SOAL-SOAL UJIAN SEMESTER 3JULI 2009

Pilihlah jawaban yang paling tepat1. Penyebab utama gangguan pertumbuhan janin intra uterin :

a. Defisiensi zat nutrienb. Penyakit vaskular ibuc. Infark plasenta yang luasd. Cacat bawaan jantunge. Infeksi virus seperti rubella

2. Komplikasi utama pada janin akibat insufisiensi utero-plasenter menyebabkan :a. Rasio HC/AC meningkatb. Oligohidramnionc. Reduksi ukuran janin terjadi secara proporsionald. Peningkatan rasio sistolik-diastolike. 75 % nampak pada triwulan terakhir

3. Partus lama/ macet pada kala I fase aktif primipara ditandai dengan ......a. Pembukaan serviks lengkap sudah melewati garis tindakanb. Pembukaan serviks lengkap dan turunnya kepala 2/5 pertama..... 25 menitc. Inersia uteri primer dengan kemajuan serviks lambat dan ....... penurunan kepalad. HIS adekuat dengan tidak ada kemajuan pembukaan jalan lahir dan penurunan kepala e. Pada akhir kala I penurunan kepala 1/5

4. Komplikasi utama kehamilan dengan inkompabilitas darah adalah a. Hidrops fetalisb. Ikterus neonatorumc. Gangguan perkembangan janin intra uterind. Abortuse. Gangguan neurologis pada neonatus

5. Diagnosis kehamilan abdominal lanjut terutama dilakukan dengan .......a. Tes kehamilanb. Keluhan ibu bila janin bergerak dirasakan sakit pada .....c. USGd. Radiologie. Palpasi abdomen menurut Leopold

6. Syok dalam obstetri yang paling sering ditemukan adalah akibat :a. Alergi obat-obatanb. Sepsis partus lamac. Perdarahan plasenta previad. Perdarahan retensio/ sisa plasenta e. Nyeri pada usaha melepaskan plasenta

7. Pada kehamilan ke-2 dengan sebelumnya pernah seksio sesar :a. Kelainan letak janin selalu terjadib. Terjadi plasenta previac. Indikasi mutlak untuk melakukan seksio sesard. Dapat dilakukan persalinan percobaan bila seksio sesaria sebelumnya telah lebih 2 tahune. Perlu pemeriksaan USG untuk menilai kerusakan jaringan akibat seksio sesaria sebelumnya

8. Gambaran “frog eyes” pada pemeriksaan USG ditemukan pada keadaan :a. Akondroplasiab. Hidrops fetalisc. Anencefalid. Hidrocefaluse. Semua di atas salah

9. Seorang ♀, 28 thn datang ke Poliklinik dengan Abortus habitualis (abortus 3 X), riwayat menikah 5 thn. Anjuran pemeriksaan yang tepat untuk ibu ini adalah:

a. Pemeriksaan TORCH

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b. Kariotypingc. USGd. Pemeriksaan kadar gula darah puasae. Pemeriksaan kadar hormon tiroid

10. Pemeriksaan USG pelvis pada kasus infertilitas berguna untuk mengetahui :a. Kelainan bentuk rahimb. PCO c. Mioma uterid. Semua disatas benare. Semua di atas salah

11. Penurunan baseline DJJ pada usia kehamilan dapat disebabkan oleh :a. Respon maturasi saraf simpatisb. Respon maturasi saraf parasimpatisc. Pertambahan ukuran tubuh janind. Perubahan hormonale. Suplai oksigen berkurang

12. Penyebab utama PJT Tipe-1 :a. Kelainan kromosomb. Hipertensic. PEBd. DM Gestasionale. Hipertiroid

13. Pada KTG , akselerasi DJJ meningkat diatas base line : (jawaban yg benar 10-15 dpm dalam 20 menit)a. 10 bpm selama 10 menitb. 15 bpm selama 10 menitc. 10 bpm selama 15 menitd. 15 bpm selama 15 menite. 25 bpm selama 15 menit

14. Penurunan DJJ bersamaan dengan kontraksi :a. Deselarasi dinib. Deselarasi lambatc. Deselarasi variabeld. Deselarasi awale. Deselarasi campuran

