NAMA :

NIM :

1. A 29 year old P2A0 is 4 days now post operation from a primary low transverse C-section for
failure to progress complicated by chorioamnionitis. She had been diagnosed with
endometritis and started on intravenous gentamicin and clindamicyn on postpartum day 2.
She has continued to spike fevers above 38ºC despite 48 hours on the antibiotic regimen. A
complete blood count revelas white blood cell count of 18.2K and hemoglobin 11, hematocrit
33. A urinalysis by catheter is leukocyte esterase and nitrite negative. Homan sign is
negative. She complain of abdominal pain. Examination reveals the following: breast
examination: no redness, inflammation or nipple cracks; no costovertebral angle tenderness;
lung are clear to auscultation. Incision is clean, dry and intact. Bowel sound are present.
There s exquisite uterine tenderness with guarding but no rebound in the lower abdomen.
Lochia is moderate and foul smelling. The addition of what antibiotic should be considered at
this time :

a. Metronidazole 500mg/8 hours (PO)

b. Cefazolin 1gr/8 hours IV

c. Ampicillin 500mg/6 hours IV

d. Doxycycline 100mg/ 12 hours IV

e.  Cefotaxime 1gr/6 hours IV

2. A 32 year old P3A0 delivered a 4160g baby boy spontaneously about 30 minute ago. Which
of the following is recommendation for exclusively breastfeeding mother in the puerperium?

a. Early supplementation with formula will help extend the time between night feedings

b. Establish a feeding schedule as soon as possible

c. Lactational amenorrhea can be acceptable form of contraception until 6 months

postpartum

d. Use of combination oral contraceptives is recommended after the 6th postpartum weeks

e. Posponed lactation after 24 hours delivery

3. You are examine the patient’s postpartum hematocrite and note a drop from her antepartum
measurement from 33% to 24%. Her estimated blood loss from vaginal delivery and preineal
laceration repair was 400ml. Nurse reports that the patient has had uterine contraction
adequate and minimal vaginal bleeding overnight, from ultrasound no hypoechoic on uterine
cavity. What is the next best step in her evaluation/treatment?

a. Reassurance and offer iron supplementation postpartum

b. Offer a blood transfusion for palliation of symptoms of anemia

c. Request a procedure room for dilatation and curettage the uterus

d. Request an abdominal ultrasound for abdominal cavity

e. Examine the site of her laceration repair for hematoma

4. The patient sees you at her 6 weeks postpartum with spontaneous delivery and say thank
you for your careful attention to her health; however she is now thingking about the future
 and worries about her risk of uterine rupture with subsequent pregnancy. What is this
patient’s risk of uterine rupture with subsequent trial of labor?

a. 1%

b. 5%

c. 10%

d. 20%

e. 30%

5. A 21 year old G1 now P1 just delivered after a prolonged induction of labor due to being
postdates. After the placental delivery she continues to bleed excessively. Your initial
intervention to address this bleeding is to activate the normal physiologic mechanisms. Which
of the following is the most important hemostatic mechanism in combating postpartum
hemorrhage?

a. Fibrinolysis inhibition

b. Increased blood-cloting factors in pregnancy

c. Contraction of interlacing uterine muscle bundles

d. Intramyometrial vascular coagulation due to vasoconstriction

e. Markedly decreased blood pressure in the uterine venules

A 34 year old G7P5A1 woman has just delivered a 4.500 g female baby at 39 weeks
gestation. She underwent induction of labor with oxytocin for severe preeclampsia diagnosed
with systolic BPs elevated to 160 mmHg. Her pregnancy was complicated by uncontrolled
gestational diabetes and resultant polyhidramnios. She was placed on magnesium
throughout her induction for seizure prophylaxis. She had an epidural placed during the first
stage of labor lasted 3½ hours; she was however, able to deliver vaginally with preemptive
McRoberts manoeuvre and steady traction. The third stage her bleeding was significant with
the expulsion of blood clots and a fundus that was notable for bogginess.

6. Which of the following are not risk factors for postpartum hemorarhage?

a. Advanced maternal age

b. Grand multiparity

c. Prolonged use of oxytocin during labor

d. Polihydramnos

e. Prolonged exposure to magnesium during labor

7.  From case above, which of the following medications would be contraindicated treatment of
uterine atony in this patient?

a. PGE1
 b. PGF2-alpha

c. Calcium glukonas

d. Methylergonovine

e. Intramuscular pitocin
A 28 year old G1P1A0 woman is being discharge from the hospital on postoperative day 4 after
having received a primary low transverse c-section for breech presentation, with an estimated
blood loss of 700 mL. Her pregnancy was otherwise uncomplicated and her hospital course was
also uncomplicated. One week after hospital discharge the patient ends up in the emergency
department complaining of severe abdominal pain. Her vitals are significant for a fever of 39ºC
and tachycardia. Her physical examination reveals acute fundal tenderness beneath low
transverse skin incision that is well-healed, clean, dry and intact. She received preoperative
antibiotics prior to her procedure. Her staples were removed prior to discharge. She endorses
residual vaginal bleeding with a slight odor that is confirmed by speculum examination.

