Gyne & Obes. Step.1st Bits

* Outpatient obstetrics * 1*11*3 *
#1
*! How long does it probably take from the moment the embryo enters the uterine cavity until
the implantation?
*24 hours
*36 hours
*48 hours
*60 hours
*+72 hours
#2
*! What is the most likely time of pregnancy when embryopathy develops?
*+ up to 10-11 weeks
*16-17 weeks
*20-22 weeks
*26-27 weeks
*30-32 weeks
#3
*! What changes are likely to occur in the cardiovascular system during pregnancy?
*+ left ventricular hypertrophy, 40% increase in cardiac output
*Reducing heart rate by 40%, increasing vascular wall tone
*vascular wall toning up, 40% increase in cardiac output
*tachycardia, cardiac output reduction by 40%
* right ventricular hypertrophy, 40% reduction of cardiac output
#4
*! Patient with delay of menstruation for 4 weeks and positive pregnancy test wants to exclude
genetic pathology of the fetus. From the anamnesis: 1 year ago, the pregnancy was terminated
within 21 weeks for medical reasons due to genetic pathology of the fetus.
What is the most likely gestational age in weeks for biopsy of chorion pulses, if there are
indications?
*3-7
*+8 -12
*13-17
*18-22
*23-27
#5
*!What is the most likely time of pregnancy in the weeks for conducting of antenatal
cardiotocography of the fetus if there are indications?
*22
*28
*+32
*36
*40
#6
*!At the conference call, the analysis of maternal mortality in Kazakhstan for the past year is
being conducted.
What is the MOST likely live birth rate for maternal mortality?
*100
*1 000
*10 000
*+100 000
*1 000 000
#7
*!The mother went for “postnatal maternity leave” after the operation C-section.
What is the most likely duration of “postnatal maternity leave” in the days after a complicated C-
section?
*30
*40
*50
*60
*+70
#8
*!Pregnant at the first visit wants to exclude genetic pathology of the fetus.
What are the NEVER likely gestational ages in the weeks for prenatal biochemical screening in
the first trimester?
*5-6
*8-9
*9-10
*+10-14
*12-13
#9
*! Woman who pregnant for the fist time, has registered at 10 weeks in the women's clinic
depatrment. Complaints of nausea, vomiting. The preliminary diagnosis: early toxicosis of the
average degree.
What is the MOST likely rate of vomiting per day for a pregnant woman?
*" Up to 5
*" Up to 15
*+"+to 10
*" less than 3
* over 20
#10
*!What is the most recommended drug for emergency cases in severe pre-eclampsia?
*dopegit
* diazepam
* euphylline
* carbamazepine
*+ magnesium sulfate
#11
*! What is the MOST possible formula for calculating perinatal mortality?
* number of stillborn babies / number of births *1000
* number of deaths in the first 168 hours / number of newborns *1000
*+number of stillborn and dead newborns in the first 168 hours/number of live and dead births
*1000
*number of stillborn and dead newborns in the first 168 hours/number of live and dead births
*100
*number of stillborn and dead newborns in the first 168 hours/number of live and dead births
*10000
* Outpatient and polyclinic obstetrics * 2 * 28 * 6 *
#12
*! What is THE MOST important event to reduce perinatal mortality?
* a complete diet of pregnant women

*producing perinatal death cause analysis
*+ timely diagnosis of threatened fetal conditions
* improvement of health education for pregnant women
*Timely decision on the possibility of pregnancy preservation
#13
*!In the first 38 weeks of pregnancy, regular labor activity began, the opening of the uterine
yawn is complete, the estimated mass of the fetus is 3200.0.
Which one of the above is MOST probably corresponds to the direct size of the fetus head in
centimeters?
*9
*10
*11
*+12
*13
#14
*!In the first 39 weeks of pregnancy, regular labor activity began, the opening of the uterine
yawn is complete, the estimated mass of the fetus is 3400.0.
Which one of the above is MOST probably corresponds to the large oblique size of the fetus
head in centimeters?
*9-9,5
*10-10,5
*11-11,5
*12 -12,5
*+13-13,5
#15
*!The pregnant woman has a belly circumference of 95 centimeters and the height of the uterus
bottom standing is 33.
Which one of the above MOST probably corresponds to the small oblique size of the fetus head
in centimeters?
*+9,5
*10,5
*11,5
*12,5
*13,5
#16
*! What does MOST probably mean "perinatal mortality"?
*feebility
*Mortality of children during the first month of life
*+pyregnancy+mortality of children during the first 7 days of life
*fatality+mortality of children during 1 month of life
*fatality+mortality of children during 1 year of life
#17
*!What is the MOST probable week of pregnancy when the maximum content of chorionic
gonadotropin in plasma is observed?
*5-7
*+8-10
*11-13
*14-16
*17-19
#18
*!In an obstetric examination of a pregnant woman's abdomen circumference of 90 cm, the

height of the uterine floor standing 36 cm, the navel is smoothed.
What is the MOST likely gestational age in weeks?
*24
*28
*32
*+36
*40
#19
*!In an obstetric examination of a pregnant woman's abdomen circumference is 95 cm, the

height of the uterus bottom is 32 cm, the navel is protruding.
What is the MOST likely gestational age in weeks?
*24
*28
*32
*36
*+40
#20
*!The difference of 2-3 weeks according to various anamnestic data was revealed for the first-
pregnant one when determining the term of maternity leave.
Which of the following is MOST precise for determining of pregnancy?
* date of last menstruation
* the date of first fetal stirring
* bimanual research data
*Fetal ultrasound at 3-6 weeks of pregnancy
*+Fetal ultrasound in 10-14 weeks of pregnancy
#21
*! What is the MOST likely needed for consider in the first period of labor in pregnant women
with pre-eclampsia?
*+epidural anesthesia
*spasmolytics
*Magnesium sulfate
*neuroleptics
*analygetics
#22
*!The fetus has a longitudinal position in the term of 36 weeks, the first position, pelvic position,
fetal heartbeat clear and rhythmic, 142 beats in 1 minute.
What is the most likely place for fetal heartbeat auscultation in a pregnant woman?
* at the navel level on the right
* above the navel on the right
* at the bottom of the navel on the right
*+ above the navel on the left
* at the bottom of the navel on the left
#23
*!The pregnant woman has the date of her last menstruation from December 28 to 31.
What is the MOST likely date of birth by the Negel formula?
*28 September
*30 September
*14 October
*7 October
*+5 October
#24
*!The pregnant woman at the term of 35 weeks on the gravidogram shows signs of delayed fetal
development. On fetal ultrasonography: the size of the head corresponds to the norm, signs of
asymmetric form of fetal delayed development.
Which fetal echographic size reduction is likely to be found in a pregnant woman?
* chest circumference
* hanger circles
*+ abdominal circumference
*vertebrate
* stop lengths
#25
*!According to the clinical protocols of the MHRK, what is the most likely tactic for pregnant
women with mild pre-eclampsia?
*ambulatory treatment
*+ careful outpatient observation
* treatment in a level 1 maternity clinic
#26
*! When is the concentration of alpha-phetoprotein likely to increase during pregnancy?
* for placenta pathology
*+ in case of fetal neural tube defect
* for fetal kidney pathology
* in case of uterine pathology
* in case of pathology of internal organs of the fetus
#27
*!In a pregnant woman with severe pre-eclampsia for the purpose of symptomatic anticonvulsant
treatment, 5 grams of magnesium sulfate dry substance was slowly injected as a load dose
intravenously for 5 minutes.
What is the optimal supportive dose of magnesium sulfate in grams per hour for 24 hours?
*+1
*2
*3
*4
*6
#28
*!The patient is 25 years old and has a diagnostic scraping of the uterine cavity for the purpose
of differential diagnosis of ectopic pregnancy from early spontaneous miscarriage, scraping was
sent for histological examination.
What are the most likely histological signs of a scrape in ectopic pregnancy?
* endometrial proliferation
* endometrial secretory transformation
*+deciduous tissue without chorionic lint
*decidal tissue with chorionic villi
*Signs of inflammation and endometrial necrosis
#29
*!A 19-year-old girl has applied for a medical termination of pregnancy at an early stage and is
concerned about the effectiveness of the chosen method.
What is the MOST likely delay in days of menstruation that medical abortion is 95-98%
effective?
*+42
*52
*64
*78
*84
#30
*!The patient is 25 years old and has a diagnostic scraping of the uterine cavity for the purpose
of differential diagnosis of ectopic pregnancy from early spontaneous miscarriage, scraping was
sent for histological examination.
What are the most likely histological signs of a scrape typical for uterine pregnancy?
* endometrial proliferation
*jealous endometrial hyperplasia
*deciduous tissue without chorionic lint
*+decidal tissue with chorionic villi
*Signs of inflammation and endometrial necrosis
#31
*! In a pregnant woman in the period of gestation of 35 weeks at the reception at the antenatal
clinic BP was measured. BP increase up to -140/90 mmHg was found for the first time.
What is the most likely tactic for a doctor?
*" Hospitalize immediately at the maternity hospital
*+ Re-measure your BP after 30 minutes
* therapist's consultation
* neurologist consultation
* ophthalmologist's consultation
#32
*! A pregnant woman with 28-29 weeks of pregnancy has complaints about swelling. In
anamnesis: chronic arterial hypertension. Objectively:BP 140/90, oedema on the lower limbs, in
the urine protein - 0.33 g / l. Uterus increased to 28 weeks of pregnancy, fetal position is
longitudinal, head, fetal heartbeat is clear, rhythmic up to 140 beats per minute.
What is the most likely diagnosis?
*+Pregnancy 28 weeks. Preeclampsia mild degree. Chronic arterial hypertension

*Pregnancy 28 weeks. Chronic Arterial Hypertension
*Pregnancy 28 weeks. Pregnancy-induced swelling
*Pregnancy 28 weeks. Acute glomerulonephritis
*Pregnancy 28 weeks. Acute pyelonephritis
#33
*! The first-pregnant woman of 33 weeks pregnancy notes weak fetal movements. Auscultation:
fetal heartbeat clear, rhythmic, 140 beats per 1 minute.
Which of the above is MOST useful for assessing the fetus?
*counting the movements of the fetus during the day
* fetal ultrasound examination
* hormonal studies
*+cardiotocography
*dopplerography
#34
*!The first-pregnant 30 years old in the period of 6 weeks complaints of nausea, vomiting up to 5
times a day. Anamnesis: chronic tonsillitis. Objectively: satisfactory condition, skin pink, BP
110/70 mm Hg, physiological administration is not impaired.
*ptiialism
* spicy gastritis
* excessive vomiting of pregnant women
*+ mild vomiting of pregnant women
*vomiting of pregnant women of average degree
#35
*!The first-pregnant 29 years old in the term of 7 weeks of complaints about nausea, vomiting up
to 20 times a day, weight loss of 6 kg. From the anamnesis: sick for 1 month, the frequency of
vomiting increased from 5 to 15-20 times a day during the last week. Objectively: the condition
is heavy, the skin is subicteric, dry, BP 90/60 mm Hg, diuresis reduced, stool was not 5 days,
acetonuria, proteinuria.
*ptiialism
* spicy gastritis
*+ excessive vomiting of pregnant women
*mild vomiting of pregnant women
*vomiting of pregnant women of average degree
#36
*! A full-term pregnant woman was delivered by an ambulance to the maternity hospital after an
attack of eclampsia; magnesia therapy is being carried out, in terms of delivery.
During what MOST probable time in hours from the onset of seizures is delivery indicated?
*1
*6
*+12
*18
*24
#37
treatment, maintenance therapy with magnesium sulfate solution 25%-80,0 is carried out.
Against the background of the therapy a decrease in respiratory frequency to 12 per minute and a
decrease in tendon reflexes were noted.
What are these symptoms likely to be associated with?
*eclampsia
*Insufficient oxygenation
*+pre-dosing of magnesium sulfate
*progressing preeclampsia
*Insufficient dose of magnesium sulfate
#38
*!A pregnant woman was admitted to the maternity ward within 36 weeks with complaints of
pain in her right footing and swelling of the extremities. There are no somatic diseases.
Objectively: the condition is severe, skin and sclera jaundice, BP 160/100 mm Hg, marked
swelling of the lower extremities, abdomen, diuresis reduced, dark urine, proteinuria 0.3 g / L,
Hb 92 g / L, platelets 100x109 / L, ALT and AST increased.
*+HELLP syndrome
* viral hepatitis
*obstructive jaundice
* Acute fat hepatosis
* cholestatic hepatosis of pregnant women
#39
*! Repeatedly pregnant 28 years old, went to a doctor in a women's consultation with complaints
of contraction pains on the bottom of the abdomen, abundant bleeding discharge from the genital
tract. In the history of 2 spontaneous miscarriages. In the vaginal examination: cervix is
shortened, cervical canal passes 1 transverse finger. The lower pole of the fetal egg is
determined. Uterus does not correspond to 16-17 weeks of pregnancy.
* + pregnancy 16-17 weeks. Abortion at the entrance. Habitual miscarriage.

