SOAL REPRO INTER 2011

Soal Final 2011

1. As a respon to increase level of estrogen at myometrium during pregnancy is :
a. Hyperthrophy muscle cell
b. Hyperplasia muscle cell
c. Metaplasia muscle cell
d. hypertrophy and hyperplasia muscle cell.
e. Hyperthropy and metaplasia muscle cell
2. Breast change during pregnancy :
a. Increase number of secretory acini adn adipose tissue
b. Proliferation of duct ep. And proliferation of adipose tissue
c. Increase number of secretory acini adn proliferation of duct. Ep
d. Decrease adipose tissue w/ increase connective tissue
e. Decrease connective tissue and duct.ep
3. Biochemical change that cause gynecomasty in male at puberty:
a. Periferal increase testosteron aromatization
b. Fall of testosteron
c. Estrogen defeciency
d. Fall of progesteron reaction
e. Limitation prenadiol reaction

Mrs.anita came to ANC clinic to check her pregnancy. She had 2 times miscarriage at 12 weeks
and 8 weeks, stillbirth at 32 weeks. She has an 8-y.o boy who weighed 3300 g at birth and 4 y.o
girl who delivery prematurely weighed 2300 g. In this current pregnancy, her last menstrual
period was 8 january 2011.
4. Obstrectic history of mrs.rahmah was:
a. G5 P2 A2 d. G6 P2 A2 M1
b. G5 P3 A2 e. P3 A2
c. G6 P3 A2
5. Estimated day deliver of the baby will be on:
a. 11 august 11’ d. 11 september 11
b. 5 august 11’ e. 5 oct 11
c. 15 october 11’
6. Delivery between 20 weeks 36 weeks of pregnancy is called:
a. Abortion d. post term
b. Preterm e. stillbirth
c. Aterm
7. The important factors that play a role the implantation phase:
a. The zone pellucidaappear
b. The synctiotrophoblastic cells disappear
c. Asynchronic development of blastosphere and endometrium
d. Enough progesteron
e. High estrogen
8. Placental function in maintaining uterine contraction is”
a. Nutrition d. hormonal function
b. Gas exchange e. Catabolic function
c. Define mechanism

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9. Function of amniotic fluid in labour is:

