements is true?
a. It does not occur until labor commences.
b. Engagement prior to the onset of labor does not
affect vaginal delivery rates.
c. It is the mechanism by which the biparietal
diameter passes through the pelvic outlet.
14. . Cardinal movements of labour are:
a. Engagement → descent → flexion → internal
rotation
→ extension → restitution → external rotation →
expulsion
b. Engagement → flexion → descent → internal
rotation
→ extension → expulsion
c. Engagement → flexion → descent → external
rotation
→ expulsion
d. Engagement → extension → internal rotation →
external rotation → expulsion
15. Best time for giving episiotomy is -- has occured
16. Ferning of vaginal fluid is consistent with what fluid in
the mother's womb?
17. The following suggests that a ruptured membrane has
occured except
A. Vaginal pH of 6.8
B. Arborization of vaginal fluid
C. Detection of alpha-Fetoprotein in the vaginal
vault

D. Amniotic fluid pools in the anterior fornix or clear
fluid flows from the cervical canal
18. What is the indication of doing cervical examination as
an initial evaluation for Management of Labor?
19. What cervical dilatation measurement will you diagnose
active labor in the presence of uterine contractions
A. 2.5 cm
B. 3.0 cm
C. 3.5 cm
D. 6 cm
20. Among 3 functional Labor mechanisms which one is
referred as the classic labor mechanisms that involve the
cardinal fetal movements of the cephalic presentation?
21. Portion of the scalp immediately over the cervical os
becomes edematous?
22. No rotation toward the symphysis takes place, the
occiput remain in the direct occiput posterior position?
23. How many degrees does the occiput rotates from
posterior to the symphysis pubis?
A. 125 degrees
B. 126 degrees
C. 135 degrees
D. 136 degrees
Quiz 11.3
1. Match:
A. Vertex or occiput presentation
B. Face presentation
C. Sinciput presentation
D. Brow presentation
1. Fetal neck may be sharply extended so that the
occiput and back come in contact, and the face is
fore- most in the birth canal
2. Fetal head may assume a position between
these extremes, partially flexed in some cases,
with the anterior (large) fontanel, or bregma
3. Fetal head partially extended in other cases
4. Ordinarily, the head is flexed sharply so that the
chin is in contact with the thorax, the occipital
fontanel is the presenting part.
2. Fill in the blanks:
a. Fetus enters the pelvis in the left occiput
transverse (LOT) position in __% of labors and in
the right occiput transverse (ROT) position in ___%.
In occiput anterior positions—LOA or ROA—the head
either enters the pelvis with the occiput rotated
___ degrees anteriorly from the transverse
position, or this rotation occurs subsequently.
3. Identify: cardinal movements of labor
| Kulin Arit, Edess Lim and Delsie Vicente
a. biparietal diameter—the greatest transverse
diameter in an occiput presentation—passes
through the pelvic inlet
b. first requisite for birth of the newborn; brought
about by one or more of four forces:
(1) pressure of the amni- onic fluid,
(2) direct pressure of the fundus upon the
breech with contractions,
(3) bearing-down efforts of maternal abdominal
muscles, and
(4) extension and straightening of the fetal body
c. head normally flexes as it meet resistance, from
the cervix, pelvic walls, or pelvic floor; chin is
brought into more intimate contact with the fetal
thorax, and the appreciably shorter sub-
occipitobregmatic diameter is substituted for the
longer occipitofrontal diameter
d. Turning of the head that the occiput gradually
moves toward the symphysis pubis anteriorly from
its original position or, less commonly, posteriorly
toward the hollow of the sacrum; essential for
completion of labor, except when the fetus is
unusually small.
e. the sharply flexed head reaches the vulva
f. delivered head next undergoes restitution. If the
occiput was originally directed toward the left, it
rotates toward the left ischial tuberosity
g. The anterior shoulder appears under the
symphysis pubis, and the perineum soon becomes
distended by the posterior shoulder. After delivery
of the shoulders, the rest of the body quickly
passes.
4. What test monitors women with low-risk pregnancies
upon admission as a test of fetal well-being?
5. Three reasons why rupture of the membranes is
significant.
Quiz 11.1 Answers
1. First maneuver assesses the uterine fundus. It permits
identification of fetal lie and determination of which fetal
pole-that is, cephalic or podalic -occupies the fundus
2. Fetal lie
3. Transverse lie
4. Sinciput
5. Brow presentation
6. Podalic pole
7. B. Decrease amniotic fluid
Quiz 11.2 Answers
1. A. Fetal lie
 | Kulin Arit, Edess Lim and Delsie Vicente