8. What is the most appropriate next step in your treatment of this patient?

a. Wound exploration

b. Abdominal and pelvic ultrasound

c. Dilatation and curettage

d. Outpatient antibiotics

e. Inpatient antibiotics

9. Two weeks after her C-section the patient presents to you with a chief complaint of serous
drainage from a 1 cm area of skin separation. The borders of the skin are midly painful but
non erythematous. Which of the following would be the best approach for described
condition?

a. The patient’s skin separation is a result of infection, requiring immediate administration of

antibiotics

b. She is at risk for necrotizing fascilitis. She should be admitted to the hospital and undergo
wound debridement and reapproximation

c. Skin separation at the incision with serous drainage is normal and need only be managed
by application of a bandage

d. Skin separation should be evaluated further with a probe to examine whether the
fascial layer below it is intact

e. Skin separation should be closed thighly with suture to prevent recurrence

10. Your patient is convinced of the benefits of breastfeeding and continues to try,
successfully breastfeeding by the end of postpartum day 1. The following morning, however,
she develops a low grade fever of 38.0ºC, for which your nurse alerts you. She complains
about pain associated with the engorgement of her breast bilaterally and very sharp,
recurrent pelvic pains. Her vital sign are otherwise normal. What is the most likely explanation
for these findings?

a. Mastitis

b.  Lactation fever

c. Breast abcess
 d. Endometritis

e. Chorioamnionitis

A 23 -year- old G2P0 1 00 at 25 weeks presents with a complaint of loss of fluid vaginally. The
fluid was copious and clear. Assessment by sterile speculum examination reveals vaginal
pooling; ferning was noted under the microscope and nitrazine paper turned blue. She is very
worried because she lost her first son about 4 weeks after he was born at 26 weeks due largely
in part to severe respiratory distress. To reassure her, you discuss using antenatal
corticosteroids.

11. Which of the following is the most correct statement with respect to antenatal
corticosteroids?

a. They are only helpful if given at least 24 hours prior to delivery

b. Men have better outcomes than women

c. Maternal infections are increased

d. Surfactant alone is more effective than in combination with corticosteroids

e. They are less effective in cases of ruptured compared with intact membranes

A 32-year-old, G2P1 , presents for a prenatal visit at 42 weeks 3 days by last menstrual period
(LMP) and 8-week ultrasound (U /S). Her previous child was delivered via low-transverse
Cesarean section due to fetal distress during a prolonged second stage of labor. The patient has
no complaints today, and her pregnancy has been uneventful to this point. The patient's vital
signs are within normal limits, but the fetal nonstress testing (NST) is nonreactive. The patient's
obstetrical (OB) informs her that they need to deliver the baby, and the patient says that she
wishes to try vaginal birth.

12. What is this patient's greatest risk if she undergoes induction?

a. Placental abruption

b. Uterine rupture

c. Cord prolapsed

d. Eclampsia

e. Pulmonary embolism

A 26-year-old G2P 1 00 1 arrives in your office for routine prenatal visit. She has a history of a
prior Cesarean section at term. She remembers that her doctor told her the baby "wasn't going
to fit" after she had labored for several hours. You perform pelvimetry and recognize the
rationale for that doctor's statement.

13. What type of pelvis is she most likely to have?

a. Gynecoid

b. Anthropoid

c. Android

d. Platypelloid
14. A 27-year-old, G0, and her husband desire to use natural family planning
for contraception. They decide to use the calendar method. Based on her regular 2 8 -day
cycle, which of the following represents her fertile period?

a. Days 14 through 21

b. Days 10 through 17

c. Days 7 through 14

d. Days 12 through 19

15. A 2 2 -year- old woman, G 2 P 2 , comes to the office 3 days after having unprotected
intercours e . She does not desire pregnancy at this time and is requesting the most effective
method of emergency contraception.

Which of the following methods of emergency contraception will have the lowest failure rate?

a. Oral levonorgestrel

b. Combined oral contraceptive regimens

c. Oral ulipristal acetate

d. Insertion of copper intrauterine device (IUD)

16. A 38 -year-old, G2P2, presents with her new husband and is interested in trying to
conceive. She is in good health, has no history of sexually transmitted infections (STis) , and
does not smoke. Her husband has fathered a child in the past.

What single test will assess her chances of getting pregnant?

a. Thyroid- stimulating hormone (TSH)

b. Prolactin

c. Hemoglobin

d. Follicle-stimulating hormone (FSH)

e. Progesterone level

17. Your patient is a 30 -year-old G0 with a long history of irregular cycles, hirsutism, and an
ultrasound appearance consistent with Polycystic ovarian syndrome (PCOS) who presents
for preconception counseling. She is a nonsmoker and is already taking prenatal vitamins.
Her husband has fathered a child with a previous partner. She understands the
pathophysiology of PCOS and her ovaries. You discuss the use of medication to help her
conceive.
What is mechanism of action of this medication?
a. It is an antiestrogen that results in increased production of Follicle
stimulatinghormone (FSH) and luteinizing hormone (LH)

b. It decreases the conversion of androgens into estrogens which reduces the negative
feedback loop on the hypothalamus which increases FSH

c. It inhibits gluconeogenesis and therefore allows the ovary to respond to normal

gonadotropin signals

d. It interferes with the pulsatile release of FSH and LH from the anterior pituitary
18. A 37-year-old G6P3205 at 34 weeks of gestational age with gestational diabetes
moderately controlled with insulin presents for her scheduled obstetric (OB) appointment.
During the course of the visit, the patient notes that the fetus is moving, but "sleeps a lot:' Her
previous pregnancy was also complicated by gestational diabetes and fetal macrosomia. Her
BP is 138/85. Fetal heart tones (FHTs) are in the 130s. Fundal height measures 36 cm. Her
last ultrasound was at 2 8 weeks and showed a fetus in the 93rd percentile.
What is the next step in the management of this patient for this visit?