a. Serve to cushion the fetus d. minimal nutrive function
b. Allowing musculosceletaldevelopment e. Support cervix dilatation
c. maintain the temperature
10. anemia in pregnancy relatively normal due to:
a. hemodilution d. Decrease of plasma volume
b. increase RBC e. Decrease of coagulation
c. increase of plasma protein
11. the pigmentation of the areola, linea alba, vulva, occasional irregularly shaped, brownish
patches of varying size appear in the face and neck is called as:
a. linea nigra d. striaegravidarum
b. corpus albicans e. purpurae
c. cloasmagravidarum
12. mrs.yanti,35 y.o complained about getting short breath in her pregnancy.This due to:
a. position of the heart
b. gastric reflux
c. insipiratory capacity increase in pregnancy
d. diaphragma rises 4 cm, excursion increases 1-2 cm
e. changes in tidal volume
13. a newborn baby has been delivered w/ a defect on it lumbal 5 procesus spinosus. The
causes of this defect:
a. def of iron d. calcium def
b. folic acid def e. Trauma in birth
c. antioxidant def
14. a pregnancy mother tend to have weight gain, swelling (oedema), related to the fluid
retention in her body. The consequency of this condition:
a. increase of RBC d. decreased of renal flow
b. Increase of albumin e. Increase of stroke volume
c. Decreased of blood & placental flow
Mrs. tuti, 19 yo having her 1st pregnancy w/ GA 2 months admitted to obstetrics policlinic w/
main complain nausea, vomit, and fatigue.
15. The correct diagnosis of mrs.tuti is:
a. Apendisitis d. hyperemesis gravidarum
b. Emesis gravidarum e. gastritis
c. Mola hidatidosa
16. Main causes of mrs.tuti complain is:
a. Increase of hPL hormone d. pressure of uterus to gaster
b. Inrease of hCG hormone e. Decrease of estrogen hormone
c. Increase of peristaltic
17. Predisposition factor of mrs.tuti complain is:
a. Molahidatidosa d. premature
b. Multigravid e. Oligohydroamnion
c. Singleton pregnancy
18. Chronic complication which could happen to mrs.tuti’s fetus is:
a. Abortus d. intra uterine growth restriction
b. Oligohydramnion e. Intra uterine fetal death
c. Congenital malformation
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A mother A mother who went to the delivery room on 10 a.m was diagnosed w/ G1P0 38 weeks
gravid. 1st stage of labor, breech presentation, estimated fetal weight (EFW) 2700 gr. Fetal
heart rate (FHR) 150 bpm. In VT examination you found the cervix dilated 7 cm. Station hodge
2, the membrane was already ruptured and there was prolapsed of the umbilical cord. Uterine
contracted twice in 10 minutes, 30 seconds of duration. Un next examination on 2 pm. FHR 160
bpm, cervix dilated 8 cm and meconeal staining.
19. The diagnosis and treatment the patient are:
a. A cito cesarean section must be done immediately
b. There was an uterine inertia and you could do an acceleration
c. There was a jammed in labor because the passengger factor
d. There was a fetal distress
20. One of the indication of cesarean section in breech presentation is:
a. Frank breech presentation
b. Fetal weight 2000 gr
c. Meconeal staining
d. Hyperextension of the fetal heart
21. At vaginal delivery in breech presentation, the fetal head will be delivered by:
a. Bracht c. lovset
b. Mauriceau d. Classic
22. The possible risk of using oxytocin in augmentation is:
a. Water intoxication c. prolapsed of the umbilical cord
b. Natrium intoxication d. Hypertension
23. In labor dystocia, we can find:
a. Hyperglycemia c. polyuria
b. Ketoacidosis d. Hyperreflex
24. Labor dystocia can increase maternal motility, it can make:
a. Cerebral palsy c. fistula vesicovaginal
b. Hyperstimulation d. Hypoalbuminemia
25. In labor dystocia, there will be a decreased of oxygen supply to fetus. The most severe stage
of decreased oxygen is:
a. Hypoxemia c. asphyxia
b. Hypoxia d. acidosis
26. According to the case, there was a meconeal staining which means:
a. A sign of asphyxia
b. Not a danger sign because the fetal was in breech presentation
c. Oxygen must be given to the mother immediately
d. The labor must be terminated by cesarean section
27. In case of more than 3 days of IUFD (Intra uterine fetal death), we could find cranial
averlapping by ultrasound exam. It is called:
a. Spaldig’s sign c. turtle sign
b. Robert’s sign d. chadwick sign
R, a female baby, born in April 20th 2011, body weight 2400 gr, body lenght 45 cm, the last
menstrual day august 17st 2010, the baby immadiately cry. Harusx mlahirkn 24 mei2011,
syarat BF. >34 week
28. The problems of neonatal adaptation for the baby that show in the scenario included:
a. Maturation and nutrition factor
b. Maturation and tolerance
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c. Maturation, nutrition, and tolerance