2. B. Oligohydramnios 4. Cardiac plasticity in pregnancy, increased left ventricular

3. C. Compound wall thickens at ____% and wall mass increases at ____%;
4. C. 25% there is also increased right ventricular mass at ____%.
5. Sinciput A. 10%, 25%, 40%
6. C. Scapula B. 28%, 52%, 40%
7. B. Maternal obesity 5. _______ almost, always is associated with heart failure.
8. C. A. S3 gallop
9. B B. S2 split
10. B 6. If there is increased O2 demand, cardiac output is
11. B ________ (increased, decreased).
12. C. 20% 7. Matching type:
13. C. Lack of analgesia A. ml/min
14. A. B. beats/min
15. After crowning C. ml/beat
16. Amniotic fluid (Cardiac output, stroke volume, heart rate)
17. D. it must be posterior fornix 8. Aortocaval compression _______ (decreases, increases)
18. Bloody show lower extremities venous pressure; __________(reduces,
19. B. 3 cm increases) maternal vascular capacitance.
20. Pelvic division 9. What is supine hypotension syndrome?
21. Caput succedaneum 10. For hemodynamics in pregnancy, systemic vasodilation
22. Persistent occiput posterior occurs at ____ (4, 5) weeks.
23. C. 135 degrees 11. At the end of the first trimester, there is/are:
A. vasodilation in the kidneys
Quiz 11.3 Answers B. Decreased GFR
1. 1B; 2C; 3D; 4A C. Increased urine excretion
2. 40%; 20%; 45 degrees D. C only
3. Engagement, descent, flexion, internal rotation, 12. True or false: ⬆️CO= ⬆️SV= ⬆️HR
extension, external rotation, and expulsion 13. True or false: Increase in CO, which reaches its peak at
4. Fetal admission test early stage of pregnancy, is attributable to increase in SV.
5. First, if the presenting part is not fixed in the pelvis, 14. The following decreases BP except:
the umbilical cord can prolapse and be compressed. A. NO2
Second, labor is likely to begin soon if the pregnancy is at or B. Relaxin
near term. Third, if delivery is delayed after membrane C. Estrogen
rupture, intrauterine and neonatal infection is more likely D. None of the above
as the time interval increases 15. Aortocaval compression starts at:
A. 13-16 weeks AOG
Notes B. 20-24 weeks AOG
*Naegele's rule 16. Increased hydrostatic pressure in lower extremities
+1 year, -3 months, +7 days result to what kind of edema?
17. Femoral pressure also _____ (increases, decreases)
due to compression.
18. RAAS in pregnancy is activated at ____ (6-8, 10-12
TOPIC 12: Physiology of Pregnancy (Doc Dee) weeks).
19. True or False: Estrogen increases NO2 and angiotensin.
Quiz 12.1 20. True or False: Maternal body is resistant to effects of
1. Cardiac silhouette in pregnancy is ____. Angiotensin II (i.e. Pre-eclampsia)
2. ECG changes in pregnancy: 21. Oncotic pressure ______ (allows, prevents) fluid out the
A. Slight left axis deviation ______.
B. Mild ST-T wave changes
C. Both A and B Quiz 12.2
D. B only 1. Compression of the inferior vena cava occurs as early as
3. Changes in heart sounds in heart sounds in pregnancy A. 13 to 16 weeks’ gestation
except: B. 16 to 18 weeks’ gestation
A. S2 P increases; S2 split C. 18 to 19 weeks’ gestation
B. S1 M increases; widely split D. 20 to 22 weeks’ gestation
C. aortic/pulmonary flow murmurs
D. Occasional S3 2. True or False. Fetal oxygen saturation 10 percent higher
E. Heart sound heard at 5th ICS midclavicular when a laboring woman is in a lateral recumbent position
compared with supine.
 | Kulin Arit, Edess Lim and Delsie Vicente

3. True or False. Cardiac output decreases to just below a. Nulliparity

pre-labor values at 24 hours postpartum and returns to b. Prolonged labor
prepregnancy levels between 12 and 24 weeks c. Placenta previa
postpartum. d. Oligohydramnios

4. True or False. Cardiac output during labor (but between 4. In which of the following clinical scenarios is
uterine contractions) increases from pre-labor values by prolonged labor associated with uterine rupture?
approximately 10% in the early first stage, by 25% in the a. High parity
late first stage, and by 40% in the second stage of labor. b. Previous cesarean delivery
c. 32-week fetus in a transverse lie
5. True or False. CO highest right after delivery due to d. All of the above
release of aorto-caval compression and uterine contraction
(autotransfusion). 5. Which of the following is a risk factor for face
presentation?
a. Prematurity
b. Multiparity
Quiz 12.1 Answers c. Anencephaly
d. All of the above
Quiz 12.2
1. A. 13 to 16 weeks age of gestation
2. True Quiz 13.1 Answers:
3. True
1. Quiet morning
4. True
2. 2 weeks
5. True
3. Progesterone
4. Estrogen
5. Hegar sign
TOPIC 13: Labor, Pregnancy and Delivery (Doc Flores) 6. Goodell sign
7. 6 weeks
Quiz 13.1 8. Gestational sac which is eccentric (pseudo gestational
1. When can quickening be felt during the day? sac), yolk sac, heartbeat
2. Breast tenderness disappears after ___ weeks 9. Preconceptional care, prompt diagnosis of pregnancy,
3. Which hormone makes the mucous thick? initial prenatal evaluation, follow-up prenatal visits
4. Which hormone makes the mucous thin and increases
when there is LH surge? Quiz 13.2 Answers
5. Sign when you can flex the uterus. 1. B. Bandl ring
6. Sign when you cervix is as soft as the lips. 2. C. Turtle sign
7. At what week could placenta be recognized? 3. C. Placenta previa
8. In sonography, 4-5 weeks _______ (_______ if in the 4. D. All of the above
middle), 5-6 weeks _____, 6 weeks (from last menstrual 5. D. All of the above
period) ________
9. Comprehensive prenatal care include: (4)