* pregnancy 16-17 weeks. Threatening spontaneous miscarriage.
* pregnancy 16-17 weeks. Incomplete spontaneous miscarriage. Habitual miscarriage.
* pregnancy 16-17 weeks. Started abortion. Habitual miscarriage.
* pregnancy 16-17 weeks. Started abortion
* Outpatient and polyclinic obstetrics * 3 * 17 * 4 *
#40
*! The patient is 4 weeks pregnant and has no embryo heartbeat at the ultrasonography. The
result of β-HCG level in the blood: 110 mE/ml at the norm for this period of pregnancy
101-4870, after 48 hours - 250.
What is the recommended doctor's tactic?
*+Sounds in 2 weeks
* chorion pile biopsy
*termination of pregnancy
*Repeat the analysis onβ-HCG in 2 days
*Repeat the analysis onβ-HCG in 2 weeks
#41
*! A pregnant woman with a pregnancy of 8-9 weeks complains of constant salivation and
weight loss. Objectively: hypotension, tachycardia to 90 beats per minute, diuresis reduced,
residual nitrogen and creatinine increased. In urine, acetone +++. Diagnosis: Pregnancy is 8-9
weeks. Early toxicosis. Patialism.
*dispatch
* hospitalization in a day-care hospital
*Hospitalization, diet, general tonic therapy
*Hospitalization, termination of pregnancy on the background of infusion therapy
*+Hospitalization, complex detoxification, infusion, general tonic therapy
#42
*! Pregnant with 32 weeks of pregnancy marks swelling on the lower extremities, the front wall
of the abdomen. Objectively: severe condition, BP 160/110 mmHg. 165/100 mmHg pulse 90 per
minute. Diagnosis: Pregnancy 32 weeks. Preeclampsia of severe degree.
* + complex treatment of preeclampsia in ICU conditions, prevention of fetal SDR,

early delivery within 24-48 hours
* treatment of preeclampsia in the conditions of the pregnancy pathology department
* treatment of preeclampsia in an ICU with an assessment of the effectiveness after 1 week
* continue outpatient follow-up
* hospitalization in a day hospital
#43
*! A primary pregnant woman, within 7 weeks, complains of nausea, vomiting up to 20 times a

day, weight loss of 6 kilograms. Objectively: the condition is severe, the skin is icteric, dry,
blood pressure 90/60 mm Hg, no stool for 5 days, urine output is reduced, acetonuria.Diagnosis:
excessive vomiting of pregnant women. Within 3 days, intensive therapy is carried out, including
sedatives that block the gag reflex, infusion agents for rehydration, detoxification and parenteral
nutrition, without effect.
What is the MOST recommended follow-up policy for the doctor?
*hemodialysis
* plasmapheresis
* hemosorption
* + termination of pregnancy
* continue ongoing therapy
#44
treatment, supportive therapy with magnesium sulfate is carried out. What is the best way to
administer this dose of magnesium sulfate?
* enterally
* intraarterially
*" in an intravenous jet
*+Intravenous drip
* Intramuscularly slow
#45
*!In the maternity ward received the first-pregnant in the period of gestation 36 weeks with
complaints about headaches. Past medical history: no somatic diseases. Objectively: severe
condition, BP 160/110 mm Hg, fetal position is longitudinal, fetal heartbeat is clear, 136 beats
per minute, cervical cervical on the scale of Bishop - 8 points, proteinuria 0.5 g / l.
* emergency caesarian section
*permission period of 37 weeks
*+ induction of labor within 24-48 hours

*planned C-section at 38 weeks
*induction of labor within 2-4 hours
#46
*! Repeatedly pregnant in the term of pregnancy 37 weeks arrived at the maternity ward with
complaints of swelling of the limbs. Past medical history: no somatic diseases. Objectively: the
state of medium gravity, BP 150/100 mm Hg, oedema on the face and limbs, the position of the
fetus is longitudinal, there is a head, heartbeat of the fetus is clear, 140 beats per minute, cervical
cervical on the Bishop scale - 6 points, proteinuria 0.3 g / L.
*amniotomy
* emergency C-section
*authorization of 38 weeks
*planned C-section at 38 weeks
*+ cervical preparation with prostaglandins
#47
*!The pregnant woman is diagnosed with severe pre-eclampsia during gestation period of 32
weeks, induction of labor is planned.
Which of the following is the most effective way to prevent respiratory distress syndrome?
*prednisolone 60 mg every 12 hours 2 times inside
*prednisolone 30 mg every 12 hours 2 times a/m
*bethamethasone 24 mg every 24 h 2 times in/m
*+dexamethasone 6 mg every 12 hours 4 times in/m
*dexamethasone 2 mg every 24 hours 2 times in/m
#48
*!The maternity ward received a pregnant woman within 37 weeks with complaints about
swelling of the extremities, sleepiness. There are no somatic diseases. Objectively: the condition
is heavy, skin and sclera jaundice, BP 160/100 mm Hg, marked swelling of the lower
extremities, abdomen, diuresis reduced, dark urine, proteinuria 0.3 g / L, Hb 90g / L, platelets
80x109 / L, ALT and AST increased.
What is the most likely cause of jaundice in the skin and mucous membranes?
*virus infection
*+ erythrocyte hemolysis
*" bile clogging
*Intrahepatic cholestasis
* indirect bilirubin conjugation violation
#49
treatment is carried out maintenance therapy 25%-80,0 magnesium sulfate. Against the
background of the therapy, a decrease in respiratory frequency to 12 per minute, a decrease in
tendon reflexes was noted.
Which of the following is the most recommended I.V. first?
*glucose 5%
*glucose 10%
*+Calcium gluconate10%
*proserin 0.05%
* sodium chloride 0.9%
#50
*!A pregnant woman was admitted to the maternity ward within 34 weeks with complaints of
pain in her right footing and swelling of the extremities. There are no somatic diseases.
Objectively: the condition is severe, skin and sclera jaundice, BP 150/100 mm Hg, marked
swelling of the lower extremities, abdomen, diuresis reduced, dark urine, proteinuria 0.6 g / l, Hb
85 g / l, platelets 96x109 / l, ALT and AST increased by 2.5 times.
*induction of labor at 36 weeks
*planned C-section
* emergency caesarian section
*permission period of 37 weeks
*+release within 24-48 hours
#51
*!Pregnant with a gestation period of 31-32 weeks is diagnosed with: Eclampsia. Objectively:
severe condition, unconscious. BP 180\100 mm.Hg. Generalized swelling. Fetal heartbeat clear,
rhythmic 140 beats per minute. Vaginal: cervix "immature".
What is the most likely medical tactic?
* prolong pregnancy until 34 weeks of pregnancy
* amniotomy, obstetrics *
*+ stabilization. C-section operation
#52
*! Pregnant C. 30 years old went to the hospital with complaints of bloody discharge from the
genital tract and pulling pain at the bottom of the abdomen. There are 2 spontaneous
miscarriages in the history of 7-8 weeks of pregnancy. The term of pregnancy is 6-7 weeks. It is
registered for uterine fibroids. The therapist is registered for endemic goiter and NDC for mixed
type.
What is the most appropriate treatment?
* bed rest
* dicinone application
*+duffaston application
* the use of antispasmodics
*application of uterine electro-relaxation
#53
*! The patient has complaints of contractile pains in the lower abdomen, moderate bleeding
discharge from the genital tract. Anamnesis: last menstruation 2 months ago, pregnancy test
positive. In vaginal examination: the external pharynx of the cylindrical cervix is closed, the
uterus is increased up to 6 weeks of pregnancy, its tone is increased, uterine appendages are not
determined. Ultra-sonography: embryo.
*spasmolytics
* bed rest
*Progesterone preparations
* uterine cavity excision
*+ uterine aspiration curettage
#54
*! The patient has complaints of contractile pains in the lower abdomen, abundant bleeding
discharge from the genital tract. Anamnesis: last menstruation 2 months ago, pregnancy test
positive. In the vaginal examination: the cervix is shortened, the cervical canal passes for 2 cm,
the uterus is increased to 7 weeks of pregnancy, hypertonicity, appendages of the uterus are not
determined, bloody secretions with clots. Ultra-sonography: in the lower third of the uterine
cavity the fetal egg has peeled off, the embryo has no heartbeat.
*+ uterine aspiration curettage
* uterine cavity excision
*Progesterone preparations
* bed rest
*spasmolytics
#55
*!Patient applied for medical abortion with a 42-day delay in her menstruation. The doctor
prescribed 200 mg mifepristone orally.
What is the NEW recommended dose of misoprostol in mcg?

*200
*400
*+600
*800
*1000
#56
*! On the dispensary records in the antenatal clinic is a pregnant woman of 26 years. She does
not lodge a complaint. In the history - 1 medical abortion, 2 spontaneous miscarriages within 21
and 25 weeks. In case of vaginal examination: uterus is increased up to 17 weeks of pregnancy.
The cervix is shortened to 1.5 cm, softened throughout, the cervical canal freely passes 1 finger.
What is the most likely tactic for a female clinic doctor?
*ambulator observation
* to administer antispasmodic therapy
*tocolytics treatment
*+ surgical ICN correction
* bed rest at home
* Gynecology * 1 * 11 * 2 *
#57
*!The couple applied for family planning center and wanted a reliable, non-invasive
contraceptive method. From the anamnesis: the wife is 30 years old, the wife - 37, have 2 healthy
children.
Which method has FULL high contraceptive reliability?
* barrier
*spermicides
*calendar
*+ hormonal
* interrupted intercourse
#58
*!A 20 year old girl asked for family planning consultation. From her anamnesis: unmarried,
sexual life is regular with a regular sexual partner, menstrual cycle without features. Microdosed
hormonal contraceptives are recommended.
What is the most likely concentration of ethinylestradiol µg/day in the recommended

contraceptive?
*5-10
*+15-20
*25-30
*35-40
*45-50
#59
*! What is MOST is typical for abnormal uterine bleeding by type of follicle persistence?
*caryopicnicnic index is below 30%
*+ Menstruation delayed by 3 months or more
*monophase basal temperature, endometrial hyperplasia
*normal basal temperature
* pupil symptom (++++)
#60
*!Patient of 23 years with infertility during 3 menstrual cycles was measuring basal temperature.
What is the most likely type of menstrual cycle disorder that the basal temperature graph
presents?
* hypoleinism
*hyperluteinism
* follicle atresi
*+ follicle persistence
*folliculin phase shortening
#61
*!The patient of 29 years with primary infertility during 3 menstrual cycles measured basal
temperature.
What is the most likely type of menstrual cycle disorder that the basal temperature graph
presents?
* hypoleinism
a
*hyperluteinism
*physiological
*+ follicle atresia
* follicular consistencies
#62
*!In a 28-year-old patient with acute bilateral salpingoophoritis, endocervicitis in a

bacterioscopic examination of the cervical canal smear detected intra- and extracellular gram-
negative diplococcus.
What is the most likely inflammatory agent?
*Escherichia coli
*" Candida albicans
*Streptococcus aureus
*Trichomonasvaginalis
*+Neisseria gonorrhoeae
#63
*! Painful after antibiotic treatment of acute pyelonephritis appeared itching vulva and abundant
"tiny" whites.
What is the most likely causative agent?
*Escherichia coli
*+Candida albicans
*Streptococcus aureus
*Trichomonasvaginalis
*Streptococcuspyogenes
#64
*! A 19-year-old patient has complaints of irritability, distraction of attention, poor sleep,