d. Nutrition and tolerance
e. Maturation, nutrition, tolerance
29. After the baby birth, what the management you will give for the baby:
a. Put the baby under radiant warmer, arrange position of the baby, and suction mucous
b. Put the baby under radiant warmer and dry all of the baby’s body
c. Put the baby on abdomen of the mother, dry all of the baby’s body except the baby’s hand
and support to make early initiated of breast feeding
d. Early initiation of breast feeding is not allowed because of prematurity
e. Early initiation of breast feeding is not allowed because of low birth weight
A, a male baby was born by sectio cesarean. You examined the baby under a radiant warmer
30. What is the important question before you make a decision?
a. How many the mother’s age? d. A & B
b. Breathing or crying? e. B & C
c. Good muscle tone
31. If you found the baby apnoe, therefor the apnoe is considerd as:
a. Primary apnoe and make tactile
b. Primary apnoe and immediately make positive pressure ventilation
c. Primary apnoe and inital step is necessary
d. 2ry apnoe and initial step is necessary
e. 2ry apnoe and immediately make pressure positive ventilation
32. If the baby remain can not be breathing spontaneously, what is your decision:
a. Initial step continued d. evaluated Apgar score
b. Positive pressure ventilation e. Measure the baby’s weight
c. Routine care
33. What is the effect of cigarrete smoking on the fetus & neonates:
a. Abruptio placenta + meconium staining d. premature labor + precipitous delivery
b. Abruptio placenta + premature labor e. Premature labor + still birth
c. Abruptio placenta + placenta previa
34. A pregnant woman who consumption physcotherapeutic drug, can effect the fetus and
neonate. The effect is?
a. Cleft lip d. nasal bridge
b. Epichantal fold e. ptosis
c. Hyplastic maxilla
Mrs. ani, admitted to hospital w/ chief complain having uterune contraction. From anamnesis,
we know that first day of last menstrual period is July 25th 2010, w/ regularly menstrual cycle
every month. Physical examination found that fetal lie is longitudinal w/ cephalic presentation,
fetal heart rate 140x/min, and uterine contraction is 2x10 min w/ duration is 30-35 second
every contraction. From inspeculo exam no dilatation on services, effacement of servix about
80% . examination performed today.
35. In mrs.ani case, we need to give a drug to induce the maturity of fetal ling. The drug of
choice is:
a. Nifedipin d. indometasin
b. Tarbutalin e. cortocosteroid
c. atosiban
36. drug of choice to relax the uterus which can give to mrs.ani is:
a. Nifedipin d. indometasin
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b. Tarbutalin e. cortocosteroid
c. Atosiban
37. Woman w/ G3 P2 A0 aterm pregnancy at labor for 20 hours. The midwife has started to
active pushing from 3 hours ago. The first thing that we should examine is:
a. Mother condition d. estimated fetal weight
b. Pelvic examination e. Fetal heart rate
c. Uterine contraction
38. From the vaginal toucher, found that the fetal head descent is Hodge III, which shows that
the fetal head as high as:
a. Spina ischiadika d. Upper border of symphisis pubic
b. Os. Coccigeus e. Lower border of symphisis pubic
c. Not engaged
39. Mrs. titi has gave birth a girl baby. On physial exam on her baby we found taht the baby’s
skin is dry and exfoliating, in yellow colour, that show that the baby is:
a. Icterus d. serotinus grade II
b. Skin infection e. Serotinus grade III
c. Serotinus grade 1
Miss S, aged 16, thought she had become pregnant after her first coital experience. Which
occured w/out contraception. Shortly after she read about the signs and symptoms of
pregnancy, ger menses stoped. Sshe related that she felt tingling in her breasts, which she
velieved were enlarged. She also reprted nausea and vommiting in morning, which was
observed by her mother. On exam, the uterus was enlarged. Breast were developed w/ darl
aerola and contained milk and apigmented line was observed from the umbilicus to the pubis.
The abdomen was not en;arged, but she believed she felt fetal movement. A pregnancy test had
negative results and the patient was so infromed, however she could not be dissuaded of her
belief that she was pregnant.
40. Diagnosis of the patient above is:
a. Pregnancy d. steril
b. Pseudo pregnancy e. abortion
c. Infertile
41. Physchological aspect of pregnancy, its really mean is:
a. Self realization d. self ego
b. Self guilt e. Aelf identity
c. Self ....
42. In early pregnancy, the problem mostly appear is:
a. Abortion d. anorexia nervosa
b. Morning sickness e. Sleep disorder
c. Hyperemesis gravidarum
43. 43. As patient mentional above as followed of hallusination amd delusion could be
diagnosed as:
a. Anxiety d. mania
b. Depressi e. skizofrenis
c. Psikotik
A woman 25 yo, post labor 7 days ago, helped by midwife. She came w/ complaint of pain in the
abdomen and a lot of vaginal bleeding and smell bad. History of fever since 3 days ago. In
physical exam, we found fundal height 2 cm above umbilicus and abdominal pain.