Quiz 13.2
1. Extreme development of both upper and lower
uterine segments may be seen with obstructed labor
and clinically may be reflected by which of the following?
a. Hegar sign
b. Bandl ring
c. Bloody show
d. Chadwick sign

2. Shoulder dystocia presents with what sign?

a. Gooddel sign
b. Dunphys’ sign
c. Turtle sign
d. Chadwick’s sign

3. Common causes of transverse lie include which of

the following?

SESSION 4
TOPIC 14: Medical Considerations Of Pregnancy
Quiz 14.1
1. Diabetic retinopathy is considered as an ophthalmic
evaluation during what trimester?
2. Women with GDM are significantly higher risk of
developing what kind of comobidity after the index
pregnancy
3. One of the fetal complications is miscarriage which has
an incidence of?
A. 9-12%
B. 9-13%
C. 9-14%
D. 9-15%
4. Neural Tube defects is how many times frequent as a
birth defect fetal complication?
5. The most important predictor of fetal growth restriction is
their underlying?
6. Birth weight of greater than ___g is considered
macrosomia
7. T or F: Offspring born to mothers with diabetes exhibited
higher levels of biomarkers for endothelial damage and
inflammation as well as higher eptin levels, BMI, waist
circumference, and systolic blood pressure and 4x of
decreased adiponectin levels.
8. Birth defects occur in _ to _ weeks after conception?
Quiz 14.2
1. Define the ff:
A. Chronic Hypertension
B. Gestational Hypertension
C. Preeclampsia and Eclampsia
D. Chronic Hypertension with superimposed
preeclampsia
2. The following are proposed mechanisms of placental
dysfunction except:
A. Diffuse placental thrombosis
B. Abnormal trophoblastic invasion of the
endometrium
C. Altered maternal immune response to
fetal/placental tissue
D. None of the above
3. Convulsive phase of preeclampsia and often preceded by
pre-monitory events such as headache and hyperreflexia?
4. In acute Hypertension, lower blood pressure within 30
minutes to prevent?
5. remains the drug of choice for seizure prophylaxis in
severe preeclampsia and for controlling seizures in
eclampsia
6. Can cause cyanide and thiocyanate toxicity in the mother
and fetus or newborn, and increased intracranial pressure
with potential worsening of cerebral edema in the mother.
7. The following are criteria for high-risk diabetes except
A. Presence of glycosuria
| Kulin Arit, Edess Lim and Delsie Vicente
B. Diagnosis of polycystic ovarian syndrome
C. Strong family history of type 2 diabetes
D. Age <25 years old
8. Women with gestational diabetes should undergo an
OGTT __ weeks postdelivery to rule out diabetes or
prediabetes;
9. What is Macrosomia?
10. Patients should take a prenatal vitamin containing at
least __ mg of folic acid daily for at least 3 months before
conception
Quiz 14.3 San Luis Part 1
1. Chronic Hypertension blood pressure exceeding______
mm Hg before pregnancy or before 20 weeks' gestation.
2. Diffuse placental thrombosis (inflammatory placental
decidual vasculopathy) Abnormal trophoblastic invasion of
the endometrium, Altered maternal immune response to
fetal/placental tissue?
3. True of Gestational Hypertension except:
A. New onset elevations of BP after 20 weeks of
gestation, often near term, in the absence of
accompanying proteinuria.
B. Outcomes in women are usually successful
C. Mild BP elevations don’t require enhanced
surveillance.
D. Although transient in nature, may be a sign of
chronic hypertension
4. True of Preeclampsia and Eclampsia except:
A. Occurrence of new-onset hypertension plus new-
onset proteinuria
B. Hypertension and multisystemic signs in the
absence of proteinuria may occur
C. Platelet count >100,000/microL
D. Impaired liver function (2x normal liver
transaminase levels) - New renal insufficiency
(Crea > 1.1 mg/dL or 2-fold Crea)
E. Pulmonary edema
F.New-onset cerebral or visual disturbances
5. Characteristics of Chronic Hypertension with
superimposed preeclampsia- women with hypertension only
in early gestation who develop proteinuria after 20 weeks
of gestation and those with proteinuria before 20 weeks of
gestation who:
A. Experience sudden exacerbation of
hypertension, or a need to increase
antihypertensive regimen when with previously
good control
B. Suddenly manifest other signs and symptoms
(e.g. increase liver enzymes to abnormal levels)
C. Present with a decrease in platelet levels <
100,000/microliter
D. Manifest symptoms such as right upper
quadrant pain and severe headaches
E. All of the above
Quiz 14.1 Answers
 | Kulin Arit, Edess Lim and Delsie Vicente