a. Schedule biweekly nonstress tests (NSTs)

b. Schedule a growth ultrasound

c. Draw preeclampsia labs and send her to triage for evaluation

d. Reassure her and return to clinic in 2 weeks

e. Refer to a maternal-fetal specialist for further management

19. After 2 hours, the patient is still 6 em. Her Montevideo units (MVUs) are adequate and the
baby is tolerating labor. What is the next step ?
a. Proceed with Cesarean section; the pelvis is too small
b. Increase Pitocin to strengthen the contractions
c. Apply oxygen to help the baby with the stress of labor
d. Start antibiotics to help decrease infection with increased risk of a long labor
e. Reexamine the patient in 2 hours

20. A 29-year- old G3 P l l 1 2 with severe preeclampsia on magnesium sulfate therapy has just
delivered a preterm infant at 31 weeks via Cesarean section for breech presentation.
During the surgery, the uterus remained flaccid and unresponsive to uterine massage. Of
the uterotonics below, which one is contraindicated in women with this presentation?

a. Carboprost tromethamine
b. Methylergonovine
c. Misoprostol
d. Oxytocin
e. Prostaglandin E2

You are reviewing the notes of a 32-year-old woman in the antenatal clinic. She is 10 weeks
pregnant based on her last period date and this is her third pregnancy. Her sons, aged 4 and 2
years, respectively, are fi t and healthy. You are looking for risk factors to offer her screening for
gestational diabetes.

21. Which of the following conditions will you NOT offer her such screening:
a. Body mass index above 30 kg/m 2
b. Family history of diabetes
c. Family origin with a high prevalence of diabetes
d. Previous macrosomic baby weighing 4.5 kg or above
e. Previous type 2 diabetes

22. Women with complex social factors have been identified as those needing special
provisions in their antenatal care. Which of the following pregnant women would be identified as
one with a complex social factor that warrants special attention by the antenatal healthcare
providers?
a. A 28-year-old primary school teacher who has recurrent migraine attacks
b. A 36-year-old housewife with previous two caesarean sections
c. A 42-year-old banker with a high paying but stressful job
d. An 18-year-old English woman who is the lead ballet dancer in a renowned troupe
e. An unmarried 38-year-old artist of Egyptian origin living legally with her partner in England
for the last 12 years and running a successful boutique
A 28-year-old woman is 22 weeks pregnant. She has long-standing type 1 diabetes mellitus. Her
20-week fetal anatomy ultrasound showed no structural fetal abnormalities. However, she is
concerned about how her diabetes may cause congenital fetal anomalies in her unborn child.

23. Of the options listed below, which SINGLE action addresses her anxiety?
a. Amniocentesis at 22 weeks.
b. Fetal cardiac echocardiography at 24 weeks.
c. Obstetric ultrasound scan for growth and umbilical artery Doppler at 28, 32 and 36 weeks.
d. Offer reassurance as normal fetal anatomy survey at 20 weeks.
e. Quadruple maternal biochemical screening test (HCG, inhibin-A, oestriol, AFP) at 20
weeks.

A 30-year-old woman, who is 36 weeks pregnant, is seen in antenatal clinic. This is her fi rst
pregnancy. She is HIV positive. She has been fully compliant with her HAART (highly active
antiretroviral therapy) throughout her pregnancy. Her latest serum viral load is <50 copies/mL.
Apart from HIV, her pregnancy has been uncomplicated, and she has an appropriately grown
cephalic presentation fetus. She is concerned about vertical transmission of HIV and is keen to
avoid surgery if possible.

24. Which one of the following is recommended management and advice?

a. Elective caesarean at 38 weeks gestation.
b. Elective caesarean at 39 weeks station.
c. Induce vaginal birth at 38 weeks gestation.
d. Offer spontaneous vaginal birth.
e. Postnatally, breastfeeding is considered safe as viral copy number is low.

A 38-year-old woman is 12 weeks pregnant with a twin pregnancy. This is her second
pregnancy, with her previous pregnancy complicated by gestational hypertension. Her booking
blood pressure, at 12 weeks, is 135/85 mmHg. Her BMI is 34 kg/ m 2. She smokes 10
cigarettes/day.

25. Which one of the following is considered a significant (high) risk factor for the development
of pre-eclampsia as her pregnancy progresses?
a. Age >35
b. BMI >30
c. Hypertensive disease during previous pregnancy
d. Multiple pregnancy
e. Smoking

A 28-year-old woman is 12 weeks pregnant with a singleton pregnancy. This is her fi rst
pregnancy. Her booking blood pressure, at 12 weeks, is 140/90 mmHg. Her BMI is 34 kg/m 2 .
She smokes 10 cigarettes/day. Her mother suffered from pre- eclampsia in her pregnancies.

26. Which one of the following is considered a significant (high) risk factor for the development
of pre-eclampsia as her pregnancy progresses?
a. BMI >30
b. Elevated blood pressure at pregnancy booking
c. First pregnancy
d. Family history of pre-eclampsia
e. Smoking

A 30-year-old woman is 16 weeks pregnant in her third pregnancy. Her blood pressure is
155/105 mmHg; 4 weeks earlier, it was 150/100 mmHg. Her urinalysis shows + protein. Her spot
urinary protein/creatinine ratio is 35 mg/mmol, and a 24-h urine collection result shows 0.35 g
protein.