headache, which occurred during the session, a few days before the next menstruation and
disappeared after menstruation.
What is the MOST probable symptom of this condition?
* diencephalic
* Itsenko-Cushinga
* + premenstrual
* Shereshevsky-Turner
* ovarian hyperstimulation
#65
*!The patient has 55 years of complaints about irritability, distracted attention, bad sleep,
headaches that worry for 2 years. Assigned by the therapist and neurologist treatment without
effect.
What is the most likely syndrome in the patient?
*densephalic
*" Izenko Kushinga
*+ climacteric
* Shereshevsky Turner
* ovarian hyperstimulation
#66
*! On admission to the hospital, a 32-year-old patient complains about high fever, chills, pain
throughout the abdomen. In the history of infertility, bilateral salpingoopharitis with frequent
exacerbations. Objectively: temperature 39.2 º C, heart rate 128 beats / minute, BP 110/70 mm
Hg, breathing rate 22 per minute. Tongue dry, abdomen swelled, tense in all partt, painful with a
pronounced symptom of Shchetkin-Bloomberg throughout the abdomen. Gynecological study:
the external reproductive organs are developed correctly, the hair is of the female type. In
mirrors: the vagina is not changed, the cervix is eroded. Extractions from the genital tract are
purulent, moderate. PV: In a vaginal examination of cervical dislocation, the appendages and
uterus cannot be determined due to painfulness. The posterior vaginal arch is flattened, painful.
* spilled peritonitis
*+pelvioperitonitis
* appendage endometriosis
* Douglas space abscess
* chronic bilateral salpingoopharitis
#67
*! Where does the diagnosis of female infertility probably begin and why?
*Test of Shuvarsky-Sims-Huner - to determine the number and mobility of sperm in cervical

mucus
*+ functional diagnostics tests - allows to estimate the completeness of the menstrual cycle
*hysteroscopy - to detect intrauterine disorders
*culdoscopy - examination of the area of rectum-uterine space using an endoscope to detect the
pathology of this area
*Laparoscopy - examination of small pelvis and abdominal organs against the background of
pneumoperitoneum - to detect pathology of these areas
* Gynecology * 2 * 27 * 5 *
#68
*!The student of 20 years old, married, went to the family planning office, wants a reliable
contraceptive for 2 years. From the anamnesis: menstrual cycle is regular, sexual life since 19
years old, uses barrier methods of contraception, there were no pregnancies.
What is the optimal contraceptive?
*barrier method
*calendar method
*Intrauterine device
*+combined oral
*pure injection progestins
#69
*!A 22-year-old girl with a body mass index of 35 went to a family planning room, wants
contraception without affecting her metabolism. From her anamnesis: menstrual cycle without
features, unmarried, sexual life from the age of 20, 2-3 times a month, no pregnancy, sexual
partner one with allergic reaction to latex.
Which method of contraception is the best?
* condom
*+spermicides
* pure gestagens
* subcutaneous implant
* Intrauterine contraceptive
#70
*! Patient, 22 years old, applied due to the absence of her period and pregnancy. From her
history: she grew up a healthy child, at the age of 13-15 years she was operated on for inguinal
hernia. She got married at the age of 20 and her husband at the age of 20 was healthy. Her own
sister has no period. When examined, height 156 cm, weight 55 kg. Secondary sexual signs are
well developed. External genitalia are formed correctly. On mirrors: the vagina ends blindly, no
neck. PV: the vagina is not in labor, the uterus and appendages are not defined.
Which of the above diagnoses is likely to show such a clinical picture?
*+primary amenorrhea
* secondary amenorrhea
*vaginal atrasia
* uterine amenorrhea
* ovarian dysfunctions
#71
*!HIV-positive couple has applied for family planning counseling and wants reliable and long
term contraception. Anamnesis: The spouses are 35 and 36 years old, have two healthy children,
and do not plan to have children in the future.
Which method of contraception is the best?
* barrier
*spermicides
* hormonal
* Intrauterine contraceptive
*+ voluntary surgical sterilization
#72
*! A re-pregnant primiparous woman had a premature stillbirth. Before discharge from the
hospital, the following examination was carried out: Hb 98g / l, erythrocytes 3x10 12 / l,
leukocytes 6.8x10 9 / l, ESR 18 mm / hour.
What is the MOST optimal contraceptive for the patient and why?
* IUD, because long-term and reliable method

* + COC, because it can be used at any age, prevents the development of IDA or reduces its
severity
* NPK, because they are effective during breastfeeding
* DHS, because it is a reliable and irreversible method of contraception
* barrier remedies, because they are inexpensive and provide immediate restoration of fertility
by protecting against STDs
#73
*! The patient is 20 years old, went to the gynecologist because of her rare period, hair growth
on the upper lip, chin from 15 years. During the year of regular unprotected sex life, she does not
get pregnant. In the anamnesis of the sister also has an irregular menstrual cycle. Menarche from
16 years, monthly in 2-3 months. Height 162 cm, body weight - 52 kg. The mammary glands are
small, there are no excreta from the nipples. Around the halo - rod hair, on the white line of the
abdomen - hair growth. In gynecological examination revealed: the uterus is small, the right
appendages are not defined; on the left - palpable ovary size 4.5 x 3.0 x 2.5 cm, painless.
What is the most likely preliminary diagnosis?
* Stein-Leventhal syndrome
* hormone-producing ovarian tumor
*polycystic ovaries syndrome of central genesis
* menstrual cycle disorder, hirsutism of obscure genesis
*+ polycystic ovary syndrome in the background of adrenal dysfunction
#74
*! A 36-year-old woman, married, after the second birth, applied for family planning counseling,
wants reliable, long-term, reversible contraception. From the anamnesis: 3 years ago, a
tubectomy due to an ectopic pregnancy, the child was 1 year old, weaned from breastfeeding.
Which of the following methods of contraception is the MOST acceptable?
*intrauterine
* barrier method
* pure progestogens
* + combined oral
* method of lactational amenorrhea
#75
*!The woman has a child of 3 months, is exclusively breastfed.
Which of the above is acceptable to the woman as a contraceptive method?
*+lactate amenorrhea method
* Intrauterine contraception
*pure progestin contraceptives
*combination oral contraceptives
* voluntary surgical sterilization
#76
*! The patient has 50 years of complaints about the abundant bloody discharge from the genital
tract. Anamnesis: delay of menstruation for 3 months. On the mirrors: the cervix is clean, the
excreta is bloody. In vaginal examination: uterus and appendages without features.
*anomal uterine bleeding of the reproductive period
*+anomal uterine bleeding of the menopause
* cervical canal polyp
* uterine submucosal myoma
*adenomyosis
#77
*! Patient N., 29 years old, went to the doctor of the women's consultation with complaints about
headaches, tides, heart rate, periodically notes the increase in blood pressure, tearfulness. In her
anamnesis 8 months ago, she had both ovaries removed on both sides because of the cyst.
Objectively: increased nutrition. BP - 140/80, 150/90 mmHg. In gynecological examination:
vaginal dryness, uterus size slightly reduced, appendages are not determined.
What is THE MOST probably the main thing in the origin of this disease?
* reduction of parathyroid hormone secretion
*+ steep decline in steroid hormone production
* lack of secretion of luteinizing hormone
* increasing hypothalamic-pituitary activity
* selective increase in FSG secretion
#78
*! A 16-year-old patient complains of the absence of menstruation. Objectively: height 145

centimeters, secondary sexual characteristics are not expressed, there are pterygoid folds on the
neck. Ultrasound examination: hypoplasia of the uterus, there are no follicles in the ovaries.
Karyotype 45X0.
Which of the following syndromes is the MOST probable in the patient?
* Shihana
* Simmonds
* Itsenko-Cushinga
* Chiari-Frommel
* + Shereshevsky-Turner
# 79
*!A 17-year-old adolescent has complaints about the absence of menstruation. Objectively:
normosthenic constitution, the mammary glands are developed, the external genital organs are
developed according to the female type, the integrity of the hymen is not violated. On recto-
abdominal examination: the cervix and uterus are not palpable. Their absence was confirmed by
ultrasound examination.
What MOST likely syndrome corresponds to this condition?
* galactorrhea
* gonadal dysgenesis
* hypopituitarism
* pituitary cachexia
* +testicular feminization
# 80
*!Patient S., 38 years old, came in due to the termination of menstruation. Last menstruation 1.5
years ago. Along with the absence of menstruation, hot flashes up to 15 times a day, poor sleep,
sweating are disturbing. Menstruation from 13 years old were regular, moderate, painless up to
36 years old. She is married, had 5 pregnancies, of which 2 deliveries on time, 3 medical
abortions. Pregnancy and childbirth were uneventful. Objectively: physically healthy, height
160cm, weight - 62kg. The mammary glands are soft, without pathological discharge from the
nipples. Gynecological examination revealed no pathology.
What is the MOST likely tentative diagnosis?
* + wasted ovary syndrome

* resistant ovary syndrome
* early menopause
* Sheehan syndrome
* early menopause
# 81
*! The postpartum period of a 30-year-old woman in childbirth was complicated by sepsis. 6
months after childbirth, he noted a decrease in body weight, agalactia. Objectively: body mass
index 18, hypotension, bradycardia, decreased levels of gonadotropic, thyroid and steroid
hormones.
Which of the following syndromes is the MOST probable in the patient?
* Shihana
* + Simmonds
* Chiari-Frommel
* Itsenko-Cushinga
* Stein-Leventhal
# 82
*!Patient B., went to the antenatal clinic with complaints of abundant discharge from the genitals
of a gray color, often with an unpleasant "fishy" odor, especially after intercourse or during
menstruation, itching and burning in the external genital area, dysuric disorders. Gynecological
status: the external genital organs are developed correctly. On the mirrors: the mucous membrane
of the cervix and vagina is slightly hyperemic, gray discharge with an unpleasant odor. Bimanual
examination: the cervix is cylindrical, the external os is closed. The uterus is in the correct
position, mobile, painless. The appendages on both sides are not defined. The vaults are free,
painless.
What is the MOST probable diagnosis?
* vulvovaginitis
* vulvitis
* endocervicitis
* + bacterial vaginosis
* colpitis
# 83
*!The patient, 26 years old, suffered from tuberculosis as a child. Is not registered at the "D"
tuberculosis dispensary. Periodically disturbed by abdominal pain. Married for 3 years,

pregnancy does not occur. Menarche from the age of 14, the last 5 years of menstruation have
become short and scanty, but the cycle is preserved - 27-28 days. A special gynecological
examination revealed no pathological changes.
* genital and extragenital endometriosis