21. Why should peroxidase be measured in primary

Quiz 14.2 Answers hypothyroidism in pregnancy?
1. Refer to book 22. Delay surgical operation until ___ trimester.
2. D. None of the above
3. Eclampsia Quiz 15.2
4. Maternal stroke 1. Peak levels of HCG is bt. __ weeks AOG
5. Magnesium sulfate 2. At what levels will the HCG can able to suppress
6. Sodium nitroprusside maternal TSH
7. D. Age <25 years old 3. Fetal thyroid tissue begins ____weeks of geststion
8. 6-8 weeks 4. Highest risk during _ weeks AOG exposure to
9. > 4000 grams; >90th percentile thionamides
10. 1.0 mg folic 5. Thionamide that are less severe but can cause
hepatitixicity
Quiz 14.3 Answers 6. T or F TSH can cross the placenta
1. 140/90 7. This thionamide drug can rarely cause embryopathy,
2. Placental dysfunction, vasospasm characterized by esophageal or choanal atresia as well as
3. C aplasia cutis.
4. C 8. Those who can't adhere to medical tx can undergo
5. E surgery which is best accomplished in what trimester?
9. Best predictor of perinatal thyrotoxicosis is presence of
10. Blood levels in Gestational transient thyrotoxicosis
A. High T4, Low HCG, High TSH
TOPIC 15: Thyroid Diseases In Pregnancy (Dr Felicen)
B. High T3, Low, HCG, High TSH
C. High T4, High HCG, Low TSH
Quiz 15.1 D. High T3, High HCG, Low TSG
1. True or False: Signs and symptoms of pregnancy overlap 11. Referring to the above question will you administer
in non-pregnant state hypo/hypoerthyroidism. antithyroid drugs?
2. What are the proteins that bind thyroid hormones? (2) 12. Thyroid Disease characterized by fatigue, constipation,
3. Active form of thyroid hormone; unbound to protein. cold intolerance, muscle cramps and weight gain
4. Circular ung thyroid hormone; bound to protein. 13. Most common cause of hypothyroidism in pregnancy is
5. Hyperthyroidism if TSH is low at what level?
6. Hypothyroidism if TSH is high at what level?
7. These two hormones significant in pregnancy are of the
same family of glycoprotein with similar subunits. Quiz 15.1 Answers
8. What happens to thyroid gland when high levels of HCG
is reached? Quiz 15.2 Answers
9. In the first half of pregnancy, T3 and T4 are increased 1. 10-12 weeks AOG
giving a negative feedback, thus TSH is slightly __ 2. HCG >400 T iu/L
(decreased, increased) 3. Wrong question. At 10-12 weeks fetus starts to produce
10. If TSH and FT4 is decreased, what other labs should TSH
you request for? 4. 6-10 weeks AOG exposure to thionamides
11. Pregnant with hyperthyroidism at 7-12 weeks AOG: 5. Invalid question
Range is at __________mU/L if reference range is not 6. False
provided. 7. Methimazole
12. At ______ and ______ trimester, T3 and T4 levels goes 8. 2nd trimester
back to pre-pregnant state. 9. Thyroid-stimulating TSH-Receptor antobodies in women
13. Thyroid storm has ____% mortality rate. with graves disease
14. At 16 weeks, total T3 and T4 levels are _________ -fold 10. C
higher than in non-pregnant women. 11. Antithyroid drugs are not warranted
15. Hypothyroidism is a contraindication to surgery; it may 12. Hypothyroidism
result to _____. 13. Hashimoto thyroiditis
16. True or False: Gestational transient hyperthyrotoxicosis
does not require therapy.
17. True or False: increased antibody affects fetal thyroid. TOPIC 16: Pediatric Correlates CHD (Dr Mendoza)
18. Factitious thyrotoxicosis is due to _____.
19. A FHR of >160 does not always indicate Grave’s Quiz 16. 1
disease. 1. Beginning of cardiac descent
20. _______ when given prevents T4 to T3 conversion 2. First heart beat occurs at what day
(propanolol, metaprolol) 3. 3rd Shunt of the fetal circulation
4. This shunt closes due to increase O2 saturation
 | Kulin Arit, Edess Lim and Delsie Vicente