27. Which one of the following is considered the most likely diagnosis?
a. Chronic hypertension
b. Chronic hypertension and superimposed pre-eclampsia
 c. Gestational hypertension
d. Nephrotic syndrome
e. Pre-eclampsia

A 40-year-old woman is 12 weeks pregnant. She is attending hospital antenatal clinic for her
dating scan. She is concerned about her risk of having a child affected by Down syndrome.

28. Which SINGLE action is the most appropriate management action given her anxiety and
consistent with current routine antenatal screening advice for the UK?
a. Measure nuchal translucency and check for presence/absence of fetal nasal bone at 12
weeks.
b. Measure nuchal translucency and maternal serum PAPP-A and HCG at 12 weeks.
c. Offer amniocentesis at 15 weeks.
d. Offer detailed fetal anatomy ultrasound to check for fetal congenital malformation at 20
weeks.
e. Offer maternal biochemical quadruple screening test at 16 weeks

A 24-year-old woman is 12 weeks pregnant. She is attending hospital for her dating scan and
routine booking serological investigations. Screening and treating for the presence of a
particular pathogen during early pregnancy will reduce the risk of developing congenital fetal
abnormality.

29. Which ONE of the pathogens listed below fulfi ls this criteria?
a. Hepatitis B
b. Herpes simplex virus
c. Rubella
d. Syphilis
e. Varicella zoster virus

28-year-old woman is 22 weeks pregnant. She has long standing type 1 diabetes mellitus. Her
blood sugars have remained well controlled in pregnancy. However, she is concerned about
how her diabetes may cause congenital fetal anomalies in her unborn child.

30. Of the options listed below, which SINGLE action best addresses her anxiety?
a. Amniocentesis at 22 weeks
b. Anomaly scan and fetal cardiac echocardiography at 20 weeks
c. Obstetric ultrasound scan for growth and umbilical artery Doppler at 28w, 32w and 36w
d. Offer reassurance as HbA1C is normal
e. Quadruple maternal biochemical screening test (HCG, Inhibin-A, oestriol, AFP) at 20
weeks

A 65-year-old woman came with complaining a mass protrude from her vagina. She can palpate
the bulging mass since 3 months ago. Sometime she difficult to urination, so she had to push
back the mass into her vagina. When she sit or laydown, the mass not too bulging, but when
she work or coughing, the mass bulge become bigger.

31. In 1996, International continence society defined a system to classfy prolapse during
phisicale examination Called Pelvic Organ Prolapse Quantification (POP-Q). The measurement
from the middle of the external urethra meatus to the midline of posterior hymenal ring defined
as:
a. Point Aa
b. Perineal Body
c. Genital hiatus
d. Diaphragma genital
e. Point D

32. In POP-Q staging, the most distal portion of the prolapse is > 1 cm below the plane of the
hymen but protrudes no further than 2 cm less than the total vaginal length in centimeters,
defined as :
a. POP Stage III
 b. Prosidentia utrine
c. POP Stage IV
d. POP Stage II
e. POP Stage I

33. The major related risk for pelvic organ prolapse :

a. smoking
b. vaginal birth
c. connective tissues disease
d. race
e. obesity

34. Anterior colporrhaphy is one of the commonly gynecology surgeries, still used as a primary
choice for repair of :
a. rectocelle
b. elongatio colli
c. cystocelle
d. Enterocelle
e. Uterine prolapsed

35. Elderly woman with pelvic organ prolapse, who have no future desire for coital activity can
be offered a surgical prosedure :
a. Vaginal hysterectomy
b. Colpocleisis
c. Sacrosinosus fixation
d. McCall culdoplasty
e. Kelly Plication

A 45-year-old woman presents with chief complaint that she always leakage urine after sneezing
or coughing. She has fuor children, all with spontaneous delivery and the heaviest baby was
4000 gr.
36. Stress Urinary incontinence is defined as :
a. The involuntary leakage of urine with excercise or laughing
b. Woman difficulty postponing urination and generally must promptly their bladder without
delay.
c. Involuntary leakage of urine
d. Woman who has both stress and urgency of urination
e. None of the above

37. The major Risk factor for urinary incontinence :

a. Childbirth
b. Intra uterine device
c. Drink coffee or tea
d. Habit of postponing urination
e. Hystory of urinary tract infection

38. A condition describes urinary urgency with or wihout incontinence and usually with increased
daytime urinary frequency and nocturia defined as :
a. urgency
b. overactive bladder
c. urinary tract infection
d. vesicovagina fistulas
e. mixed urinary incontinence

39. To diagnose over active bladder, urinary tract infection (UTI) must excluded. Most common
etiologic pathogen which caused UTI :
a. Proteus species
b. Klebsiella species
c. Escherichia coli
d. Enterobacter species
e. Morganella species
40. The easiest way to make a urinary stress incontinence diagnose :
a. Bladder diary
b. Cough test
c. Count post residual volume
d. Urodinamic test
e. Body mass index more than 30
An 18-year-old G0 comes to see you complaining of a 3-day history of urinary frequency,
urgency, and dysuria. She panicked this morning when she noticed the presence of bright red
blood in her urine. She also reports some midline lower abdominal discomfort. She had
intercourse for the first time 5 days ago and reports that she used condoms. On physical
exam,there is no discharge from the cervix or in the vagina and the cervix appears normal.
Bimanual exam is normal except for mild suprapubic tenderness.There is no flank tenderness,
and the patient’s temperature is normal.