15. Bila pada USG didapatkan “halo sign” berhubungan dengan :a. Fetal distressb. Fetal demisec. IUGRd. DMe. Hidrops fetalis

16. Ibu datang dengan amenorea 10 minggu, tes kehamilan (+), pada USG tidak tampak kantong gestasi. Tindakan yang dilakukan :

a. Ulangi tes urineb. Ulangi USG 1 minggu kemudianc. Ulangi USG 2 minggu kemudiand. Pemantauan ß HCG serume. Pemantauan ß HCG urin

17. Tanda PJT pada USG : (Semua jawaban dibawah benar)a. Oligohidramionb. Pada pemeriksaan Doppler didapatkan S/D ratio arteri umbilikalis (> 3 – setelah UK 30 minggu)c. Berat badan janin kurang dari percentil 10d. A dan B benare. A dan C benar

18. Nifedipine, except :

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a. Could be stop abruptly (dpt menyebabkan angina & infark miokard pd penderita jantung koroner)

b. Hot environment can exaggregated the effects of this drugc. Reduce liver & kidney functiond. Should not be use by persons who had a previous ...... drugse. Can be given to pregnancy induced hypertension by ........

19. The cause of postsurgery infection, EXCEPT :a. The mount of the microorganism infected the woundb. The virulency of the microorganismc. Immunologic status of the patientd. External factors as such as length of stay in the hospital (...... hours)e. Short of antiseptic using before the operation

20. The most benefit of using soap & clean water in infection prevent :a. Eradicated microorganism without making harm to skinb. Eradicated microorganism included viralc. Washed dirty and clean the surface of the skin or other tools microorganismd. More than 50 % microorganism can be eradicatede. Delayed the growthy of several microorganism

21. Which of the following is contraindicated in the treatment of chronic hypertension in pregnancy :a. Metyldopab. Hidralazinc. ACE Inhibitord. Labetolol

22. How is magnesium secreted?a. Lungsb. Liver c. Kidneysd. Gastrointestinal tract

23. What plasma magnesium level most often prevents seizures?a. 3 to 4 mEq/ Lb. 4 to 7 mEq/ Lc. 7 to 10 mEq/ Ld. Over 10 mEq/ L

24. How is magnesium toxicity treated?a. Calcium glukonate 1 g ivb. Calcium glukonate orallyc. Calcium glukonate 1 g iv and discontinue magnesiumd. Dyalisis

25. In nulliparas with preeclampsia-eclampsia what is the risk ........ chronic hypertension in the future?a. Less than for the general populationb. The same as for the general populationc. Double that of the general populationd. Four times that of the general population

26. What is the following is true about interstitial pregnancy?a. Represents 3% of tubal pregnanciesb. Frequency rupture later (8 to 16 weeks)c. Is usually associated with massive hemorrhage if ruptured. All of the above

27. What is the common simptom of ectopic pregnancy?a. Bleedingb. Painc. Dizzinessd. Gastrointestinal symptom

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28. With typical use, which of the following contraceptive methods has the highest failure rate within the first year of use?

a. Male condomb. Norplant c. Spermicidesd. Withdrawl

29. Which of the following estrogens is used in oral contraceptive?a. Estrogenb. Ethinyl estradiolc. Estriold. Aquiline

30. What is the progestin with the least androgenic effect?a. Norethindroneb. Norgestrelc. Levonorgestreld. Norgestimate

31. Which of the following drugs may decrease the effectiveness of oral contraceptive?a. Aspirinb. Eritromisinc. Rifampisind. Propanolol

32. Which of the following is NOT reduced with oral contraceptive.....a. Breast milk productionb. Salpingitisc. Endometrial cancerd. Cervical cancer

33. The risk of stroke is increased with oral contraceptive use if which of the following co-factors is present?a. Hypertensionb. Migrainesc. Smokingd. All of the above

34. Which intra uterine device is the most effective in prevent pregnancy?a. Cu-T 380 Ab. Levonorgestrelc. Progestasertd. All the equally effective