5. Fetomaternal shunt that is first to disappear. 5. Fetal UTZ can be performed as early as what week AOG

Quiz 17.2
Quiz 16.2 1. High-risk pregnancy except?
1. Most common congenital heart lesion? A. Fetal death
2. Medication that can cause ebstein’s anomaly? B. Preterm delivery
3. Congenital rubella is characterized by? C. Intrauterine growth restriction
4. SLE can cause what congenital heart problem? D. Well cardiopulmonary or metabolic transitioning
5. Alcohol can cause? at birth
2. Hypertension can cause IUGR through what mechanism?
Quiz 16.3 3. Prednisone can cause?
1. True or False: Cleft palate associated with congenital 4. Decreased potential of the fetus due to genetic
heart disease. conditions or extrinsic conditions active EARLY in
2. 1st heartbeat: ____days pregnancy?
3. Fetal circulation 5. First step in prevention?
A. Placenta➡️OV➡️FO➡️DA
B. Placenta➡️DS➡️OV➡️DA Quiz 17.3
1. IUGR in renal transplantation is due to what mechanism?
4. What is needed for DA to close A. Fetal hypoxia
A. Increased pressure B. Renal insufficiency
B. O2 saturation 2. Identity (Symmetric or assymetric IUGR)
A. HC= Ht = Wt, All <10%
5. VSD (isolated) most common CHD with a percentage of? B. HC= Ht > Wt, All <10% ; brain is spared

3. In prenatal care weight gain to follow up should be?

A. Not < 5% of previous weight 6 weeks ago
Quiz 16.1 Answers B. Not < 10% of previous weight 2 weeks ago
1. 19th day
2. 22nd-23rd day
3. Foramen ovale
4. Ductus arteriosus Quiz 17. 1 Answers
5. Placenta 1. ACE-I and ARBs
2. Thiazides
Quiz 16.2 Answers 3. 10th percentile
1. VSD 4. Asymmetric IUGR
2. Lithium 5. 6th weeks
3. Congenital cataract, deafness and heart disease
4. Congenital heart block Quiz 17.2 Answer
5. ASD, VSD and TOF 1. D
2. Uteroplacental insufficiency
3. Oral clefts
Quiz 16.3 Answers
4. Symmetric IUGR
1. True
5. Risk identification
2. 22-23
3. A
4. B Quiz 17.3 Answers
5. 25-30% 1. B
2. A. Symmetric, B. Assymmetric
3. A
TOPIC 17: Pediatric Correlates HTN & Renal Disease
(Dr Antonio)
TOPIC 18: Malnutrition During Pregnancy & Pulmonary
Quiz 17.1 Complications (Dr Malayan)
1. Intake of this drug during pregnancy can cause potter-
like syndrome Quiz 18.1
2. Intake of this drug can cause neonatal thrombocytopenia 1. This organ has high levels of Vit. A
but rarely 2. Acts together with Vit. E to prevent peroxide fornation
3. IUGR is below what percentile? 3. Alveolarization is until __ years of age
4. Type of IUGR whereby Brain growth is usually spared 4. LBW is less than ____grams
thus has better outcomes
 | Kulin Arit, Edess Lim and Delsie Vicente

5. Very good preventive mineral in pneumonia in children;

given at 4-6 months

Quiz 18.2
1. The following are the four stages of lung development
except?
A. Pseudoglandular
B. Glandular
C. Saccular
D. Tubular
2. Basic unit of the lung?
3. Responsible for Branching morphogenesis and to limiting
excess branching?
4. Responsible for Pneumocyte II maturation and
Enhancement of surfactant’s biosynthesis?
5. Childhood malnutrition causes a __ pattern which
preserves the normal lung function.

Quiz 18.3
1. Development of lungs: _____ AOG
2. RDS will result if low in what biochemical substance?
3. Most important nutrients needed for lung development

Quiz 18.1 Answers

1. Liver
2. Selenium
3. 22 years old
4. <1000grams
5. Zinc

Quiz 18.2 Answers

1. D
2. Acinus
3. Vitamin A: Retinoic Acid
4. Vitamin D
5. lung-sparing growth pattern

Quiz 18.3 Answers

1. 7 weeks
2. Phosphatidylglycerol
3. DHA, Selenium, Omega-3, vitamin ADE
 | Kulin Arit, Edess Lim and Delsie Vicente