41. What is the most likely diagnosis?

a. Chlamydia cervicitis
b. Pyelonephritis
c. Cystitis
d. Bladder dyssynergia
e. Kidney stone

An 18-year-old G0 comes to see you complaining of a 3-day history of urinary frequency,

urgency, and dysuria. She panicked this morning when she noticed the presence of bright red
blood in her urine. She also reports some midline lower abdominal discomfort. She had
intercourse for the first time 5 days ago and reports that she used condoms. On physical
exam,there is no discharge from the cervix or in the vagina and the cervix appears normal.
Bimanual exam is normal except for mild suprapubic tenderness.There is no flank tenderness,
and the patient’s temperature is normal.

42. What is the next step in the diagnosis of this patient?

a. Urine culture
b. Intravenous pyelogram
c. Cystoscopy
d. Wet smear
e. urine microscopic

An 18-year-old G0 comes to see you complaining of a 3-day history of urinary frequency,

urgency, and dysuria. She panicked this morning when she noticed the presence of bright red
blood in her urine. She also reports some midline lower abdominal discomfort. She had
intercourse for the first time 5 days ago and reports that she used condoms. On physical
exam,there is no discharge from the cervix or in the vagina and the cervix appears normal.
Bimanual exam is normal except for mild suprapubic tenderness.There is no flank tenderness,
and the patient’s temperature is normal.
43. What is the likely organism responsible for this patient’s condition?
a. Chlamydia
b. Neisseria gonorrhoeae
c. Klebsiella
d. E. coli
e. Candida albicans

A 33-year-old woman, gravida-1 para-0, came to hospital with major complaint, watery leakage.
She was on her 33 weeks of gestational age. Data from medical record, showed that she came
previously a week ago, complaining vaginal discharge. Vaginal swab has done.

44. In case above, what kind of examination should you performed for establishing diagnosis.
a. Vaginal examination
b. Inspeculo
c. Blood test
d. Ultrasound
e. Simple urine test
45. You found on LeOpold 1, hard, round with ballottement (+). Contraction was infrequent and
weak. A What was your next plan?
a. Went for labour induction
b. Immediate C-section
c. Tocolytic and corticosteroid provision
d. Performed ultrasound
e. Performed external version
Woman refer from primary health care due considerably low maternal body weight. She is on
her 35 weeks of gestation, height 150 cm weight 32 kg. She had previous history of severe
hyperemesis. Other medical problems were denied.

46. Ultrasound examination showed that trans-cerebellar diameter was proper to gesrtational
age, abdominal circumferrence was lower than 2.5 centile and amniotic fluid deepest pocket
was 1.2 cm. What is the most likely diagnosis?
a. Growth restriction with olygohydramnion
b. Normal Growth with olygohydramnion
c. Growth restriction with normal amniotic fluid
d. Normal growth with normal amniotic fluid
e. Need another examination for establishing diagnosis.

47. Lack of baby movement had been felt for two days, fetal heart rate was 146 bpm. What was
your next step?
a. Termination of pregnancy
b. Giving oxygenation and left lateral position
c. Ensuring Fetal well-being by Manning criteria
d. Fetal lung maturation
e. Giving intravenous fluid rehidration.

48. Cardiotocography, showed low variability with checkmark pattern and no desceleration.
What was your interpretation and the best management through?
a. Category one, continued for fetal lung maturation
b. Category two, intrauterine resuscitation for 24 hours and reevaluation after
c. Category two, went for doppler velocymetri
d. Category three, went for doppler velocymetry ultrasound exam.
e. Category three, delivered the baby

A 42 y.o. woman, came for screening at 13 wga.She got married 3 years ago with one child.
Previous pregnancy complicated by iatrogenic pPROM after amniocentesis for karyotiping. But
fortunately the problem spontaneously resoved within 5 days after.

49. The women saw risk for her baby developing congenital anomaly due to her age. How would
you answer this?
a. Age is uncorrelated with aneuploidy, equal risk for developing congenital anomaly
compare to younger pregnant women.
b. Age is a risk factor for congenital anomaly, performing chorionic villous sampling is the
best for this case
c. Age is a risk factor for congenital anomaly, performing chordocentesis sampling is the best
for this case
d. Age is a risk factor for congenital anomaly, performing amniocentesis sampling is the best
for this case
e. Age is a risk factor for congenital anomaly, performing NIPT is the best for this case

Pregnant woman referred from midwife due to increase of blood pressure with no prior history.
Clinical examination showed BP was 170/120, proteinuria (-). She was on 36 weeks of
gestation, of second pregnancy. She had delivered once by C-section due to narrow pelvic.
50. She complained of deep and sharp pain behind eyes and blurred vision. What is the most
likely diagnosis?
a. Gestational hypertension
b. Severe preeclampsia
c. Superimposed preeclampsia
d. Impending eclampsia
e. Eclampsia
51. What is the best management?
a. Intravenous single anti-hypertension drugs, conservative
b. Intravenous multiple anti-hypertension drugs, deliver the baby.
c. Intravenous magnesium sulfate 40%, conservative
d. Intravenous magnesium sulfate 20%, deliver the baby
e. Intravenous magnesium sulfate 40%, deliver the baby
A 43-year-old woman who was 37 weeks pregnant (Gravid 4, Para 3) presented in hospital with
a ten-day history of low extremities edema, with idiopathic hypertension for 1 year. At
presentation, she had a blood pressure of 170/100 mmHg. Laboratory findings were normal
except urinalysis (protein 2+). She was diagnosed with superimposed severe preeclampsia. It
was decided to deliver the fetus by means of a C-section by indication transverse lie. Blood
pressure measurement was 150/100 mmHg. She lost consciousness for 30 seconds five hours
after operation. The laboratory studies gave the following results: serum aspartate
aminotransaminase (AST), 225 IU/L; serum alanine aminotransaminase (ALT), 140 IU/L; serum
lactate dehydrogenase (LDH), 1017 IU/L; serum urea and creatine were normal; hemoglobin,
10.6 mg/dL; platelet count, 50 × 103 μ/mL. A brain computed tomography (CT) scan was
performed on patient which revealed the left frontal lobe lacunar infarction. The patient was
transferred to intensive care unit.