* chronic adnexitis.
* polycystic ovary syndrome.
* + tuberculosis of the genitals.
* chlamydia of the genitals.
# 84
*! A 28-year-old female patient complained of general weakness, slight fatigue, weight loss, and
absence of menstruation for a year. Childbirth 2 years ago with blood loss of more than 2 liters.
objectively: asthenic constitution, BP-90/60 mm.hm.st. Gynecological examination revealed:
severe dryness of the vaginal mucosa, the uterus is less than normal, the appendages are not
determined.
What is the MOST diagnosis of the listed data?
* Itsenko-Cushing's syndrome
* + Sheehan syndrome
* Rokitansky-Kustner syndrome
* Chiari-Frommel syndrome
* gonadal dysgenesis
# 85
*! A 19-year-old female patient complains of feeling unwell, obesity and lack of menstruation.
Objectively: a patient with increased nutrition, hypertrichosis on the shoulder girdle. PV: the
cervix is conical, the uterus is enlarged to 5-6 weeks of gestation. In the area of the appendages,
tight-elastic formations are determined on both sides. In the blood, an increase in the level of
prolactin. With R-graph of the skull: a child Turkish saddle.
What syndrome is the described clinic MOST typical for?
*syndrome Simmonds
* Shereshevsky-Turner syndrome
*syndrome Frommel-Chiari
* + syndrome of "empty" Turkish saddle
* Sheehan syndrome
# 86
*!Upon admission to the hospital, a 32-year-old patient complains of high temperature, chills,
pain throughout the abdomen. History of infertility, bilateral salpingoopharitis with frequent
exacerbations. Objectively: temperature 39.2 ° C, pulse 128 beats / minute, blood pressure
110/70 mm Hg. Art., the number of breaths 22 per minute. The tongue is dry, the abdomen is
swollen, tense in all parts, painful with a pronounced Shchetkin-Blumberg symptom throughout
the abdomen. Gynecological examination: the external genital organs are developed correctly,
hair growth is female. In the mirrors: the vaginal mucosa is not changed, the cervix is eroded.
Discharge from the genital tract is purulent, moderate. PV: On vaginal examination, the

displacement of the cervix is sharply painful, the appendages and the uterus cannot be
determined due to pain. The posterior fornix of the vagina is flattened, painful.
What is the MOST appropriate treatment plan?
* conservative therapy
* puncture through the posterior fornix
* + surgical treatment
* antibacterial therapy
* hormone therapy
# 87
* 35-year-old female patient complains of no menstruation for 8 months, headache. Objectively:
increased nutrition, body mass index 32, hirsutism, bp 160/100 mm Hg, the mammary glands are
satisfactorily developed, on the skin of the abdomen, blue-purple stretch stripes, external and
internal genital organs without features.
What is the MOST probable syndrome that this clinical picture corresponds to?
*Morris
* Simmonds
* Chiari-Frommel
* Stein-Leventhal
* + Itsenko-Cushing
# 88
*!The patient is 33 years old, taken to the hospital by an ambulance. The patient is conscious, but
weakly reacts to the environment. Answers questions in monosyllables, sluggishly. History of
delayed menstruation by 6 weeks. Skin and visible mucous membranes pale, cold sweat on the
forehead. Pulse 120 beats / minute, weak filling, frequent, poorly counted. BP 70/40 mm Hg The
abdomen is uniformly distended, peristalsis is absent. On palpation of the abdominal wall, there
is a moderately pronounced tension of the abdominal muscles, which increases with palpation.
There is no external bleeding. HB 66g / l.
What is the MOST probable preliminary diagnosis?
* + ectopic pregnancy, impaired by the type of rupture of the tube, hemorrhagic shock 3 tbsp.
* ectopic pregnancy, impaired by the type of rupture of the tube, hemorrhagic shock 2 tbsp.
* ovarian apoplexy, hemorrhagic form, hemorrhagic shock 3 tbsp.
* rupture of the ovarian cyst, hemorrhagic shock hemorrhagic shock 3 tbsp.
* beginning spontaneous miscarriage, hemorrhagic shock 2 tbsp.
# 89
*! A 23-year-old patient on the 14th day of the menstrual cycle developed sharp sudden pains in
the lower abdomen radiating to the rectum. Objectively: a state of moderate severity, pale skin,
blood pressure 100/70 mm Hg, pulse 80 per minute. During vaginal examination: the uterus is
not enlarged, on the right in the region of the appendages, soreness, the posterior fornix is deep.
In the analysis of blood: hemoglobin 125g / l, erythrocytes 3.9x1012 / l.
* salpingo-oophoritis

* early spontaneous abortion
* + ovarian apoplexy, painful form
* an interrupted tubal pregnancy
* ovarian apoplexy, anemic form
# 90
*! On the 14th day of the menstrual cycle, a 25-year-old patient developed sharp pains in the
lower abdomen radiating into the rectum. Objectively: the condition is satisfactory, the skin is
pink, blood pressure is 100/70 mm Hg, pulse is 80 beats per minute. On vaginal examination: the
uterus is of normal size, on the right in the region of the appendages, soreness, the posterior
fornix is deep, painless. In the analysis of blood: hemoglobin 120g / l, erythrocytes 3.8x1012 / l.
What is the MOST recommended research method?
* hysteroscopy
* + ultrasonography
* MRI of the pelvic organs
* puncture of the abdominal cavity through the posterior fornix
* diagnostic curettage of the uterine cavity
# 91
*! A 19-year-old female patient complains of weakness, dizziness, sharp pains in the lower
abdomen radiating to the rectum. From the anamnesis: fell ill on the 20th day of the menstrual
cycle, 3 months ago ultrasonography revealed a follicular cyst of the left ovary with a diameter
of 6.0 cm.Vaginal examination: the uterus is of normal size, painless, the appendages are not
determined, in the region of the left appendages - soreness, painful vaults flattened.
* torsion of the legs of the ovarian tumor

*ectopic pregnancy
* acute salpingo-oophoritis
* + ruptured ovarian cyst
* ovarian apoplexy
# 92
*! A 52-year-old patient has complaints of pain in the lower abdomen for a week, fever up to 39
° C for the last 3 days, nausea, vomiting. From the anamnesis: menopause 1 year ago, exposure
of the IUD for 10 years, not removed. Objectively: pallor of the skin, positive symptoms of
irritation of the peritoneum in the lower abdomen. During vaginal examination: the external
cervical os is closed, the threads of the IUD, the uterus and the appendages are not determined
due to severe pain and tension of the anterior abdominal wall.
* acute endometritis
* + pelvioperitonitis
* acute metroendometritis
* acute salpingo-oophoritis
* tubo-ovarian abscess

# 93
*! A 36-year-old patient has complaints of pain and bloating, fever, nausea, vomiting. From the
anamnesis: fibroids for 3 years. Objectively: skin hyperemia, hyperthermia 380C, dry tongue,
tachycardia, positive symptoms of peritoneal irritation in the lower abdomen. During vaginal
examination: the uterus is enlarged to 12 cm, lumpy, heterogeneous consistency, in the area of
the bottom of the uterus a painful, sedentary formation 5.0x5.5x6.0 cm is palpated.
* ovarian apoplexy
* ruptured ovarian cyst
* + myoma node necrosis
*ectopic pregnancy
* torsion of the legs of the ovarian tumor
# 94
*!The patient has hyperemia, edema of the urethra, abundant purulent discharge, cramps during
urination, hyperemia of the vaginal part of the cervix, and abundant purulent discharge from the
cervical canal.
At which of the listed diagnoses is the MOST likely to have a similar picture?
* + gonorrhea
* chlamydia
* gardnerellosis
* trichomoniasis
*candidiasis
* Gynecology * 3 * 16 * 3 *
#95
*!Patient 42 years old is hospitalized in the gynecological department with abnormal uterine
bleeding.
What is the most likely treatment tactic?
*hormonal hemostasis
*terotonic therapy
*cyclic hormone treatment
*hemostatic therapy, hemotransfusion
*+hysteroscopy, diagnostic uterine cavity scraping

#96
*! Patient P. 29 years old, went to the doctor of the women's consultation with complaints about
headaches, tides, heartbeats, periodically notes an increase in blood pressure, tearfulness. In her
anamnesis 8 months ago, she had both ovaries removed, but the cyst on both sides. Objectively:
increased nutrition. BP - 140/80, 150/90 mmHg. In gynecological examination: vaginal dryness,
uterus size slightly reduced, appendages are not determined.
What hormone therapy is MOST RECOMMEND to this patient?
*androgens
* gestagens
* estrogens
*+ estrogens and gestagens in cyclic mode
*glucocorticoids
#97
*!A woman of 58 years of age has complaints about bloody discharge from the genital tract on
the background of 5 years of postmenopause. When examining on mirrors: cervical and vaginal
mucosa without visual changes; in vaginal examination: uterus and appendages within the age
range. Hysteroscopy and diagnostic scraping of the uterine cavity and cervical canal were
performed.
What is the most likely future medical tactics?
* endometrial ablation
*hemostatic treatment
* gestagenic hormone therapy
* hormonotherapy with androgens
*+histological examination of the scraper
#98
*!In the gynecological department received a girl of 16 years old with complaints of excessive
bleeding of the genital tract within 2 weeks after a delay of menstruation for 3 months. From the
anamnesis: menarche at the age of 14, the menstrual cycle was not established. In rectal
examination: the uterus corresponds to the age norm, appendages are not defined.
What is the most likely treatment strategy?

*Surveillance
*hemostatics
*terotonics
*+ hormonal hemostasis
*surgical hemostasis
#99
*!The postpartum period was complicated by purulent-septic infection. From the anamnesis: 6
months after delivery, she noted a decrease in body weight, agalacty. Objectively: body mass
index 18, hypotension, bradycardia, reduction of gonadotropic, thyroid and steroid hormone
levels.
What is the most likely treatment for this pathology?
* estrogens
* agonists GnRG
* pure gestagens
*+ substitutional hormone treatment
*combination oral contraceptives
#100
*!The 13-year-old girl entered the pediatric gynecology department with complaints of lower
abdominal pain, which is repeated every 28 days for the last 6 months, there was no menarche.
Examination of the external genitalia: clitoris, large and small labia are developed correctly, in
anticipation of the vagina there is a swelling and tension of the elastic tissue of the cyanide color
without holes, when palpation the content is liquid.
* hymn dissection
* hymn coagulation
*+ anthem dissection
*booking of the anthem

*vaginal probing
#101
*!The patient is 25 years old on the 14th day of the menstrual cycle after coitus has severe pains
in the lower abdomen with irradiation into the rectum. Objectively: skin pale, AD 90/60 mm Hg,
pulse rate 100 per minute. Vaginal examination: normal size uterus, painless, painful in the area
of right appendages, flattened hindquarters, painful. In laparoscopy: abdominal blood 300.0, the
uterus is not increased, rupture of the upper right pole of the ovary 1.0 cm, bleeding.
What is the MOST recommended surgery?
*drilling
*+coagulation
*ovaro-ectomy
*dnexectomy
* wedge-shaped resection
#102
*! The patient, 25 years old, complained of contraction pains in the lower abdomen, irradiating
into the rectum and blistering blood secretions from the genital tract. She got sick 2 days ago.
Anamnesis: delivery - 1, medical abortion - 2. The condition is satisfactory, heart rate 78
beats / minute, BP 115/70 mm Hg. On the mirrors: vaginal and cervical mucosa cyanosis,
bleeding, poor secretions. PV: uterus slightly above normal, mobile, painless. Right in the area of
appendages palpable formation without clear contours, doughy consistency, painful. The
posterior arch is thickened, painful.
What is the most likely treatment plan?
*culdocentesis
* endometrial biopsy
*+ laparoscopy
* HG detection
* abdominal radiography
#103
*!In a 25-year-old patient with primary infertility, the diagnostic laparoscopy revealed bilateral
ovarian enlargement with a smooth, shiny surface, dense shell.
What is the MOST recommended surgery?
*+ ovarian grilling
* ovarian removal
*resection of ovaries
*dnexectomy
*cystectomy
#104
*!The patient has 25 years of complaints about abundant secretions with the smell of "rotten
fish", itching and burning in the external genital area. In the bacterioscopic study of the smear
found curdners, "key" cells.
What is the most likely treatment tactic?
*Antimicrobic drugs, vaginal biocenosis normalization
*vaginal splints with potassium permanganate solution
*+metronidazole, vaginal biocenosis normalization
*vaginal trays with solution of fuccillin
*normalization of vaginal biocenosis
# 105
*! A 23-year-old patient complains of profuse leucorrhoea, itching, burning sensation in the
perineal region after antibiotic therapy. On the mirrors: the vaginal mucosa is hyperemic, the
discharge is abundant, “tiny”, white.
What is the MOST likely treatment?
* + antimycotic drugs, normalization of the vaginal biocenosis

* vaginal baths with potassium permanganate solution
* douching the vagina with a solution of potassium permanganate
* metronidazole, normalization of the vaginal biocenosis
* normalization of the vaginal biocenosis
# 106
*! U nfemale patient 30 years old with secondary amenorrhea, primary infertility complaints
of"tides" up to 15 times a day, increased sweating for 6 months. Anamnesis: autoimmune
thyroiditis. Objectively: body mass index 23, the mammary glands are developed, the external
and internal genital organs are normal. FSH and LH levels are elevated. Diagnosis: resistant
ovarian syndrome.
Which of the MOST probable authors first described this syndrome?
* Shien
*Morris
* Simmonds
* + Savage
* Asherman
# 107
*!A 24-year-old patient was admitted to a gynecological hospital with complaints of high
temperature, weakness, spotting from the genital tract. From the anamnesis: 3 days ago, in order
to terminate the pregnancy, an iron catheter was inserted into the uterine cavity. She doesn't
remember her last periods. She is not registered for pregnancy. General condition on admission
of moderate severity. Body temperature 39 ° C. The abdomen is tense, painful on palpation in the
navel. Symptom Shchetkin-Blumberg positive. On the mirrors - there are traces of injections on
the anterior lip of the cervix. From the cervical canal - bloody discharge with an unpleasant odor
in moderation. In vaginal examination, the cervix is conical in shape, the pharynx passes the tip
of the finger. The uterus cannot be palpated separately. In the small pelvis, a formation without
clear contours is palpable, inactive, painful on palpation. The appendages are not palpable.
What is the MOST advisable tactic for further patient management?
* dynamic observation
* antibacterial therapy
* scraping of the uterine cavity
* + urgent extirpation of the uterus
* emergency supravular amputation of the uterus
# 108
*!A 26-year-old patient complains of worsening of her condition 5 days before menstruation:
edema, weight gain, feeling of tension and soreness in the mammary glands, irritability, bad
mood, headache. With the onset of the next menstruation, the complaints disappear.
Gynecological examination revealed no pathological changes. What is the MOST likely
treatment strategy?
* sedatives (grandaxin) 2 tablets in the morning and at lunch