SESSION 5 B. Psoas' sign

TOPIC 19: Surgical Indications (Cocos) C. Dunphys' sign
D. Obturator's sign
Quiz 19.1
1. At what AOG is the fetus susceptible to irradiation? 5. Surgery delayed >24 hrs has a --% chance of
2. Acute cholecystitis is best managed conservatively in perforation?
what trimester? A. 50%
3. Appendix can be displaced to iliac crest at what AOG? B. 66%
4. At 12 weeks the appendix is located at C. 80%
5. Among all complications of acute appendicitis this gives D. 86%
the highest rate. What is it?
6. Surgical operation of acute appendicitis should be done
within ____hours Quiz 19.1 Answers
1. 6 weeks
Quiz 19.2 2. First trimester
1. Bile stasis due to progesterone; female predominance 3. 24 weeks
due to estrogen and OCP- _______ 4. Mcburneys point
2. Disease answer in number 1 is managed conservatively 5. Preterm labor
due in _____ trimester and surgery at _____ trimester. 6. Within 24 hours
3. Location of acute appendicitis: _____ at 12 weeks; ____
at at 24 weeks; ____ at 36 weeks. (RUQ, McBurney’s point, Quiz 19.2 Answers
iliac crest) 1. Acute cholecystitis
4. Complications of acute appendicitis in pregnancy except: 2. 1st; 2nd
A. Abortion 15% 3. McBurney’s point, iliac crest, RUQ
B. Fetal loss 4. E
C. Premature labor 5. B
D. Perforation
E. Breast cancer Quiz 19.3 Answers
1. B. Second trimester
5. True of breast CA in pregnancy: 2. D. None of the above
A. Chemo after 20 weeks. 3. B. Iliac crest
B. More malignant in pregnancy 4. C. Dunphy's sign
C. Biopsy and appropriate surgical treatment after 5. B. 66% risk of perforation
delivery
D. Mammography
E. Diagnosis usually detected early
TOPIC 20: Benign Tumors (Cocos)
Quiz 19. 3
1. Best time to do operation on a pregnant woman: Quiz 20.1
A. First trimester 1. Most common large cyst of the vulva
B. Second trimester 2. Most common small cyst of the vulva
C. Third trimester 3. Most common benign solid tumors of the vulva
D. Postpartum 4. Usage of this can sometimes cause Toxic Shock
Syndrome
2. Surgery is indicated immediately except: 5. Most frequent pelvic tumor
A. Can't differentiate from acute appendicitis 6. Most common benign tumor of the fallopian tube
B. Emlarging mass (empyema) 7. Known as chocolate cyst
C. Jaundice 8. Most common functional cyst of the ovary
D. None of the above 9. Helban triad
10. Can present RUQ pain except
3. Appendix is displaced where during the 24th week? A. Paratubal torsion
A. McBurney's point B. Hemorrhagic corpus luteum
B. Iliac crest C. Ectopic pregnancy
C. Right upper quadrant D. None of the above
D. Right lower quadrant
Quiz 20.2
4. Sign wherein there is increase abdominal pain with 1. In post menopausal women, asymptomatic, 1-2cm,
coughing treatment is oral/topical estrogen, laser, cryosurgery-
A. Rovsing's sign __________
 | Kulin Arit, Edess Lim and Delsie Vicente

2. Initial treatment for Straddle injury if there is hematoma 1. Urethral caruncle

on vulva- _____ 2. Ice compression
3. Most common benign neoplastic growth of cervis 3. Endocervical and cervical polyp
4. True or False: Endometrial polyp can cause abnormal 4. True
uterine bleeding; 25% is associated with malignancy. 5. UTZ and drainage
5. Mgt of hematometra 6. Submucosa
6. Leiyomyoma can cause AUB if located in ________ 7. Dermoid cyst
7. 90% of germ cell tumor, slow growing and dense
echogenic area seen in UTZ
Quiz 20.3 Answers
Quiz 20.3 1. C. Marsupialization
1. Treatment for bartholin's gland cyst: 2. C. Adenomyosis
A. Surgery 3. B. Follicular cysts
B. Cryoprecipitation 4. A. Theca lutein cysts
C. Marsupialization 5. B. Fibroma
D. Nothing. It will regress spontaneously