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44. The most possible diagnosis for the condition above is:
a. Puerpural infection d. placental remnant
b. Mastitis e. metritis
c. Uterine subinvolution
45. The most common causes of the condition above is:
a. Puerpural infection and inflammation d. mastitis
b. Placental retention e. PID
c. Placental remnant
46. Signs and symptoms of uterine subinvolution are:
a. Bad small lochia, abdominal pain, fever
b. Uterine tenderness, pyrexia, offensive lochia
c. Unpalpableof fundal height, uterine tenderness, pyrexia, offensive lochia
d. Inadequate uterine cintraction, pyrexiam uterine tenderness
e. Abdominal tenderness, pyrexia, offensive lochia
47. Virologiic diagnosis of HIV infection in infants born to HIV-positive mother, have to perform
for the 1st time:
a. HIV PRC test at 2 weeks of age
b. HIV PRC test at 4 weeks of age
c. HIV PRS test at 6 weeks of age
d. HIV PRS test at 16 weeks of age
e. HIV PRS test at 24 weeks of age
48. The most HIV transmission in indonesia was:
a. Homosexual d. oral sex
b. Heterosexual e. IDU (Injecting drugs users)
c. Anal sex
49. Clinical symptoms of HIV infection in adult: decrease of BW <10%, recurrent oral ulcus,
seborrhoic dermatitis dan herpes zooster in last 5 years. According who classification was:
a. Stadium I c. stadium III
b. Staduim II d. stadium IV
50. Side effect of quinine of the postterm pregnancy:
a. Anemia d. hypoglicemia
b. Leucopeni e. hypothyroidea
c. Thrombocytopeni
51. Complication of malaria during pregnancy to the fetus:
a. Acure renal failure d. prematurity
b. Ling edema e. Cerebral malaria
c. Hypoglicemia
52. The impact of pregnancy to HBV as follow:
a. Decreased immune system of the mother
b. Mid increased phosphatase alkaline
c. Enhance replication of (HBV-DNA)......
d. Post partum, hormonal increased
e. Progesteron has tumor promoting effect
53. Vertical transmission of hepatitis B mostly:
a. Intrauterine d. during delivery
b. Transfussion e. Ruptured of the amniotic membrane
c. Breastfeeding
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54. Toxoplasmosis infection caused by:

a. Schiostosoma d. chlomydia
b. Bacterioides e. listeria
c. Paracytes
55. Delayed defects of congenital rubella syndrome:
a. Deafness, cataract, microphtalmia, and cardiac abnormally
b. Deafness, glaucoma, microphtalmia,mental retardation
c. Deafness, occular defects, septal defects, pulmonal stenosis
d. Insulin dependent diabetes, mental retardation, thyroid disorder
e. CNS defect, deafness, microcephaly, hepatosplenomegally
56. The most appropriate imaging technique is detect the IUFD is:
a. CT Scan d. plain abdominal film
b. MRI e. Nuclear medicine scan
c. USG
57. In transabdominal USG, the sign of IUFD as overlapping of the cranial bones is defined as:
a. Ball sign d. silhouette sign
b. Deuel halo sign e. Spalding sign
c. Robert sign
58. In USG exam, ovarial cyst will be show as:
a. A hyperechoic lesion w/ or w/out .... is one or both ovaries
b. A hyperechoic lesion in one or both ovaries
c. An anechoic lesion w/ smooth / thin ....
d. An anechoic lesion w/ thick and irregural .... in one or both ovary
e. None is correct
G5 P3 A1, 33 yo, 2nd trimester, w/ fatigue and dizziness and history of post partum
hemorrhage in 2 previous labours. Lab result: Hb 7,2 g/Dl
59. Possible cause of anemia:
a. Folic acid def d. cooper def
b. Hemoglobinopathy e. Iron def
c. B12 vit def
60. Supportive test method immediately:
a. Peripheral blood smear d. schillings test
b. Cytogenetics e. Blood group type
c. Flowcytometry
G2 P1 A0. GA 24-26 weeks w/ hydrops fetalis, AFI 32 cm
61. Possible causes of polyhidramnions in this case:
a. Circumvallate placental syndrome d. DM
b. Placental chorioangioma e. Idiophatic
c. Rh iso-immunization
62. Hystopathology of the placenta in this case will be:
a. Decreased number of functioning villi
b. Subchorionic fibrin plaques and intervillous thrombi
c. Prominent cotyledons and edematous villi
d. Villi embedded within the fibrionus mass
e. Obliterated fibrin in the intervillous space
63. Women the cycles above 65 yo is called:
a. Pre-menopause d. Pre-senium
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b. Menopause e. climacterium
c. Senium
64. ........... menopause decrease of _______ hormone
a. Progesteron d. testosteron
b. Androgen e. FSH
c. Estrogen
65. Basic principal of hormonal replacement therapy (HRT) in menopausal women who still
having her uterus is:
a. Estrogen should be combined w/ progesteron
b. Progesteron whould be combined w/ androgen
c. Estrogen should be combined w/ androgen
d. Androgen should be combined w/ FSH
e. Estrogen should be combined w/ testosterone
66. Contraindication of HRT in menopausal women is:
a. Hypertension d. unidentified uterine bleeding
b. Smooking e. History of TB
c. Anemia
67. Endometrial hyperplasia associated w/ prolonged and unopposed to?
a. Estrogen d. FSH
b. Progesteron e. LH
c. Estrogen+progesterone
68 – 82 ........
68. Treatment for endometrial hyperplasia without atyphical is ?
a. IUD withot hormone
b. Depoprovera 150 mg IMq 3 months
c. Total hysterectomy
d. Subtotal hysterectomy
e. radical hysterectomy type 1
69. Conservative therapy for endometrial hyperplasia ?
a. Progestin d. D n C
b. Non steroidalanli inflammatory drugs e. Hysteroscopy
c. Radial hysterectomy
70. Primary dismenorrhea is caused by
a. Pelvic inferior
b. endometritis
c. endometritis polyp
d. myoma
e. prostaglandin 2F
71. Menstrual rare,long cycles more than 2 month
a. oligomenorrhea
b. polymenorrhea
c. hypomenorrhea
d. bradymenorrhea
e. menometrorhagia
72. Dysfunctional Uterine Bleeding (DUB) cause
a. cancer endometrium
b. uterine polyp
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c. infection of uterus
d. anovulatory bleeding
e. uterine leiomyolima

73. mechanism of combine oral contraception

a. suppressed ovulation
b. myometrium not ready for implantation
c. thin cervical mucous
d. delayed ovum transportation
e. decrease cilia tubal motility
74. indication of combined oral contraseption
a. young active sexual female
b. multyparty
c. post partum, breast feeding women
d. delayed post abortus
e.not wanted children anymore
75. True about levonorgestrel implant
a. have progestin + estrogen
b. suppressed endometrial growth
c. can be used for breastfeeding
d. .........STD and HIV
e. need check everyday
76. contraindication implant
a. cervix carcinoma
b. abnormal uterine bleeding with defined causes
c. Hypertension
d. Smoking
e. unknown vaginal bleeding
77. The side effect of implant
a. irregular vaginal bleeding
b. Headache
c. decrease libido
d. acne
e. infection of implant site.
78. .....
79. ......
80. ......
81. Which of the following hormone is responsible for the ovarian follicular growth prior to
ovulation
a. chorion gonadotropin
b. Estradiol
c. luteinizing hormone
d. follicle stimulating hormone
e. progesterone
82. 22 yo female, main complaint painfull mens with profuse blood flow. Doctor prescribe low
dose oral contraceptive for menorrhagia n ibuprofen for amenorrhea. Biological action od
estrogen involve decrease in which of the following ?
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a. libido c. duct growth in breast e. ovarian follicular growth