* + vitamin therapy (magnesium B6)
* diuretics
* nitroimidazole groups
* physiotherapy
# 109
*! A 14-year-old girl complains of recurrent bursting pains in the lower abdomen, which appear
monthly for 1 year. Surgical pathology was excluded by surgeons. Gynecological examination:
the external genitals are developed correctly, hair growth is female, there is a swelling of the soft
tissue of a bluish color between the labia minora, without holes. Rectal examination: the ampulla

of the intestine is free, a tight-elastic, painful elongated formation is palpable, the uterus is larger
than normal, painful. Diagnosed with ginatresia.
What is the MOST likely treatment strategy?
* + dissection of the hymen

* vaginal bougienage
* bougienage of the cervical canal
*hysterectomy
* excision of the hymen
# 110
*! A 16-year-old patient complains of the absence of menstruation. Objectively: asthenic
constitution, high forehead, bald patches, long upper and lower limbs, narrow pelvis. Preliminary
diagnosis: primary amenorrhea.
Which of the following is the MOST priority in examining a patient?
∗determination of sex hormones in the blood

∗ultrasound examination of the pelvic organs
∗+ determination of karyotype
∗magnetic resonance imaging of the brain
∗determination of thyroid hormones
*" Physiological delivery and postpartum period " 1*11*2
#111
*!The woman in labor began the necessary activity, the opening of the uterine yawn is complete,
there is a head in a wide part of the cavity of the small pelvis.
What is the combination of progressive and rotational movements that the fetus makes when
passing through the small pelvis and soft parts of the birth pathways?
* head configuration
*+ birthing biomechanism
* head flexion
*crumbs
*Shoes
#112
*! A woman in labor began regular labor activities, was hospitalized in the maternity ward,
where the graphical representation of the course of labor began.
What is the name of this type of graphical image?

*histogram
*+parthogram
*gravitogram
*cardiotocogram
* electrocardiogram
#113
*!The fetus was discharged from the maternity hospital for the 3rd day after the physiological
birth, a conversation was held about the hygiene of the postpartum period.
What is the MOST likely duration of the postpartum period in weeks?
*4
*+6
*9
*12
*24
#114
*! In a woman in vaginal examination: the opening of the uterine yawn is complete, the sacrum
and bosom are free, the fetus head is not repelled, arrow-shaped seam in the left oblique size, a
small fontanelle on the right and front.
What are the most likely positions, fetal species and head location?
*I position, front view, head pressed to the small pelvis entrance
*I position, rear view, head with large segment in the entrance to the small pelvis
*+II position, front view, head with small segment in the small pelvis entrance
*II position, rear view, head above pelvis entrance
*I position, front view, head with small segment in the small pelvis entrance
#115
*! The woman gave birth to a live, full-term boy.

Who is most likely to use the Apgar scale to assess the condition?
* + newborn
* postpartum women
* pregnant
* women in labor
* fetus
# 116
*! A newborn after childbirth needs to ensure temperature adaptation, colonization by the
mother's microflora, early breastfeeding, psycho-emotional contact with the mother, and the
formation of family ties.
What is the MOST likely contact to provide the above to a newborn?
* with other family members

* Skin-to-skin on father's chest
* + Skin-to-skin on mother's chest
* with a midwife taking delivery
* with a doctor examining a newborn
# 117
*!Which of the following partograph parameters is MOST likely to help diagnose fetal hypoxia?
* dynamics of opening of the cervix

* nature of contractions
* + color of amniotic fluid
* configuration of the fetal head
* advancement of the fetal head
# 118
*! The parturient woman gave birth to a live immature girl.
Which of the following is one of the MOST likely signs of newborn immaturity?
* covering the labia minora with large

* + lanugo on the back, shoulders, chest
* hard ear and nasal cartilage
* lack of original lubrication
* dense bones of the skull
# 119
*! The postpartum purulent-septic disease was diagnosed in the postpartum woman on the 8th
day of the postpartum period.
Which of the following is MOST likely to be the second the stage of spread of postpartum
purulent-septic infection according to the Sazonov-Bartels classification?
*sepsis
*peritonitis
* endometritis
* postpartum ulcer
* + pelvioperitonitis
# 120
*! On the partograph in primiparous, the duration of the 1st stage of labor is 5 hours,
contractions after 3 minutes for 40 seconds. During vaginal examination, the opening of the
uterine pharynx is 3 cm, the fetal bladder is intact, the head is pressed against the entrance to the
small pelvis.
What is the MOST likely time in hours to perform a repeat vaginal examination to determine the
rate of labor?
*2
*3
*+4
*5
*6
# 121
*! Which of the following is one of the MOST likely signs of newborn immaturity?
* dense bones of the skull

* lack of original lubrication
* hard ear and nasal cartilage
* body weight 2500.0 grams or more
* + low position of the umbilical ring
* Physiological childbirth and the postpartum period * 2 * 28 * 5 *

# 122
*! The woman in labor began regular labor activity, contractions after 3 minutes for 40 seconds,
the opening of the uterine pharynx 6 cm, the fetal bladder is intact, the head is present, pressed
against the entrance to the small pelvis.
What is the MOST probable average rate of cervical dilatation during labor in cm / hour?
* 0.15
* 0.35
* 0.5
* + 1.0
* 1.5
# 123
*!A woman in labor with a body weight of 60 kilograms began the 3rd stage of labor. What is the
MOST physiological blood loss during childbirth, which is defined as a percentage of the body
weight of the woman in labor?
* + 0.5
* 1.0
* 1.5
* 2.0
* 2.5
# 124
*!In the partogram, in the column "number of contractions in 10 minutes", 3 cells were painted
over. This MOST probably means that at the moment the woman in labor is in labor with the
following frequency and nature of contractions?
* 3 contractions of 5-10 seconds

* + 3 contractions of 40-45 seconds
# 125
*! The woman gave birth with a large fetus, blood loss was 600.0.
Excess of which MOST probable volume of postpartum blood loss in milliliters is considered
pathological?
* 400
* + 500
* 600
* 700
* 800
# 126
*! The woman in labor began regular labor activity 4 hours ago, filling in the partograph began.
What is the MOST probable cervical dilatation in centimeters shown by the “X” symbol on the
partograph fragment?
* +3
*4
*five
*6
*7
# 127
*! The woman in labor began regular labor activity 3 hours ago, a partogram is being recorded.
What is the MOST probable level of passage of the fetal head in the pelvic cavity shown by the
"O" symbol on the partogram fragment?
* + 5/5
* 4/5
* 3/5
* 2/5
* 1/5
# 128
What is the MOST likely partogram parameter to diagnose a threatening fetus?
* + meconium amniotic fluid

* dynamics of opening of the cervix
* configuration of the fetal head
* advancement of the fetal head
* nature of contractions
# 129
What is the MOST probable configuration of the fetal head indicated by the “+” symbol on the
partograph fragment?
* the bones of the skull do not touch, the seams are easily identified
* fetal skull bones overlap significantly
* + fetal skull bones touch slightly
* fetal skull bones overlap
* skull bones are severed, wide sutures
# 130
*!First pregnant N., 22 years old, was admitted to the hospital with complaints of cramping pains
in the lower abdomen for 4 hours. The gestation period is 39-40 weeks. Objectively contractions
after 5 minutes to 35 seconds. Vaginally: the cervix is smoothed, the opening of the uterine
pharynx is 2 cm, the fetal bladder is intact, the head is presented, pressed against the entrance to
the small pelvis.
What is the MOST probable diagnosis for a woman in labor?
* Pregnancy 39-40 weeks. False contractions.

* Pregnancy 39-40 weeks. Preliminary period.
* Pregnancy 39-40 weeks. Pathological preliminary period.
* + Pregnancy 39-40 weeks. First stage of labor, latent phase.
* Pregnancy 39-40 weeks. First stage of labor, active phase.
# 131
*! On the partogram, the duration of the first stage of labor is 8 hours, contractions after 6
minutes for 25 seconds, the opening of the uterine pharynx is 2 cm, the fetal bladder is intact, the
head is presented, the small pelvis is pressed to the entrance.
What is the MOST probable rate of labor?
*quick
*moderate
*sufficient
*monotone
* + insufficient
# 132
*! On the partograph, the duration of the first stage of labor is 9 hours, contractions after 3
minutes for 45 seconds. At the first vaginal examination, the opening of the uterine pharynx is 3

cm, the fetal bladder is intact, the head is pressed to the entrance to the small pelvis, after 4 hours
- the opening of the uterine pharynx is 7 cm.
What is the MOST probable rate of labor?
*quick
*moderate
*monotone
* + sufficient
*inadequate
# 133
*! A full-term primary pregnant woman was admitted to the hospital with complaints of
cramping pains in the lower abdomen for 4 hours. Objectively: contractions after 4 minutes to 35
seconds, fetal heart rate 146 beats per minute. During vaginal examination: the cervix is
smoothed, the opening of the uterine pharynx is 2 cm, the fetal bladder is intact, the head is
pressed against the entrance to the small pelvis.
What is the MOST probable diagnosis for a pregnant / parturient woman?
* false contractions
* preliminary period
* first stage of labor, active phase
* + first stage of labor, latent phase
* pathological preliminary period
# 134
*!Pregnant N., 33 years old, was admitted to the maternity hospital with complaints of cramping
pains in the lower abdomen for 6 hours. The gestation period is 38-39 weeks. Objectively,
contractions after 2-3 minutes to 60 seconds, of a taut nature. Vaginally: the cervix is smoothed,
the opening of the uterine pharynx is complete, there is no fetal bladder, the head is presented,
with a large segment at the entrance to the small pelvis.
What is the MOST probable diagnosis for a pregnant woman?
* Pregnancy 38-39 weeks. False contractions.