2. Growth of endometrial glands and stroma into the

uterine myometrium to a depth of 2.5 mm from the basalis TOPIC 21: Cervical Cancer (Cocos)
layer of the endometrium Quiz 21.1
A. Hematometra 1. T or F Cervical cancer is fast-growing
B. Endometrial polyp 2. Pathology starts on what location
C. Adenomyosis 3. Carcinoma in situ CIN stage?
D. Leiomyoma 4. Most common type of Cervical Ca derived from what
epithelium
3. Most common functional cyst of the ovary 5. If Associated with Renal failure. What stage already?
A. Theca lutein cysts
B. Follicular cyst Quiz 21.2
C. Corpus luteum cyst 1. Cervical CA ranks _____ most common cancer in women
D. B and C (OBGYNE)
2. HPV 16, 18, 31, 33, 45, 52, 58 are considered low or
4. Commonly found in H-mole due to overstimulation of High risk serotype?
HCG 3. Advanced stage symptoms of cervical CA except:
A. Theca lutein cysts A. loss of appetite and weight
B. Follicular cyst B. Renal failure
C. Corpus luteum cyst C. AOTA
D. B and C 4. Which complication of cervical CA is no. 1 cause of
death?
5. Meg's syndrome: fibroma, ascites and hydrothorax is 5. What kind pf hysterectomy in cervical CA?
found in
A. Adenoma Quiz 21.3
B. Fibroma 1. Most common gynecologic malignancy in the Philippines
C. Struma ovarii A. Cervical cancer
D. Cystosarcoma phyllodes B. Endometrial cancer
C. Ovarian cancer
D. Vaginal cancer
Quiz 20.1 Answers 2. High-risk HPV associated with cervical cancer:
1. Bartholin's Cyst A. HPV16 and HPV18
2. Inclusion cyst B. HPV 6 and HPV11
3. Fibroma C. HPV 9 and 10
4. Tampons D. All of the above
5. Leiomyoma 3. Cervical cancer starts at the squamocolumnar junction.
6. Adenomatoid tumors True of False?
7. Endometrioma 4. Recommended age for cervical cancer screening is:
8. Follicular cyst 5. In VIA, 3-5% __ is placed in the cervix causing the
9. 1. Period of delay; spotting 2. Unilateral pelvic pain 3. precancerous lesion to turn white.
Small tender adnexal mass
10. D. None of the above
Quiz 21.1 Answers
Quiz 20.2 Answers 1. False
 | Kulin Arit, Edess Lim and Delsie Vicente

2. Transformation/transitional zone/Squamocolumnar
junction 3. Endometrial cancer spread can occur via:
3. CIN III A. Direct extension
4. Squamous cell B. Lymphatics
5. Stage IIIb C. Hematogenous spread
D. All of the above
Quiz 21.2 Answers
1. 2nd 4. True or false. Cervical cancer is staged clinically while
2. High risk endometrial cancer is staged surgically.
3. C
4. Renal failure Quiz 22. 1 Answers
5. Radical 1. Endometrial Ca
2. Estrogen
Quiz 21.3 Answers 3. Surgical
1. A. Cervical cancer 4. Stage II
2. A. HPV16 and HPV18 5. Stage IIIB
3. True
4. 21 years old Quiz 22.2 Answers
5. Acetic acid 1. E
2. Surgically
3. 3rd; 50-60 yrs old
TOPIC 22: Endometrial Cancer (Cocos) 4. Tamoxifen
5. IIIA
Quiz 22. 1
1. Most frequent in western countries
Quiz 22.3 Answers
2. This hormone is the main culprit for this 1. E. All of the above
3. Staging is assessed via surgical or clinical? 2. C. Abnormal uterine bleeding
4. This stage will be needing radiation because of cervical 3. D. All of the above
involvement 4. True
5. What stage if it includes the vagina and parametria

Quiz 22.2 TOPIC 23: Ovarian Cancer (Cocos)

1. Treatment of endometrial CA include:
A. Surgery, radiation and chemo (adjuvant therapy) Quiz 23. 1
B. THBSO 1. It is the _ most common cancer of the lower part of
C. PFC female genital tract ( 1st, 2nd, 3rd)
D. BLND 2. Most common histologic type is
E. AOTA 3. T of F chemotherapy is done first before proceeding to
2. How is endometrial CA staged? surgery
3. Ranked __ in Philippines of OBGNYE conditions and 4. T or F Dysgerminoma is not radiosensitive
pesos at what age? 5. Involvement of >1/2 of myometrium is at what stage
4. Intake of this med is a risk factor due to selective
estrogen receptor modulator. Quiz 23.2
5. Stage when adnexa is included 1. Most frequent histologic type of ovarian CA (70%)
2. Stage 3C:
Quiz 22.3 A. Seeding >2cm
1. Which of the following are risk factor/s for Endometrial B. Seeding <2cm
cancer: C. Spread to inguinal lymph node
A. Unopposed estrogen D. A and C
B. Obesity
C. PCOS 3. Treatment include:
D. Tamoxifen use A. Hysterectomy
E. All of the Above B. Removal of tubes, ovaries, omentum (debulking)
C. Radio therapy
2. Clinical presentation of Endometrial cancer: D. A, B only
A. Abnormal uterine contractions E. AOTA
B. Abnormal uterine pain
C. Abnormal uterine bleeding 4. What stage with metastasis?
D. Palpable tumors 5. Stage when only one o art is affected.
 | Kulin Arit, Edess Lim and Delsie Vicente

Quiz 23. 3
1. Germ cell tumors except:
A. Teratoma
B. Dysgerminoma
C. Yolk-sac tumors
D. Granulosa cell tumors

2. The following are protective against ovarian cancer

except:
A. Breast-feeding
B. Oral contraceptives
C. Early menarche
D. Pregnancy

3. Specifically done in ovarian cancer treatment:

A. Radiation
B. Palliation
C. Omentectomy
D. Chemotherapy

4. Radio-sensitive tumor:
A. Embryocarcinoma
B. Yolk-sac tumors
C. Theca lutein cysts
D. Dysgerminoma

Quiz 23.1 Answers

1.2nd
2. Epithelial cell tumor
3. F. Surgery then chemotheraphy
4. F. It is Radiosensitive
5. Stage IB

