1. A G2P1 comes to your clinic. She had pregnancy test with positif result.

She wants to
check her pregnancy for the first time. She is wondering her age of pregnancy since
she had period last May, 25, 2019. Today is August 22,2019.
a. Compute her age of gestation : 12 minggu
b. When is her due date? 29 febuari 2019
c. On this age of gestation, where can you palpate the uterine fundus (at the level
of?) di symphysis os pubis
2. A 25 years old primigravida is brought to the LDS at 39 weeks pregnancy. She
complains of labor pains. Fundie height 33 cm, head presentation and FHR 145 bpm.
On internal examination revealed cervix is soft, mid position, 6 cm dilated with 70%
effaced, intact water, cephalic with right occiput anterior, station 0. she has an
adequate uterine contraction.
a. What is your diagnosis: G1P0A0 gravid 39 minggu tunggal hidup prestasi kepala
impartu kala 1 fase aktif
b. What is your estimated fetal birth weight?
(TFU – constanta) x 155 = berat (g)
Constanta
Station minus : 13 (belum masuk pap)
Station 0 : 12
Station plus : 11 (melewati ischial)
TFU 41, station 0
(33-12) x 155 = 3,255
c. When do you expect she will reach full cervical dilatation? (how many hours)
Primi 1 cm per jam  4 jam. Multi 2 cm per jam  2 jam.
d. After 4 hours, if you still have the same internal examination findings, what then
is your diagnosis? G1P0A0 gravid 39 minggu tunggal hidup presentasi kepala
impart kala 1 fase aktif persalinan macet (arrest disorder)
3. A G7P5A1 on her 38 weeks of pregnancy comes due to vaginal bleeding. She had
monthly regular prenatal check up in a clinic. The history of prenatal check up and
ultrasound were uneventful. All previus four pregnancies were delivered normal, but
the fifth one delivered by casaeran section due to malpresentation.
a. What are the three most conditions you are thinking of?
Placenta previa, solution placenta dan bloody show im partu
b. Her uterus is hard, tender, FHR 160 bpm. She is not in labor. What is the most
likely diagnosis? G7P5a1 GRAVID 38 minggu suspect solution placenta derajat
sedang.
c. Her BP 160/110 mmHg. Pulse is 112 bpm. She is slightly pale. What investigation
will you perform? Cek cross match, screening DIC (blood fibrinogen, thrombosit,
PT/APTT, clotting time).
d. What is the most possible cause of her cause? Darah tinggi dan riwayat SC
4. A 20 years old primigravida is referred from a clinic to your hospital due to
hypertension at 39 weeks of pregnancy. She complains of severe headache and
blurring vision. She vomits on admission. Her BP 180/110 mmHg. FHR 132 bpm and
estimated fetal weight is 2800 grams. She is not in labor.
a. what are types of hypertension in pregnancy?
- Pre eclampsia ringan
- Pre eclampsia berat
 - Eclampsia
- Chronic hypertension
- Gestational hypertension
- Superimposed pre eclampsia
b. What is your diagnosis and 2 principal management for this case?
G1P0A0 gravis 39 minggu dengan preeclampsia berat
The 2 principal :
1. Pemberian MgSO4 (untuk mencegah kejang)
2. Pemberian antihipertensi cepat (nifedipine)
c. If it is a case of severe preeclampsia, how do you administer MgSO4? Please
describe the pre-requsites and doses
d. What is the mode of delivery that you choose? SC
5. 39 years old multiparous woman comes with abnormal uterine bleeding. She
experiences a heavy and long menstrual bleeding since 2 months.
a. What are the causes of abnormal uterine bleeding?
PALM COEIN
Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia
Coagulopaty
Ovulatory dysfuntion  PCOS
Endometrial
Iatrogenic
Not yet classified
b. Give four differential diagnosis for case above.
- Mioma uteri, coagulapaty, PCOS, polyp
c. Investigation (at least 2)
USG abdomen, Coagulation factors
6. A 28 years old woman comes to your clinic due to vaginal discharge since two weeks
ago. It is abnormal according to the patient. She denies fever, dysuria and lower
abdominal pain.
a. What are the 5 most common vaginitis?
- Bacterial vaginosis
- Trichomoniasis vaginalis
- Vulvo vagina Kandidiasis
- Atrophic vaginitis
- Inflammatory vaginitis
b. What investigation will yu perform to confirm diagnosis?
Inspeksi
Inspekulo  pH (pake lakmus), kOH, gram staining
Pemeriksaan dalam
c. If on speculum examination, you notice the purulent yellowish discharge from
the cervix, what will be your diagnosis and management?
Trichomoniasis vaginalis
Metronidazole 500 mg tablet 2 x1 (7 hari)
7. An 18 years old woman comes to ER due to severe abdominal pain since 3 hours ago.
She is slightly pale. According to her, she has just finish her period abour 3 days ago,
but it seems abnormal since it was only spotting and lasting for only 4 days, usuallt
she has a regular normal menstruation, one- week duration and denies
dysmenorrhea. She denies fever, urination and bowel movements are normal.
a. What is your differential diagnosis (2 at least)
- KET
- Abortion incomplete
b. What investifation will you perform to confirm the diagnosis? (at least 2)
- Beta HCG
- USG abdomen
8. A 32 years old P5A1 comes to your clinic for contraceptive counselling. She just
delivered her baby 1 month ago.
a. What contraceptive options are suitable for this patient (4)
- Steril : vasektomi, tubektomi
- LAM (lactational Ammenorhe method)
- IUD
- kondom
b. Give two choices of long term contraceptive for this patient
1. STERIL (tubectomy or vasektomi)
2. implant