52. What is the most appropriate diagnosis?

a. DIC
b. Acute Fatty Liver in Pregnancy
c. HELLP Syndrome
d. Severe peurpural infection
e. Thrombotic thrombositopenic Purpura

53. Twelve hours observation showed urine production was 100 ml, what is next management?
a. Immediately giving diuretics bolus iv.
b. Immediately giving diuretics maintained by syringe-pump.
c. Check albumin level, giving diuretic justified after hipoalbuminemia condition had been
distinguished.
d. Renal failure due to micro thrombopathy suspected, heparin provision could be considered
e. Immediately step on fluid rescucitation

54. The stage of gestational development at which endometrial implantation occurs is

a. Eight cell embryo
b. Zygote
c. Morula formation
d. Blastocyst
e. Embryonic disk

55. During early pregnancy, which of the following replaces the ovary as the main Source of
progesterone production?
a. Amnion
b. Chorion
c. Trophoblast
d. Myometrium
e. Yolk sac

56. In which of the following circumstances of HELLP syndrome should platelet transfusions be

given?
a.  Platelet count < 150,000/µl
b. Platelet count < 100,000/µl
c. Platelet count< 50,000/µl
d. Platelet count <50,000 /µl and cesarean planned
e. Platelet count < 30.000/µl

57. Which of the following histories might lead you to suspect the existence of diabetes in a
patient now pregnant for the third time?
a. Spontaneous rupture of the membranes occurred during the second trimester in both
preceding pregnancies
 b. Jaundice appeared in the last trimester of her second pregnancy.
c. Both preceding infants were premature.
d. Unexplained intrauterine death occurred at 38 weeks gestation in her last
pregnancy.
e. Abruptio placentae occurred in the second pregnancy.

58. Anti-D immunoglobulin should not be given for Rh-negative women in which of the following
settings?
a. Threatened abortion
b. Following complete hydatidiform mole evacuation
c. Before external cephalic version
d. After first-trimester elective pregnancy
e. Following complete abortion

59. A patient at 34 weeks of gestation develops mark pruritus and mildly eleveted liver function
tests. Among the diagnostic possibilities is
a. Pancreatitis
b. Hyperthyroidism
c.  Diabetes insipidus
d. Cholestasis of pregnancy
e. Progesterone allergy

60. Which two drugs decreases the effectinevenes of oral contraceptive

a. aspirin and ibuprofen
b. erytomicin and ceftriaxone
c. rifampicin and phenytoin
d. propanolol and isoniazid
e. nifedipine and methyldopa

61. To preserve the pneumoperitoneum when placing secondary trocars, it is important to:
a. Ensure the surgeon is in the proper position
b. Close the stopcock on the secondary port before insertion
c. Ensure the stopcock on the secondary port is open before insertion
d. Ensure the blade on the trocar is sharp
e. Close the insufflation stopcock on the primary port

62. Which of the following disorder is not a recognized complication of PCOS?

a. Endometrial carcinoma
b. Diabetes
c. Infertility
d. Dyslipidaemia
e. Thromboembolism

63. Secondary causes of PCOS include the following, EXCEPT:

a. Late-onset congenital adrenal hyperplasia
b. Epilepsy
c. Acromegaly
d. Cushing’s syndrome
e. Androgen-secreting adrenal neoplasm

64. Clinical features suggestive of hyperandrogenism include all of the following, EXCEPT:

a.  Facial acne
b. Seborrhoea
c. Alopecia
d. Anovulation
e. Hirsutism

65. Invasive cervical cancer identified only microscopically, invasion is limited to mesured
stromal invasion with a maximum depth of 3 mm and no wider than 7 mm should be treated
with:
a. Observation
b. Tissue ablation
 c. LEEP/LLETZ
d. Simple total hysterectomy
e. Radical hysterectomy

66. Most cervical cancers arise:

a. In the endocervix

b. On the portio vaginalis

c. At the internal os

d. At the tip of oue

e. At the squamocolumnar junction

67. The majority of vulvar, vaginal and cervical cancers appear to have a common cause and
ussualy caused by:
a. High risk types of herpes simplex virus (HSV) infection

b. High risk types of human papilloma virus (HPV) infection

c. Increased exposure to endogenous estrogen

d. Increased exposure to exogenous estrogen

e. Chronic bacterial and parasitic infection

68. Derived from vulvar apocrine gland, slightly elevated, sharply demarcated, white indurated,
eczematous lesion in post menopausal woman:
a. Vulvar intraepithelial neoplasia