Quiz 23.2 Answers

1. Epithelial
2. D
3. A
4. Stage 4
5. Stage 1

Quiz 23.3 Answers:

1. D. Granulosa cell tumors
2. C. Early menarche
3. C. Omentectomy
4. D. Dysgerminoma
 | Kulin Arit, Edess Lim and Delsie Vicente

SESSION 6 D. Implants

TOPIC 24: Family Planning (Dr Rajagukguk) 3. methods need to be used only at the time of intercourse,
but that is the feature that most profoundly decreases their
Quiz 24. 1 use and increases their failure rate.
1. Give at least 2 medical conditions in which use of IUD is A. Implants
indicated. B. Condoms
2. Most effective method of contraception available with C. Pills
effectiveness equal or superior to sterilization and IUD D. IUD
3. What type of progesterone contained in Intradermal
contraceptive 4. Contraindications of IUD insertion:
4. Most effective method of Emergency contraception A. Pregnancy
5. Implants are good for only __ years B. Acute PID
C. Post-partum endometriosis
D. Menstruation
Quiz 24.2
1. Reversible contraceptive options except:
5. Typical and perfect use of abstinence is?
A. IUD
A. 65%
B. Implant
B. 75%
C. Microinsert
C. 85%
D. Intratube device
D. 100%
2. Timing of insertion of IUD:
A. Immediately post abortion
B. Any day of the cycle provided she is not
pregnant, not sexually active and used appropriate Quiz 24.1 Answers
contraception 1. DM, Thromboembolism, AUB/dysmenorrhea,
C. Immediately post partum following either vaginal Breastfeeding, Breast Ca, Liver disease
or post CS 2. Subdermal implants
D. AOTA 3. Etonorgestrel
3. Match: 4. Copper IUP
Levonorgestrel _______, copper-releasing __ (with 5. 3 years
and without mens)
4. IUD mild symptoms treatment ______; severe symptoms Quiz 24.2 Answers
__ 1. C
5. Lactation amenorrhea method is effective for first _ 2. D
months exclusive breast feeding 3. Without mens, with mens
6. Subdermal implants good for __ years 4. NSAIDS; IUD removal
7. Which is True: 5. 6
A. Body weight does not influence effectiveness of 6. 3
oral EC thus it should not be witheld from women 7. B
who are obese or overweight.
B. EC should be made available to patients up to 5 Quiz 24.3 Answers
days after u protected or inadequately protected 1. D. Progesterone
sexual intercourse. 2. A. LAM
3. B. Condoms
Quiz 24.3 4. D. Menstruation
1. Hormone that has a thermogenic effect on the brain and 5. C. 85%
is responsible for increase basal body temperature
A. Estrogen
B. LH TOPIC 25: Nutrition In Pregnancy (Balagtas)
C. FSH
D. Progesterone
Quiz 25.1
E. All of the above
1. Fill in the blanks:
2. Limited to women who consistently (and exclusively)
Nutrient
breastfeed during the first 6 months postpartum and who
Normal requirement
remain amenorrheic
Additional requirement
A. Lactational Amenorrhea Methods
Function/Source/Deficiency
B. Progestin Only Pills
C. Oral Contraceptive Pills
Energy
 | Kulin Arit, Edess Lim and Delsie Vicente

Protein 1. C. 500 kcal

Vitamin A 2. C. 300 kcal
Vitamin C 3. increase of 3 kg/month during the 2nd & 3rd trimester
Vitamin B1
4. C. Iodine
Vitamin B2
Vitamin B3 5. fetus draws 13 mg/hr from the mother or 250-300 mg
Folate per day
Calcium
Iron
Iodine

2. _________ - protein sparer

3. Ca:P= _______

4. Rapid weight gain in pregnancy: > ____kg/month

increase during 2nd and 3rd trimester.

5. Number four results to risk in what conditions in

pregnancy?
A. Pregnancy induced HTN
B. LGA
C. Difficult labor and birth
D. AOTA

6. Recommended ratio intake of fats in pregnancy-induced

HTN ___UFA:__PUFA

Quiz 25.2
1. Energy requirement for lactating mothers
A. 300kcal
B. 400 kcal
C. 500 kcal
D. 600 kcal

2. Energy requirement for pregnant mothers

A. 100 kcal
B. 200 kcal
C. 300 kcal
D. 400 kcal

3. Rapid weight gain is defined as:

4. Prevents cretinism in infants
A. Iron
B. Folate
C. Iodine
D. Vitamin C

5. The fetus draws calcium from the mother in the rate of?

Quiz 25.1 Answers

1. Refer to ppt lecture
2. Carbohydrates
3. 1:1
4. 3kg
5. D
6. 1:3

Quiz 25.2