b. serum cholesterol level
83. A 22 yo women w/ amenorrhea of 6 weeks duration undergoes surgery for acute
appendicitis. At the time of surgery, a 3 cm semisolid left ovarian cyst is discovered. It is
vascular and disappear to contain blood. A serum pregnancy test is positive. Which of the
following diagnosis do you think?
a. ovarian cyst d. endometriosis
b. appendicitis e. Pelvic inflammatory disease
c. ovarian pregnancy (ectopic pregnancy)
84. the following statement are true regarding endometriosis:
a. Pelvic endometriosis is also called as the true endometriosis
b. Direct visualization should be done by laparotomy to estabolish the fixed diagnosis
c. The presence of endometriosis is more frequent in the menopausal women
d. Endometriosis is more common in women w/ cervical stenosis
e. A & D are true
85. which of the following theories associated w/ the occurance of endometriosis cyst
(endometrioma)?
a. implantation theory d. hormonal theory
b. invagination theory e. Embrionic cell theory
c. induction theory
86. the following statement is true regarding adeomyosis:
a. adenomyosis is also called as true of endometrium
b. adenomyosis is the presence of endometrium in the uterine cavity
c. adenomyosis is the presence of endometrium outside of uterine
d. adenomyosis is the presence of endometrium in the nyometrium
e. adenomyosis is the presence of endometriumoutside the myometrium
87. regarding pelvic endometriosis, which of the following statement is true?
a. umbilical endometriosis is included in pelvic endometriosis
b. pelvic endometriosis is not associated w/ implantation theory
c. pelvic endometriosisis associated w/ on vagination theory
d. the basic of pelvic endometriosis is simpson’s theory
88. the principles management of endometriosis is:
a. hormonal therapy should be given to inactive endometriosis
b. hormonal therapy should be given to endometriosis w/ more endometrial glands
c. hormonal therapy should be given to endometriosis w/ more endometrial stroma
d. hormonal therapy is not recommended to red lesion endometriosis
Mrs.A, P4 A0, 36 yo. The oldest son 16 yo, the youngest one is 6 month old still breastfeeding.
Came to the doctr to have family planningcounseling w/ husband. Her husband is a civil
servant. As a doctor, what do you suggest of them?
89. the best contraception that suitable for this couple is:
a. Oral combination pill d. Tubectomy/vasectomy
b. condom e. implant
c. IUD
90. the aim of method that we choose above is:
a. to prevent fertilization of ovum and sperm
b. to prevent implantation
c. to kill the sperm
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d. to induce sterile infection in cervix

e. to prevent ovulation
91. from laboratory exam, HB 9,2 gr/dl, leukocyte 8000/ui, trombocyte 100.000/ml prolonged
CT and BT. The best method of this client is:
a. tubectomy/vasectomy d. cooper T-IUD
b. stabilization general condition e. Hormonal contraception
c. IUD w/ progesteron
92. fertility rate for tubectomy acceptor is low, because:
a. both of tube has been cut
b. the cilia of tube has been broken although recanalitation was performed
c. hysterectomy has been performed
d. possibility of getting pregnant only 10%
e. both of fallopian tube has been ligated
a young mother want to postpone her pregnancy because she is a temporary government
employee.
93. the best contraception for woman who doesn’t want to use hormonal contraception is:
a. spermicide d. tubectomy
b. male condom e. IUD
c. female condom
94. IUD mechanism of action is:
a. supress ovulation
b. neutralize cervical discharge
c. prevent fertilization of ovum and sperm
d. induce infection in cervix
e. prevent implantation in uterine cavity
95. the best contraception for mother w/ HIV/AIDS is:
a. male/female condom d. tubectomy
b. IUD e. Condom+hormonal contraception
c. Hormonal contraception
... yo woman w/ postpartum bleeding. A carefull exam revealed a perineum rupture involved
spincter ani interna
96. the degree of rupture can be defined as:
a. degree 2 c. degree 3c
b. degree 3b d. degree 4
97. the perineal body consist of the what structure of muscle, except:
a. m. Bulbocavernosa d.M.Puborectal
b. anococcygeal ligament e.Sfingter Ani externa
c. m.transversa perineal
98. 60 yo woman, have incontinence defecation, and have diarrhea for 6 month ago
a) urine incontinence
b) prolapsed rectum
c) anal incontinence
d) bowel incontinence
99. Cause of urine incontinence
a) prolapsed
b) dengue fever
c) overflow incontinence, multiple necrosis
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d) small urine … during activities

e) best treated by surgery
100. Normal storage of urine bladder
a) 150-250 cc
b) 250-350 cc
c) 350-450 cc
d) 450-600 cc
e) >600 cc

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