* Pregnancy 38-39 weeks. Pathological preliminary period.
* Pregnancy 38-39 weeks. First stage of labor, latent phase.
* Pregnancy 38-39 weeks. First stage of labor, active phase.
* + Pregnancy 38-39 weeks. Second stage of labor.
# 135
*!On the partogram, the head configuration is marked with "+++". What is the MOST likely
indication of this parameter?
* good labor
* beginning of the second stage of labor
* ineffectiveness of contractions
* + discrepancy between the size of the pelvis of the mother and the head of the fetus
# 136

*! The woman in labor 3 minutes ago had an urgent birth, there is informed consent to expectant
management of the 3rd period. After 10 minutes, the fundus of the uterus rose above the navel,
the body of the uterus deviated to the right, the clamp placed on the umbilical cord at the genital
slit fell on10 cm, there was an urge to push.
What are the MOST probable signs of separation of the placenta in a woman in labor?
* + Schroeder, Alfeld, Mikulich

* Schroeder, Küstner-Chukalov, Klein
* Mikulich, Hunter, Kustner-Chukalov
* Schroeder, Kustner-Chukalov, Alfeld
* Schroeder, Kustner-Chukalov, Alfeld, Klein
# 137
*! The body weight of a newborn at birth was 3000.0 grams, on the 5th day of life - 2850.0
grams, body weight loss was 5%.
What is the MOST likely weight loss for this newborn?
* borderline
* pathological
* + physiological
* compensated
* decompensated
# 138
*! The body weight of a newborn at birth was 3000.0 grams, on the 5th day of life - 2640.0
grams, body weight loss was 12%.
What is the MOST likely weight loss for this newborn?
* borderline
* + pathological
* physiological
* compensated
* decompensated
# 139
*! The woman gave birth to a living full-term boy.
After what is the MOST probable period of time to assess the state of the newborn on the Apgar
scale?
* 1 and 5 seconds
* 10 and 50 seconds
* + 1 and 5 minutes
* 1 and 5 hours
* 10 and 50 minutes
# 140
*! The woman gave birth to a living full-term boy. The child was placed on the mother's chest,
and it is planned to conduct a medical examination of the newborn, weigh it, measure and
process the umbilical cord.
What is the MOST recommended time after birth for a complete physical examination of a
newborn?
* 20 seconds
*2 minutes
*20 minutes
* + 2 hours
* 2 days
# 141
*! A full-term male newborn has been delivered.
What is the MOST recommended time after the birth of a newborn to perform cord clamping?
* 6 seconds
* + 60 seconds
* 3 minutes
* 60 minutes
*6 o'clock
# 142
*!A woman with regular labor is in the maternity ward for 8 hours, a partogram is recorded. Last
2 hourscontractions every 6 minutes for 25 seconds, regular, monotonous.
Which of the following is MOST likely to correspond to the indicated contractions?
* + weakness of labor
* excessive labor
* normal labor
* discoordinated labor
# 143
*!A woman with regular labor is in the maternity ward, a partogram is being recorded. Last 2
hours contractions are strong and prolonged with short intervals.
Which of the following is MOST likely for a woman in labor?
* weakness of labor
* + excessive labor
* normal labor
# 144
*!A woman in labor with regular labor is in the maternity ward, a partogram is being recorded.
Last 2 hours contractions are strong, prolonged and painful at short intervals.
Which of the following is MOST likely for a woman in labor?
* weakness of labor
* excessive labor
* normal labor
* + discoordinated labor
# 145
*! On the 5th day after childbirth, the postpartum woman has a body temperature of 37.5 ° C,
pain in the lower abdomen. From the anamnesis: in childbirth - manual removal of the delayed
parts of the placenta, leukocytosis - 13.2x109 / l, shift of the leukocyte count to the left, ESR - 45
mm / hour.
Which of the following is the MOST probable form of postpartum septic infection?
*mastitis
*peritonitis
*parametritis
* + endometritis
* pelvioperitonitis
# 146
*! On the 5th day after childbirth, the postpartum woman has a body temperature of 37.5 ° C,
pain in the lower abdomen. From the anamnesis: in childbirth - manual removal of the delayed
parts of the placenta, leukocytosis - 13.2x109 / l, shift of the leukocyte count to the left, ESR - 45
mm / hour.
*parametritis
* pelvioperitonitis
* + endometritis, mild form
* endometritis, severe
# 147
*! In the postpartum woman, on the 2nd day after childbirth, an increase in body temperature to
39 ° C, pain in the lower abdomen, weakness, lochia with an ichorous odor, tachycardia, chills.
From the anamnesis: in childbirth, manual removal of the delayed parts of the placenta,
leukocytosis - 19.2x109 / l, shift of the leukocyte formula to the left, ESR - 50 mm / hour.
*parametritis
* pelvioperitonitis
* endometritis, mild form
* + endometritis, severe
# 148
*! A postpartum woman with purulent-septic postpartum disease was diagnosed with systemic
inflammatory response syndrome on the 18th day.
What is the MOST probable number of symptoms from systemic inflammatory response
syndrome that is sufficient to establish postpartum sepsis in the presence of a primary focus of
infection?
* at least 1
* + at least 2
* at least 3
* not less than 4
* not less than 5
# 149
*! A postpartum woman with purulent-septic postpartum disease was diagnosed with systemic
inflammatory response syndrome on the 18th day on the basis of objective data: hyperthermia
more than 380C, tachycardia, tachypnea, pronounced leukocytosis.
In addition to the above symptoms, which of the following is also the MOST characteristic of
systemic inflammatory response syndrome?
* + hypothermia less than 360C, leukopenia less than 4.0x109 / l

* hypothermia less than 36.60C, leukopenia less than 5.0x109 / l
* hypothermia less than 36.60C, leukopenia less than 6.0x109 / l
* hyperthermia 370C, bradycardia less than 60 beats per minute
* hyperthermia 37.50C, bradycardia less than 50 beats per minute
* Physiological childbirth and the postpartum period * 3 * 16 * 3 *
# 150
*! The woman in labor began regular labor activity, began filling in the partogram, and informed
consent was obtained for the active management of the subsequent period.
What is the MOST likely uterotonic agent to be used in the active management of the third stage
of labor?
* methylergometrine
* misoprostol
* carbetocin
* + oxytocin
* enzaprost
# 151
*! The woman in labor began regular labor activity, began filling in the partogram, and informed
consent was obtained for the active management of the subsequent period.
According to clinical protocols, after what moment of delivery is it MOST likely to administer
10 U of oxytocin intramuscularly?
* allocation of placenta
* birth hangers
* head penetration
* teething heads
* +after birth of the front shoulder
# 152
*!A 24-year-old primary pregnant woman with a gestational age of 38 weeks came to the
emergency room. Ultrasound revealed twins, both fetuses in a longitudinal position, cephalic
presentation. Estimated fruit weight 3000 g.
What is the MOST likely delivery plan?
* cesarean section as planned

* + conservative childbirth, with the development of weakness of labor - cesarean section
* conservative childbirth, with the development of weakness of labor - rhodostimulation
* conservative childbirth, cesarean section for health reasons by the woman in labor
* amniotomy, labor induction with oxytocin
# 153
*! During a vaginal examination in a full-term pregnant woman, the cervix is 3-4 cm long,
dense, relative to the wiring axis of the pelvis is deflected posteriorly, the cervical canal is
closed, the head is 2 cm above the level of the sciatic spines.
What is the MOST likely assessment of this cervical condition on the Bishop scale?
* mature
* + immature
* ripening
* latent phase of labor
* active phase of labor
# 154
*! In a primiparous woman with a full-term pregnancy, a partogram is kept for 4 hours by regular
labor.
What is the MOST probable time interval in minutes after which the fetal heart rate is recorded
on the partogram?
*five
*fifteen
* + 30
* 45
* 60
# 155
*! The woman in labor began regular labor activity, began filling in the partogram. After 2 hours,
the woman in labor notes painful contractions.
What is the MOST likely drug-free method of labor pain relief used in the first stage of labor?

* analgesics
*acupuncture
* therapeutic sleep
* antispasmodics
* + stroking and massage
# 156
*! After 7 hours from the onset of labor, amniotic fluid poured out in the multiparous woman and
attempts began. During vaginal examination, the opening of the uterine pharynx is complete,
there is no fetal bladder, the head occupies the entire cruciate cavity and pubic articulation, the
sciatic spines are palpated, the coccyx is palpated, the sagittal suture in the left oblique size, the
small fontanel on the right front.
What is the MOST likely head location?
* on the pelvic floor

* above the entrance to the small pelvis
* pressed against the entrance to the small pelvis
* in the wide part of the pelvic cavity
* + in the narrow part of the pelvic cavity
# 157
*! In a multiparous woman in the 2nd stage of labor within 2 hours there is no progress in the
movement of the head along the planes of the small pelvis, the fetal heartbeat is rhythmic, 140
beats per minute, attempts after 1 minute for 60 seconds, good strength. Vaginal examination: the
opening of the uterine pharynx is complete, there is no fetal bladder, the head is at the entrance to
the small pelvis, the sagittal suture is deflected anteriorly to the bosom.
What is the MOST probable management of labor?
* rhodostimulation with oxytocin

* vacuum extraction of the fetus
* obstetric forceps
* + cesarean section
* expectant
# 158
*! A woman in labor with a full-term pregnancy has regular labor for 12 hours. At the next
vaginal examination, the opening of the cervix is 3 cm, the fetal bladder is intact, the head is
pressed against the entrance to the small pelvis. Diagnosed with weakness of labor.
Which of the following is the MOST acceptable for the indicated pathology?
* + amniotomy
*cesarean section
* labor arousal
* vacuum extraction of the fetus
* dynamic observation by partogram

# 159
*! A woman in labor with a full-term pregnancy has regular labor for 12 hours. At the next
vaginal examination, the opening of the cervix is 3 cm, the fetal bladder is intact, the head is
pressed against the entrance to the small pelvis. Diagnosed with weakness of labor.
Which of the following is the MOST acceptable for a woman in labor?
*amniocentesis
*cesarean section
* + amniotomy, oxytocin rhodostimulation
* epidural anesthesia, oxytocin induction
# 160
*! On the partogram of a primiparous woman with a full term and an estimated fetal weight of
3500.0 in the first stage of labor, secondary weakness of labor was diagnosed.
What is the MOST likely further tactic?
* amniotomy followed by rhodostimulation with prostaglandins

* + amniotomy followed by oxytocin rhodostimulation
* digital detachment of the lower pole of the fetal bladder
* rhodostimulation with prostaglandins
* emergency caesarean section
# 161
*! The woman in labor has secondary weakness of the 2nd stage of labor, a threatening condition
of the fetus, the head of the fetus on the pelvic floor.

* + vacuum extraction of the fetus
* treatment of threatening fetal conditions
# 162
*! In the postpartum woman, on the 2nd day after childbirth, an increase in body temperature to
39 ° C, pain in the lower abdomen, weakness, lochia with an ichorous odor, tachycardia, chills.
In childbirth, there was a manual removal of the delayed parts of the placenta, leukocytosis
15.2x109 / l, shift of the leukocyte count to the left, ESR 40 mm / hour. Diagnosed with
endometritis, severe form.
*hysterectomy
* vitamin therapy
* plasma transfusion
* + antibiotic therapy
* acupuncture

# 163
*! Postpartum women undergo complex treatment of postpartum pelvioperitonitis.
After what is the MOST probable number of hours indicated for hysterectomy in case of
ineffectiveness of conservative treatment?
*12
* + 24
* 36
* 48
* 60
# 164
*! The postpartum woman was diagnosed with peritonitis on the 3rd day after the caesarean
section.
Which of the following is MOST indicated for peritonitis after a cesarean section?
* hysteroscopy, drainage of the uterine cavity

* laparotomy, abdominal drainage
* laparoscopy, abdominal drainage
* laparotomy, uterine amputation, abdominal drainage
* + laparotomy, extirpation of the uterus, drainage of the abdominal cavity
# 165
*! The puerperant mastitis of the right breast was diagnosed on the 15th day after childbirth.
What is the MOST likely treatment for purulent mastitis?
* + surgical
* antibacterial
* suppression of lactation
* UFO of the breast
* extracorporeal detoxification
* Pathological obstetrics * 1 * 11 * 2 *
# 166
*! A pregnant woman in the period of 36 weeks has complaints of amniotic fluid outflow.
Which of the following is the MOST priority action when choosing the tactics of managing a
preterm pregnancy with prenatal rupture of amniotic fluid?
* + registration of the patient's informed consent

* urgent delivery
* operative delivery in a planned manner
* observation in the conditions of antenatal clinic
* induction of labor
# 167
*! Until what stage of pregnancy is it MOST likelyare glucocorticoids used in preterm labor to
prevent fetal distress?
* 32 weeks of pregnancy
* + 34 weeks of pregnancy
* 38 weeks pregnant
# 168
*! Strengthening the synthesis of which MOST probable substance plays a significant role in the
pathogenesis of hypertensive conditions during pregnancy?
* prolactin
* oxytocin
* + thromboxane
* prostacyclin
* prostaglandin E
# 169
*! What is the MOST characteristic of severe preeclampsia?
* BP 130/80 mm Hg proteinuria 0.033 g / day