35. How long (years) can the Cu-T 380 A be left in the uterine cavity?a. 1b. 3c. 5d. 10

36. Of the following, which is NOT effective for postcoital contraceptive?a. Ethinyl estradiol plus levonorgestrelb. Copper intra uterine devicec. Levonorgestrel aloned. Norplant

37. Which puerperal tubal sterilization procedure is least likely to fail but most difficult to perform?a. Pomeroyb. Irvingc. Parklandd. Fimbriectomy

38. What is the least effective sterilization procedure?a. Fimbriectomyb. Madlener (& Kroener → high failure rates)c. Parkland

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d. Irving 39. What laparoscopic tubal sterilization, which factors increase morbidity?

a. Obesityb. Previous abdominal or pelvic surgeryc. Diabetesd. All of the above

40. Contraindications to inductions of labor include all, EXCEPT which condition?a. Makrosomiab. Prior classical cesarean birthc. Plasenta previad. Fetal renal anomaly

41. Whic of the following is NOT component of the Bishop score?a. Parityb. Dilationc. Effacementd. Stasion

42. When using PGE2 for cervical ripening, what percentage of .......a. 10b. 25c. 50d. 75

43. What is the dose of misoprostol that the ACOG recommends be used for cervical rippening?a. 25 ugb. 50 ugc. 100 ugd. 200 ug

44. How long dose it take oxytocin to reach steady state levels in the plasma?a. 5 minb. 10 minc. 20 mind. 40 min

45. Tindakan awal bila terjadi perdarahan antepartum adalah :a. Segera lakukan pemberian oksigen dengan sungkup dan ibu baring miring kiri & periksa DJJb. Pasang infus dgn jarum besar dan pemberian cairan ringer asetat dan transfusi darah sebagai

cairan pengganti darah yang hilang ditambah 2 liter cairan per infusc. Pasang cateter tetap dan cacatd. Evaluasi jumlah perdarahan dan cacate. Periksa D-Dimer

46. Selama kehamilan terjadi perubahan, KECUALI:a. Vasodilatasi umum dan peningkatan curah jantung sebesar 40% karena stroke volume

bertambahb. Penigkatan volemue darah dan ektraseluler serta aliran darah ginjalc. Tidak terjadi perubahan fungsi tubulus ginjald. Penyebab terjadinya perubahan tersebut karena efek prostaglandin dalam sirkulasie. Penurunan tekanan darah sebesar 10 % dari kehamilan pada kehamilan awal dan berangsur

menjadi normal pada kehamilan cukup bulan 47. Pemature rupture of the membranes is most strictly defined as spontaneus rupture anytime prior:

a. Stage of fetal viabilityb. The second stage of laborc. The 32nd week of gestationd. The onset of labore. The 37th week of gestation

48. Face presentations are commonly with:a. Anencephalyb. Hydranenchepalyc. Prematurity

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d. Placenta previae. Oligohidramnions

49. Post partum hemorrhage unresponsed to oxytocin and uterine massage is likely due to:a. Laceratumb. Placenta acretac. Retined placentad. Rupture uteruse. Coagulopathy

50. High dose of progesterone for threatened abortion may:a. Save the fetusb. Keep the placenta alivec. Keep the corpus luteum runchbarsd. Cause habitual abortione. Cause retention of dead fetus

51. Therapy for threatened abortion should include:a. Progesterone imb. Dilatation and curetagec. Prolonged bed restd. Restricted activitye. Prostaglandin suppositories

52. The uterine sometimes shed when a pateint has an ectopic pregnancy is made up of:a. Decidua capsularisb. Decidua basalisc. Decidua verad. Thropoblast (5-10% ada desidua tapi tanpa jaringan tropoblas)e. Blood

53. What is the average interspinosus measurement?a. 8 cmb. 9,5 cmc. 10 cmd. 10,5 cm

54. What bodylandmark determines the designation of lie in shoulder [resentation?a. Acromionb. Browc. Breechd. Occiput

55. What is the approximate incidence of breech presentation at term?a. < 1 %b. 3-4%c. 7-8%d. 12-15%

56. In severe preeclampsia with pulmonary edema what immediate treatment given?a. Furosemide ivb. Digoxinc. Hydrochlorotiazided. Fluid restriction