b. Bowen’s disease

c. Paget’s disease

d. Verucous carcinoma

e. Invasive carcinoma

69. Childhood neoplastic ovarian masses most commonly originate from:

a. Gonadal epithelium

b. Gonadal stroma

c. Sex cords

d. Germ cells

e. Metastatic disease

70. A patient returns for a postoperative checkup 2 weeks after a total abdominal hyserectomy
for fibroids. She is distressed because she is having continous leakage of urine from the vagina.
Her leakage is essentially continous and worsens with coughing, laughing, or movement. Given
her history and physical, you perform both a metthylene blue dye test, which is negative and an
indigo carnine test, which is positive. The most likely diagnosis is:

a. Rectovaginal fistula
 b. Uretro vaginal fistula

c. Vesico vaginal fistula

d. Uretero vagina fistula

e. Impossible to distinguish

A 17-year-old G1P0 woman presents at 25 weeks’ gestation complaining of headache for the
past 36 hours. She has had regular prenatal visits going back to her first prenatal visit at 8
weeks’ gestation. A 20- week ultrasound redated her pregnancy by 2 weeks as it was 15 days
earlier than her LMP dating. She has a BP of 155/104 mm Hg.

71. You review her medical record and determine that she does not have chronic hypertension.
The patient denies having RUQ pain but because of your high suspicion of severe preeclampsia
you order a CBC, liver enzymes, renal function test, and a 24-hour urine protein collection. Her
laboratory test results reveal a normal platelet count and liver enzymes but a slightly elevated
creatinine and proteinuria of 550 mg in 24 hours. Her headache has resolved after a dose of
acetaminophen. What is the next best step in her management?

a. Give her a prescription for labetalol and have her follow-up in clinic in 2 weeks

b. (a) plus bed rest

c. Hospitalization for further evaluation and treatment

d. Immediate delivery

e. Begin induction of labor

72. Over the next 12 hours, her SBPs rise above 160 mm Hg on several occasions, most
notably to 174/102 mm Hg 2 hours after admission and to 168/96 mm Hg 9 hours after
admission. Her headache does not return and she has no RUQ pain or visual symptoms. A set
of repeat laboratory test results are unchanged and by increasing her labetalol dose to 400 mg
TID, her BPs decrease to 140s–150s/70–90 mm Hg. She is also started on magnesium sulfate.
What change in physical or laboratory examination do you observe that would indicate delivery?

a. Another BP of 174/102 mm Hg

b. Headache returning

c. Double vision

d. Platelets of 108

e. AST of 265

You are working in the emergency department when an 18-year-old Caucasian woman arrives
via ambulance. EMS reports that she was found seizing in a local drug store approximately 10
minutes ago. She appears to be 7 to 8 months pregnant. She had no family or friends with her,
but police have contacted family who are on the way to the emergency department. Here vital
signs on arrival are as follows: BP,180/116 mm Hg; heart rate, 76 bpm; respiratory rate, 16 bpm;
oxygen saturation, 98%. Her pants are soiled and she is not responding to questions at this
time. Bedside ultrasound demonstrates fetal cardiac activity in the 130s. Quick bedside biometry
estimates gestation age to be 32 weeks 1 day.

73. What is the best first step in managing this patient?

a. Obtain formal fetal ultrasound for gestational age

 b. Obtain CBC, metabolic panel, serum toxicology screening]

c. Order CT head

d. Emergent cesarean section

e. Begin empiric magnesium sulfate therapy

74. At what stage of pregnancy is eclampsia most likely to occur?

a. First trimester

b. Second trimester

c. Third trimester

d. Immediately postpartum within 48 hours of delivery

e. Postpartum period between 48 hours and 4 weeks

While on call you are paged to the emergency department to see a 16-year-old G0 adolescent
girl with cyclic pelvic pain. She has never had a menstrual cycle. She denies any history of
intercourse. She is afebrile and her vital signs are stable. Her pregnancy test is negative. On
physical examination, she has age-appropriate breast and pubic hair development and normal
external genitalia. However, when attempting the pelvic examination, you are unable to locate a
vaginal introitus. You obtain a transabdominal ultrasound, which reveals a hematocolpos and
hematometra.

75. What is the most likely diagnosis?

a. Transverse vaginal septum

b. Vertical vaginal septum

c. Imperforate hymen

d. Vaginal agenesis (MRKH)

e. Bicornuate uterus

76. You explain to the patient and her mother that further evaluation is needed. Evaluation
would most likely include all except which of the following?

a.  IVP

b. Ultrasound

c. MRI

d. Removal of streak ovaries

e. Karyotyping
77. What are the treatment options for this condition?

a.  Patient education

b. Vaginal dilators

c. Creation of a neovagina
 d. Psychological support

e. Psychological support

A mother brings her 13-year-old daughter in to see you because she is experiencing cyclic lower
abdominal pain every month that lasts for about 4 days. She is also concerned that the patient
has not started her period like most of her classmates, and wants to know if you think this is
normal. Physical examination reveals Tanner stage 4 breast and pubic hair development.
Vaginal examination shows an intact hymen and a small, nulliparous cervix without lesions.