* BP 140/90 mm Hg, proteinuria 0.3 g / day
* BP 150/90 mm Hg, proteinuria more than 0.3 g / day
* + BP 160/110 mm Hg, proteinuria more than 0.3 g / day
* BP 180/120 mm Hg, convulsions, proteinuria 3 g / day
# 170
*! In a pregnant woman with a narrow pelvis, an ultrasound examination at 18 weeks revealed
that the placenta completely overlaps the internal pharynx.
Which of the following creates the MOST high risk of true placenta accreta - "placenta acсreta"?
* narrow pelvis
* large fruit
* + placenta previa
* breech presentation of the fetus
* transverse position of the fetus
# 171
*! After giving birth by macrosomia, the postpartum woman started bleeding from the genital
tract, the uterus is flabby, the bottom of the uterus is 2 cm above the navel.
Which of the following is the MOST characteristic of postpartum atonic bleeding?
* dense uterus
* bleeding without clots
* + bleeding with clots
* delay of parts of the placenta in the uterus
* jet bleeding immediately after the birth of the fetus
# 172
*!What is the MOST likely change in homeostasis of the post-term newborn?
* + hypercoagulability
* hypocoagulation
* increase in APTT
* activation of the plasma link
* activation of the erythrocyte link
# 173
*! After the release of the placenta, the woman in labor started bleeding from the genital tract,
the uterus is dense, the fundus of the uterus at the level of the navel, placental defect, on the
mirrors - the birth canal is intact.
What is the MOST likely cause of bleeding in the early puerperium?
* uterine atony
* ruptured cervix
* true augmentation of the placenta
* + delay of parts of the placenta in the uterus
* tight attachment of the placenta
# 174
*!In multiparous labor activity within 3 hours, contractions every 1-2 minutes, for 50-55
seconds. Vaginally: opening of the uterine pharynx by 7 cm, the fetal bladder is intact, the head
is a small segment at the entrance to the small pelvis.
What is the MOST likely rate of labor?
* weak
* + fast
*inadequate
* impetuous
*satisfactory
# 175
*! Pregnant on ultrasonography: pregnancy 37 weeks + 4 days, breech presentation of the fetus.
At 39 weeks, complaints of regular labor, discharge of amniotic fluid. On vaginal examination,
12 hours after the onset of contractions: the opening of the uterine pharynx is 7 cm, there is no
fetal bladder, there is a voluminous soft part of the fetus, pressed against the entrance to the
small pelvis, the inguinal fold of the fetus is palpated.
What is the MOST probable part of the fetus that can be additionally determined by vaginal
examination?
* + sacrum
* both legs
* one leg
* feet next to the buttocks
* round, dense presenting part
# 176
*! Pregnant woman on ultrasonography: pregnancy 38 weeks + 4 days, mixed breech
presentation of the fetus. At 39 weeks, complaints of regular labor, during vaginal examination:
the opening of the uterine pharynx is 6 cm, the fetal bladder is intact, the voluminous soft part of
the fetus is presented, pressed against the entrance to the small pelvis, the groin fold and sacrum
of the fetus are palpated.
Which of the following is MOST likely to be determined additionally during a vaginal

examination?
* both legs
* one leg
* groin fold
* + feet next to the buttocks
* round, dense presenting part
# 177
*!A pregnant woman with a period of 35-36 weeks of pregnancy was admitted to the hospital
with complaints of weakness, profuse bleeding from the genital tract. History: 4 medical
abortions, the last one was complicated by metroendometritis, this is the fifth pregnancy.
Objectively: the skin is pale, the blood pressure is 90/60 mm Hg, the pulse is 96 per minute, the
uterus is not excitable, the fetal position is longitudinal, the head is high above the entrance to
the small pelvis, the fetal heart rate is 140 beats per minute, there is no edema. In mirrors:
spotting.
What is the MOST probable preductive diagnosis?
* + Pregnancy 35-36 weeks. Placenta previa. Bleeding. Hemorrhagic shock 1 degree

* Pregnancy 35-36 weeks. Premature detachment of a normally located placenta.
* Pregnancy 35-36 weeks. Bleeding from varicose veins of the vagina
* Pregnancy 35-36 weeks. The beginning of the rupture of the uterus.
* Pregnancy 35-36 weeks. Placenta previa.
# 178
*! Immediately after the birth of a newborn weighing 4100.0 g, a woman in labor started
bleeding from the genital tract against the background of oxytocin rhodostimulation, the uterus
was dense, the fundus of the uterus was at the level of the navel, there were no signs of
separation of the placenta.
What is the MOST likely cause of subsequent bleeding?
* uterine atony
* + rupture of the cervix
* placenta previa
# 179
*!The primiparous had an urgent labor with a large fetus. On examination the mirrors revealed a
gapvaginal walls, skin and muscles of the perineum, bleeds.
What is the MOST probable obstetric injury in a postpartum woman?
* rupture of the cervix of the 1st degree

* rupture of the cervix of the 2nd degree
* perineal rupture of the 1st degree
* + 2nd degree perineal tear
* perineal rupture of the 3rd degree
# 180
*! In a woman in labor, with an estimated weight of the fetus of 4500.0 g., Intense attempts after
1-2 minutes for 50-60 seconds. Vasten's sign is positive, the lower segment is painful on
palpation outside the contraction, the contraction ring is at the level of the navel. Doesn't urinate
for 3 hours. The head is presented, fixed at the entrance to the small pelvis. Fetal heartbeat up to
160 beats / minute. Vaginal examination: the opening is complete, the edges of the cervix are
swollen. The head is fixed at the entrance to the small pelvis. Sagittal seam in the right oblique
size. Small fontanelle on the right at the sacrum. A generic tumor is expressed on the head. The
cape is not reached.
* II stage of labor. Large fruit. Excessive labor.

* II stage of labor. Large fruit. Discoordinated labor.
* + II stage of labor. Large fruit. Clinically narrow pelvis. Threatening rupture of the uterus.
* II stage of labor. Clinically narrow pelvis. Large fruit. The beginning of the rupture of the
uterus.
* II stage of labor. Clinically narrow pelvis. Large fruit. Completed rupture of the uterus.
# 181
*! Postpartum women have profuse bloody discharge from the genital tract, when examined on
mirrors, a rupture of the cervix with a transition to the vaginal vault was found.
* ruptured uterus
* vaginal rupture
* rupture of the cervix of the 1st stage.
* rupture of the cervix II stage.
* + rupture of the cervix III degree
# 182
*!A multiparous woman with a scar on the uterus had urgent labor through the natural birth
canal. With manual examination of the uterine cavity, it was suspectedviolation of the integrity
of the uterus in the lower segment. During laparotomy: transudate 100.0 in the abdominal cavity,
the uterus is enlarged to 18 weeks, dense, in the lower segment in the scar area there is a
discrepancy between the mucous and muscle layers, the integrity of the serous membrane of the
uterus is preserved.
What is the MOST probable obstetric uterine injury in a postpartum woman?
* eversion
* complete breaking
* + incomplete breaking
* started gap
* threatening breaking
# 183
*! The woman in labor is observed in the maternity ward for 8 hours. During the last 2 hours, the
contractions are regular, monotonous, every 6 minutes for 25 seconds.
What is the MOST probable type of labor that the indicated birth rate corresponds to?
* + weakness of labor
* excessive labor
* physiological labor
# 184
*! The woman in labor is observed in the maternity ward for 2 hours, the contractions are
regular, strong and prolonged with short intervals.
What is the MOST probable species activity corresponding to the indicated rate of labor?
* weakness of labor
* + excessive labor
* normal labor
# 185
*! The woman in labor is observed in the maternity ward for 6 hours, the contractions are
regular, strong and prolonged with short intervals, painful.
What is the MOST probable type of labor that the indicated birth rate corresponds to?
* weakness of labor
* excessive labor
* normal labor
* + discoordinated labor
# 186
*! Pregnant on ultrasonography: pregnancy 37 weeks + 4 days, breech presentation of the fetus.
At 39 weeks, complaints of amniotic fluid discharge, regular labor.
What complication is MOST likely in the first stage of labor in a woman in labor, apart from
weakness of labor?
* + loss of umbilical cord loops

* throwing back the handles
* perineal tear
* head extension
*bleeding
# 187
*! The pregnant woman on ultrasonography: pregnancy 37 weeks + 4 days, breech presentation
of the fetus. At 39 weeks, complaints of amniotic fluid discharge, regular labor. After 12 hours
from the beginning of the contractions, the opening of the uterine pharynx is complete, there is
no bottom bladder, the buttocks are pressed to the entrance to the small pelvis.
What complication is MOST likely in the second stage of labor besides weakness of labor and
throwing back the arms?
* early rupture of amniotic fluid

* loss of umbilical cord loops
* + head extension
* drop of the handle
*bleeding
# 188
*! A full-term pregnant woman was diagnosed with transverse presentation of the fetus, which
was confirmed by ultrasonography, and was admitted to the hospital.
What complication is MOST likely in the first stage of labor, besides early rupture of amniotic
fluid and weakness of labor?
* + loss of umbilical cord loops

* throwing back the handles
* perineal tear
* head extension
* prolapse of the leg
# 189
*! A full-term pregnant woman revealed: transverse position of the fetus, second position,
anterior view. There is no informed consent of the pregnant woman to external rotation of the
fetus on the head of the herod through the vaginal birth canal.
What is the MOST preferred management plan?
* external rotation of the fetus

* + planned cesarean section
* birth through the natural birth canal
* cesarean section with onset of labor
# 190
*!Pregnant 28 years old. The gestation period is 38 weeks. History of caesarean section 1.5 years
ago. Upon receipt of a complaint of constant pain in the lower abdomen, which is aggravated by
the movement of the fetus. The uterus is in normotonus. Head is presented. The fetal heartbeat is
clear, 136 beats / minute. On palpation of the postoperative scar, the pain intensifies. Vaginal
examination: the neck is soft, length1.5 cm, the cervical canal passes 1 transverse finger for the
internal os, in the area of which the "transitional roller" is defined. Head is presented. The cape is
not reachable. The discharge is mucous.
* Pregnancy 38 weeks. A scar on the uterus. Harbingers of childbirth

* Pregnancy 38 weeks. A scar on the uterus. I stage of labor
* Pregnancy 38 weeks. The beginning rupture of the uterus along the scar
* + Pregnancy 38 weeks. Threatening rupture of the uterus along the scar
* Pregnancy 38 weeks. A scar on the uterus. Premature detachment of a normally located
placenta
# 191
*!During the operation, a cesarean section, performed in connection with full placenta previa,
when trying to separate the placenta, profuse bleeding began, the placenta is not separated
throughout. Diagnosed with complete true placental enlargement
* introduction of oxytocin into the myometrium

* intravenous oxytocin administration
* extirpation of the uterus with appendages
* + extirpation of the uterus without appendages
* amputation of the uterus without appendages
# 192
*! A pregnant woman with gestational hypertension at a period of 32 weeks complains of
bursting pains in the lower abdomen, bloody discharge from the genital tract. Objectively: the
uterus is tense, local soreness, fetal heartbeat is muffled, 170 beats per minute.
What is the MOST likely cause of bleeding?
* ruptured uterus
*cervical erosion
* placenta previa
* varicose veins of the vagina
* + premature detachment of a normally located placenta
# 193
*! During a cesarean section for premature detachment of a normally located placenta, a
cyanotic-purple uterus, atonic, was found.
* uterine atony
* + Cuveler's uterus
* varicose veins of the uterus
# 194

*! 33-year-old woman with chronic arterial hypertension at the age of 35 weeks, complaints of
bursting pain in the abdomen, spotting from the genital tract. Objectively: blood pressure 160/90
mm Hg, pulse 84 beats per minute, uterus is excitable, local soreness along the anterior wall of
the uterus, fetal heartbeat 148 beats per minute, no edema, bloody discharge from the genital
tract, moderate, sufficient urine output, proteinuria no.
What is the most probable preliminary diagnosis in a pregnant woman?
*eclampsia
*ruptured uterus
*preeclampsia
*placenta previa
* +premature detachment of a normally located placenta
# 195
*! A premature baby boy was born at the age of 27 weeks with a weight of 940.0 grams, a length
of 35 cm.
What are the most difficult things to expect when feeding a premature newborn?
* prolonged sleep
* decreased intestinal peristalsis
* decreased activity of the lipase enzyme
* + suppression of sucking and swallowing reflexes
* small stomach volume and lengthening of food evacuation time
# 196
*! The parturient woman was born a premature boy at 34 weeks with weight 2240.0gram, length
43cm.
Which of the following is the MOST likely negative impact in caring for a premature newborn?
*insulation
* + hypothermia
* polyglassia
* invasive procedures
* artificial feeding
# 197
*! The mother gave birth to a premature boyin a period of 32 weeks, with a weight of 1930.0
grams, a length of 41 cm.
Which of the following is MOST critical to successful nursing of a premature baby?
* + adherence to the "heat chain"