57. How is hypertension in pregnancy defined?a. Blood pressure 160/100 mmHg or greaterb. Blood pressure 140/90 mmHg or greaterc. Incrased systolic pressure by 30 mmHgd. Increased diastolic pressure by 15 mmHg

58. Which of the following was aproved by the food and drug.......tocolytic of preterm labor:a. Indometacin

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b. Magnesium sulfatec. Ritrodined. Terbutaline

59. Which of the following is the principal reason for increased fetal risk in the postterm pregnancy?a. Placental insufficiencyb. Cord compression with oligohydramnionc. Decreased umbilical cord diameterd. Meconium-stained amniotic fluid

60. Zygotic division to form dichorionic, diamniotic twins accurs which of the following time periods following fertilization?

a. ≤ 72 hrb. > 72 hr and ≤ 120 hrc. > 120 hr and ≤ 240 hrd. ≥ 264 hr

61. Your patient presents for evaluation following her third spontaneous abortion. Which of the following might be a logical next step for this patient?

a. Herpes simplex antibody assayb. Lupus anticoagulant assayc. Protein C assayd. Antinuclear antibody assay

62. At 8 weeks gestation, if vaginal bleeding develops, what is the risk of spontaneous abortion?a. 10 %b. 30 %c. 50 %d. 70 %

63. What is the presenting part with a face presentation?a. Sinciputb. Malar eminencec. Mentumd. Occiput

64. Which of the following is associated etiologically with a face presentation?a. Contracted pelvic inletb. Oxytocin inductionc. Small for gestational age infantd. Tight abdominal musculature

65. In labor, if presenting part is the sagittal suture midway between the orbital rigde and the anterior fontanella, what is the presentation?

a. Faceb. Browc. Occiputd. Left occiput anterior

66. In which situation is the brow presentation likely it delivery vaginally?a. Small fetus, large pelvisb. Small fetus, small pelvisc. Large fetus, large pelvisd. Large fetus, small pelvis

67. What bodylandmark determines designation of lie in shoulder presentation?a. Acromionb. Browc. Breechd. Occiput

68. Which of the following is the common cause of transverse lie?a. Placental abruptionb. Normal uterusc. Posterm pregnancyd. Contracted pelvis

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69. Which of the following is a maternal risk factor for shoulder dystocia?a. Nulliparab. Obesityc. Class F diabetesd. Chronic hypertension

70. Which of the following is NOT part of the management of shoulder dystocia?a. Woods cocksrew manuverb. Fundal pressurec. Mc Robberts manuverd. Delivery of posterior shoulder

71. Of the following methods used for delivery of shoulder dystocia associated with the highest incidence of orhtopedic and neurologic complication?

a. Supra pubic pressureb. Mc Robberts manuverc. Hibbard manuverd. Woods cockscrew manuver

72. Which of the following is associated etiologically with severe preeclampsia? a. HLA-DR4 histocompability antigentb. Variant of angiotensin genec. Factor V Leiden mutationd. All of the above (merupakan genetic factors)

73. What is the recurrence rate of the HELLP syndrome?a. 2 %b. 5%c. 17%d. 25%

74. How is hypertension in pregnancy defined?a. Blood pressure 160/100 mmHg or greaterb. Blood pressure 140/90 mmHg or greaterc. Incrased systolic pressure by 30 mmHgd. Increased diastolic pressure by 15 mmHg

75. Which of the following patients would be MOST likely to develop true preeclampsia?a. 16 years old primigravidab. 24 years old gravida 4, para 3c. 25 years old primigravidad. 35 years old with essential hypertension

76. With regard a preeclampsia, proteinuria is defined as how much urinary excretion?a. > 100 mg/ 24 hrb. > 200 mg/ 24 hrc. > 300 mg/ 24 hrd. > 500 mg/ 24 hr

77. Which of the following is NOT diagnostic of severe preeclamsia?a. Increase serum creatinineb. 1+ proteinuriac. Thrombocytopenia d. Elevated liver enzymes

78. Which of the following is considered an abnormal 24 hours proteinuria for diagnosis of severe preeclampsia?

a. > 300 mg/ 24 hrb. > 1 gm/ 24 hrc. > 2 gm/ 24 hrd. > 4 gm/ 24 hr

79. Which of the following is associated with a decrease in hypertensive disease pregnancy?a. Twinsb. Smokingc. Obesity

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d. Age > 35 thn80. Which of the following is true concering blood volume in eclampsia?

a. Similar to the non pregnant stateb. Similar to the normal pregnant statec. Lower than the non pregnant stated. Increased compared with the normal pregnant state

81. Which of the following characterizes trombocytopenic in women with preeclampsia?a. Platelet activationb. Platelet consumptionc. Increased platelet productiond. All of the above

82. How is the level of aldosterone affected by preeclampsia in pregnancy?a. Increasedb. Decreased (Renin & Angiotensin II also)c. Unchanged from normal pregnancyd. As the same level as in nonpregnancy

83. What happens to renal plasma flow and glomerular filtration in preeclampsia?a. Increasedb. Remain the samec. Decreasedd. Very greatly

84. Which of the following does not decreased placental blood flow?a. Furosemideb. Apresolinec. Thiazide diureticsd. Magnesium sulfate

85. Of the following, which is NOT considered to be a predisposition of preeclampsia?a. Family history of preeclampsiab. Multipel fetusesc. Vascular diseased. Multiparity

86. Which deterious effect associated with oxytocin when given intravenous 10-IU bolus?a. Bradycardiab. Hypotension (dosis besar → relaksasi otot polos pembuluh darah → ↓TD Sistolik & Diastolik)c. Oligouriad. Cardiac arrhytmia

87. Which of the following is NOT a risk factor for breech?a. Multipel fetusesb. Hydramnionsc. Uterine anomaliesd. Low parity

88. Which of the following is NOT associated with persistent breech presentation?a. Perinatal morbidity and mortalityb. Macrosomiac. Prolapsed cordd. Placenta previa

89. When examining a woman at term, hearing fetal tone loudest above the umbilicus suggests which type of presentation?

a. Chepalic presentationb. Transverse liec. Breech presentationd. Multipel pregnancy

90. Cerebral palsy is a breech-presenting fetus is more likely related to wich of the following delivery events?

a. Vaginal breech delivery

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b. Piper forceps to aftercoming fetal headc. Cesarean sectiond. Not related to mode of delivery

91. What percentage of breech deliveries will be complicated by vaginal delivery?a. < 1b. 3c. 6d. 10

92. At what gestational age the uterine response to oxytocin increased?a. 6 to 10 weeks b. 10 to 18 weeksc. 20 to 30 weeksd. 32 to 36 weeks

93. PGE2 (dinoprostone) has been shown to decreased which of the following?a. Induction to delivery timeb. Cesarean delivery ratec. Bishop scored. Chorioamnionitis

94. Which of the following is NOT associated with successful external version?a. Postterm gestationb. Large amniotic fluid volumec. Unengaged fetus d. High parity

95. Which medication, when given orally to mothers, decreases fetal urine?a. Aspirinb. Cimetidinec. Bromocriptined. Indomethacine

96. The neural tube starts to fuse from:a. Days 30 – 35 b. Days 26 – 31c. Days 19 – 23 (Days 21-23)d. Days 10 – 15 e. Days 43 – 46

97. Which of the following factors is crucial for implantation?a. A surge in estrogen secretionb. A surge of follicel-stimulating hormonec. A surge of luteinizing hormoned. A surge of human chorionic gonadotropine. A surge of angiotensin hormone

98. In this condition, placental villi implant on uterine smooth muscle intervening decidua?a. Superficial implantationb. Placenta accretac. Placenta previad. Placenta membranaceae. Placenta circumvallate

99. Each of the following statements about placenta is true, EXCEPT:a. Retroplacental hematoma is related to, but not synonymus with abruptionb. Trauma can cause retroplacental hematomac. Preeclampsia can cause retroplacental hematomad. Placental abruption can cause consumption coagulopathye. Placental hydrops is associated with retroplacental hematoma

100. Chronic villitis is commonly caused by:a. Toxoplasmosisb. Herpesc. Rubella

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d. Cytomegaloviruse. Unknown organisms

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