* long stay on mechanical ventilation
* prolonged stay in the Kuvez
* long-term tube feeding
* feeding with milk formulas
# 198
*!A pregnant woman was delivered unconscious at 31-32 weeks of gestation. At home there was
an attack of convulsions. The condition is serious, unconscious. BP 180 \ 100 mm Hg, BP 190 \
110 mm Hg Generalized edema. The fetal heartbeat is clear, rhythmic 140 beats per minute.
* Pregnancy 31-32 weeks. Epilepsy

* Pregnancy 31-32 weeks. Glomerulonephritis
* + Pregnancy 31-32 weeks. Eclampsia. Coma.
* Pregnancy 31-32 weeks. Severe preeclampsia
* Pregnancy 31-32 weeks. Acute renal failure
# 199
*! A pregnant woman on CTG showed signs of fetal hypoxia: bradycardia up to 180 beats per
minute, unstable basal rhythm, variable deceleration lasting 65 seconds.
Which of the following is MOST likely synonymous with fetal hypoxia?
* critical
* + threatening
* compensated
* satisfactory
* decompensated
# 200
*!A woman in labor was diagnosed with premature detachment of a normally located placenta in
the first stage of labor when the uterine pharynx is opened by 3-4 cm.
What is the MOST preferred doctor's tactic?
* amniotomy and conservative management of labor

* + emergency caesarean section
* conservative management of labor
* amniotomy, rhodostimulation
* application of obstetric forceps
# 201
*! A full-term pregnant woman was diagnosed with premature detachment of a normally located
placenta, antenatal fetal death, and grade I hemorrhagic shock.
* labor induction by oxytocin

* amniotomy, labor induction
* cesarean section as planned
* observation before the onset of labor
# 202
*! In a full-term pregnant woman with twins, ultrasound examination identifies both fetuses in
the longitudinal position and breech presentation. At vaginal examination of the cervix according
to Bishop - 10 points.
What is the MOST likely delivery plan?
* + planned cesarean section

* amniotomy, labor induction with oxytocin
* cesarean section with the development of weakness of labor
* conservative childbirth, with weakness of labor - rhodostimulation
# 203
*! Posterior asynclitism was diagnosed in a primiparous woman with a full-term term and a large
fetus in the 2nd stage of labor with full opening of the uterine pharynx.
* application of obstetric forceps

* wait and see tactics for 2 hours
* childbirth to lead through the natural birth canal
* rhodostimulation with oxytocin intravenously drip
# 204
tract with clots, the uterus is flabby, the bottom of the uterus is 2 cm above the navel, the
afterbirth is without a defect, the birth canal is intact on the mirrors. Conducted: mobilization of
free personnel, catheterization of the bladder and assessment of the volume of blood loss.
Which of the following is MOST likely to be included in the first step of management
postpartum bleeding?
* compression seams
* + examination of the birth canal
* compression of the abdominal aorta
* bimanual uterine compression
* manual examination of the uterine cavity
# 205
afterbirth is without a defect, the birth canal is intact on the mirrors. The second step of the step-
by-step therapy of postpartum hemorrhage is carried out: mobilization of free personnel,
assessment of the volume of blood loss, manual examination of the uterine cavity.
Which of the following is MOST likely to be included in the second step of the step-by-step
therapy for postpartum bleeding?
* compression seams
* examination of the birth canal
* bladder catheterization
* + bimanual uterine compression
# 206
afterbirth is without defect, the birth canal is intact on the mirrors. The third step of the step-by-
step therapy of postpartum hemorrhage is being carried out: mobilization of free personnel,
assessment of the volume of blood loss, manual examination of the uterine cavity.
Which of the following is MOST likely to be added to the third step of step-by-step therapy for
postpartum bleeding?
* examination of the birth canal

* + compression of the abdominal aorta
* bladder catheterization
* suturing of soft tissue tears
# 207
afterbirth is without a defect, the birth canal is intact on the mirrors. The fourth step of the
stepwise therapy of postpartum hemorrhage is carried out: laparotomy and injection of
prostaglandins into the uterus.
Which of the following is MOST likely to be added to step 4 of the step-by-step ?
*hysterectomy
* + ligation of the uterine arteries according to O'Leary
# 208
*!The woman had an urgent labor with a large fetus. On examination the mirrors revealed a
gapvaginal walls, skin and muscles of the perineum, bleeds.
What is the MOST likely treatment strategy for a postpartum woman?
* + suturing
* observation
* perineum ointment
* cold on the crotch
* wound treatment with hydrogen peroxide solution
# 209
*! Postpartum women have profuse bloody discharge from the genital tract, when examined on
mirrors, a rupture of the cervix with a transition to the vaginal vault was found.
What is the MOST likely treatment strategy for a postpartum woman?
* suturing
*hysterectomy
* imposition of brackets on the cervix
* + manual examination of the uterine cavity and suturing
# 210
*! Delivery in breech presentation. Anhydrous period 20 minutes. During the vaginal
examination, the umbilical cord fell out. The fetal heartbeat is rhythmic, 160 beats / minute.
Dilation of the cervix 6-7 cm...
What is the MOST possible tactic?
* + without removing your hands from the vagina, go to the operating room and perform a
cesarean section
* tuck the umbilical cord loop and conduct labor conservatively
* extraction of the fetus by the pelvic end
* extraction of the fetus by the leg
# 211
*! A woman in labor with a full term and breech presentation of the fetus gives birth through the
vaginal birth canal with her informed consent. The second period is carried out according to
Tsovyanov, an antispasmodic was introduced, oxytocin was administered intravenously, the fetus
was born to the angle of the shoulder blades, there was no further progress within 2 attempts. It
was decided to use a classic manual tool for removing the handles and the head of the fetus.
Which of the following is also the MOST likely target of a classic manual tutorial?
* extraction of the fetus by the leg

* external rotation on the head
* + prevention of head extension
* prevention of tilting handles
* maintenance of normal fetal position
# 212
*!On admission to the maternity hospital, N., 28 years old, was diagnosed with Pregnancy 42
weeks. Breech presentation of the fetus. Antepartum rupture of amniotic fluid. Objectively: the
fetal position is longitudinal, the pelvic end is present, the fetal heartbeat is clear, rhythmic, 140
beats per minute. Estimated fetal weight 3800.0. Vaginal examination: the cervix is "immature",
the amniotic fluid is light.
What is the MOST likely doctor's tactic?
* preparation of the body for childbirth during the day

* preparation of the body for childbirth within 3 days
* elective surgery cesarean section

# 213
*! A pregnant woman in the period of 41 weeks + 1 day was admitted to the emergency room of
the maternity hospital in the direction of the doctor of the antenatal clinic. Objectively: blood
pressure 110/70 mm Hg, the uterus is not excitable, the fetal heartbeat is rhythmic, 142 beats per
minute, the cervix is "ripening", according to Bishop - 6 points, mucous leucorrhoea. Informing
the pregnant woman about the methods of delivery, chooses vaginal delivery.
What is the MOST probable further tactics for pregnant women?
* amniotomy
* observation
* labor induction by oxytocin
* + preparation of the cervix for childbirth
* digital detachment of membranes
# 214
*! N., 23 years old, diagnosed with pregnancy 40 weeks. First stage of labor. Primary weakness
of labor. Objectively: the fetal position is longitudinal, the head is presented, the fetal heartbeat is
clear, rhythmic, 140 beats. in min. Contractions in 5-6 minutes for 25 seconds, weak strength.
Estimated fetal weight 3500.0. What is the MOST likely doctor's tactic?
* amniotomy
* rhodostimulation
* + amniotomy followed by subsequent birthstimulation
* emergency operation caesarean section
* obstetric sleep - rest
# 215
*! The woman in labor has secondary weakness of the 2nd stage of labor, a threatening condition
of the fetus, the head of the fetus on the pelvic floor.
* + vacuum extraction of the fetus

* treatment of threatening fetal conditions
# 216
*!In the second stage of labor, a woman in labor with chronic arterial hypertension increased
blood pressure to 170/100 mm Hg, fetal heartbeat 146 beats per minute, clear, rhythmic, the fetal
head in the plane of the pelvic exit.
What is the MOST plausible obstetric tactic?
* introduce magnesium sulfate

* make a perineotomy
* + apply obstetric forceps

* perform a cesarean section
* carry out epidural anesthesia
# 217
*! A pregnant woman with incomplete placenta previa at 34 weeks had scanty spotting, was
hospitalized.
* amniotomy, rhodostimulation
* full-term delivery through the vaginal birth canal
* + bed rest, antispasmodic and hemostatic therapy
# 218
*! A woman in labor with premature detachment of a normally located placenta during a
caesarean section revealed a cyanotic-purple uterus, hypotonic. Diagnosed with Cuveler's uterus.
* sanitation and drainage of the abdominal cavity

* total hysterectomy with uterine appendages
* + total hysterectomy of fallopian tubes
* subtotal hysterectomy with uterine appendages
* subtotal hysterectomy without uterine appendages
# 219
*! At a woman in labor within 32 weeks a premature boy was born weighing 2140.0 grams, 42
cm, with a syndrome of respiratory disorders.
What treatment tactics are MOST justified for respiratory distress syndrome in a premature
newborn?
* oxygen therapy
* nasal oxygen therapy
* artificial lung ventilation
* + endotracheal injection of curosurf
* correction of acid-base state.
# 220
*! At a woman in labor within 34 weeks a premature boy was born weighing 2240.0 grams,
height is 43cm.
Which of the following is the MOST acceptable for providing effective perinatal care to a
premature baby?
* artificial lung ventilation

* tube feeding
* introduction of surfactant
* + compliance of the heat chain
* parental involvement in childcare.

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* Outpatient obstetrics * 1*11*3 *

*! What is the most likely time of pregnancy when embryopathy develops?

*+ left ventricular hypertrophy, 40% increase in cardiac output

*Reducing heart rate by 40%, increasing vascular wall tone

*vascular wall toning up, 40% increase in cardiac output

*tachycardia, cardiac output reduction by 40%

* right ventricular hypertrophy, 40% reduction of cardiac output

*" less than 3

*! What is the MOST possible formula for calculating perinatal mortality?

* number of stillborn babies / number of births *1000

* number of deaths in the first 168 hours / number of newborns *1000

* Outpatient and polyclinic obstetrics * 2 * 28 * 6 *

*! What is THE MOST important event to reduce perinatal mortality?

* a complete diet of pregnant women

*+ timely diagnosis of threatened fetal conditions

* improvement of health education for pregnant women

*Timely decision on the possibility of pregnancy preservation

*! What does MOST probably mean "perinatal mortality"?

*Mortality of children during the first month of life

*+pyregnancy+mortality of children during the first 7 days of life

*fatality+mortality of children during 1 month of life

*fatality+mortality of children during 1 year of life

*!In an obstetric examination of a pregnant woman's abdomen circumference of 90 cm, the

*!In an obstetric examination of a pregnant woman's abdomen circumference is 95 cm, the

What is the MOST likely gestational age in weeks?

Which of the following is MOST precise for determining of pregnancy?

* date of last menstruation

* the date of first fetal stirring

* bimanual research data

*Fetal ultrasound at 3-6 weeks of pregnancy

*+Fetal ultrasound in 10-14 weeks of pregnancy

* at the navel level on the right

* above the navel on the right

* at the bottom of the navel on the right

*+ above the navel on the left

* at the bottom of the navel on the left

What is the MOST likely date of birth by the Negel formula?

Which fetal echographic size reduction is likely to be found in a pregnant woman?

*+ careful outpatient observation

* treatment in a level 1 maternity clinic

* treatment in a level 2 maternity clinic

* treatment in a level 3 maternity clinic

*! When is the concentration of alpha-phetoprotein likely to increase during pregnancy?

* for placenta pathology

*+ in case of fetal neural tube defect

* for fetal kidney pathology

* in case of uterine pathology

* in case of pathology of internal organs of the fetus

* endometrial secretory transformation

*+deciduous tissue without chorionic lint

*decidal tissue with chorionic villi

*Signs of inflammation and endometrial necrosis

*jealous endometrial hyperplasia

*deciduous tissue without chorionic lint

*+decidal tissue with chorionic villi

*Signs of inflammation and endometrial necrosis

What is the most likely tactic for a doctor?

*" Hospitalize immediately at the maternity hospital

* Outpatient obstetrics * 1113 *