78. All of the following are formed by the paramesonephric ducts, except:

a. superior vagina

b. cervix

c. ovaries

d. uterus

e. Fallopian tubes

79. In addition to a detailed evaluation of her uterus, you perform an additional workup knowing
that all of the following are commonly associated with uterine anomalies except:

a. Unilateral renal agenesis

b. Pelvic or horseshoe kidney

c. Inguinal hernia

d. Imperforate anus

e. Ureteral duplication

80. Which of the following is the most common mullerian anomaly?

a. Bicornuate uterus

b. Septate uterus

c. Uterine didelphys

d. Unicornuate uterus

e. Arcuate uterus

81. A pregnant woman, age 40 years old, G2P1A0, gestational age of 12 weeks. The first child
10 years of age. Never use contraceptives. Weight 80 kg, height 156 cm. has never antenatal
care.The conclusion below is not true :

a. High-risk pregnancy due to maternal age of 40 years

b.  Including overweight.

c. Have history of secondary infertility.

d. There is the possibility of pregnancy termination by cesarean sections.

e. Need for ultrasound screening

82. Select the incorrect regarding guidelines for Nuchal Translucency (NT) measurement is:

a. The margins of NT edges must be clear enough for proper caliper placement and
the fetus is not necessary in the midsagittal plane.
b. The image must be magnified so that it is filled by the fetal head, neck, and upper thorax

c. The fetal neck must be in a neutral position, not flexed and not hyperextended

d. The amnion must be seen as separate from the NT line, and the + calipers must be placed
on the inner borders of the nuchal space with none of the horizontal crossbar itself
protruding into the space.

e. The calipers must be placed perpendicular to the long axis of the fetus and the
measurement must be obtained at the widest space of the NT.

83. Choose the wrong statement about Down syndrome is :

a. An increased NT thickness itself is not a fetal abnormality.

b. Nuchal translucency is a marker that confers increased risk of fetal abnormality.

c. Approximately one third of fetuses with increased nuchal translucency thickness will
have a chromosome abnormality, nearly half of which are Down syndrome

d. Down syndrome is caused by an autosomal trisomy, is the most common nonlethal

trisomy

e. All cases of Down Syndrome is caused by trisomy 21.

84. One mother after a normal delivery, G4P4A0, age 35, weight 56 kg, height 160 cm. Having
deliverery one day ago, 3,000 grams birth weight, breastfeeding, want injectable contraceptives
before returning home.
If in the cases mentioned above, the mother wanted contraception progestogen-only
contraceptives (POCs), the correct statement below is:

a. Breastfeeding women who are < 6 weeks postpartum should not use levonorgestrel (LNG)
and etonogestrel (ETG) implants.

b. Breastfeeding women who are < 6 weeks postpartum generally should not use
progestogen-only injectables (DMPA).

c. There is no theoretical concern about the potential exposure of the neonate to

DMPA/NET-EN during the first 6 weeks postpartum.

d. Breastfeeding women who are < 48 hours postpartum can generally use LNG-IUDs.

e. Progestogen-only contraceptives (POCs) consist of POPs, progestogen-only injectables

(DMPA and NET-EN), and LNG and ETG implants.

85. In Indonesia, pregnancy-related morbidity and mortality risks are high, and access to
services is limited. the correct statement below is:

a. DMPA may be one of the few types of methods widely available and accessible to
breastfeeding women immediately postpartum.

b. In Indonesia DMPA injections should not be given one day after the delivery as early
postpartum contraception.
 c. Breastfeeding women who are 6 weeks to < 6 months postpartum can use without
restriction the following contraceptive methods: progestogen-only injectables (DMPA), and
LNG and ETG implants.

d. Breastfeeding (and non-breastfeeding) women generally should not have an LNG-IUD

inserted from 48 hours to < 4 weeks postpartum.

e. Available data from clinical and observational trials do not suggest an increased risk for
either breastfeeding performance or infant health outcomes with use of progestogen-only
injectables compared to outcomes in studies using other progestogen-only methods
.
86. Family planning services in Indonesia is important because it has a role in efforts to reduce
maternal mortality. Select the statement that is not true:

a. The maternal mortality rate (MMR) by IDHS in 2012 amounted to 259 / 100,000 births.

b. Number of maternal death related to pregnancy or childbirth in Indonesia based on the

Demographic and Health Survey in 2012 a number of 17,000 up to 18,000 mothers during
one year.

c. Estimates of the number of maternal death related to pregnancy or childbirth in Indonesia

is about 50 deaths per day.

d. Family planning services for mothers immediately after delivery of the placenta s / d 2
days postpartum included as postpartum family planning services.

e. In planning services we prioritize contraceptive Long Term Contraception Method (LTM),

the IUD, implant or tubal ligation or vasectomy

87. Choose the right statement about Medical eligibility criteria (MEC) categories for
contraceptive use and about family planning is :

a. Category 1 = A condition where the theoretical or proven risks usually outweigh the
advantages of using the method.

b. Category 2 = A condition where the advantages of using the method generally

outweigh the theoretical or proven risks.

c. Category 3 = A condition for which there is no restriction for the use of the contraceptive
method.

d. Category 4 = A condition which represents an acceptable health risk if the contraceptive
method is used.

e. Typical use is among couples who initiate use of a method (not necessarily for the first
time) and who use it perfectly (both consistently and correctly), the percentage who
experience an accidental pregnancy during the first year if they do not stop use for any
other reason.

88. A 48 year old woman presents with intermenstrual bleeding for 2 months. Episodes of
bleeding occur any time in the cycle. This is usually fresh red blood and much lighter than a
normal period. It can last for 6 days. There is no associated pain. She has no hot flushes or
night sweats. She is sexually active and has not noticed vaginal dryness. She has three children
and has used the progesterone only pill for contraception for 5 years. Her last smear test was 2
years ago and all smears have been normal. She takes no medication and has no other relevant
medical history. On physical examination, the abdomen is unremarkable. Speculum examination
shows a slightly atrophic-looking vagina and cervix but there are no apparent cervical lesions
and there is no current bleeding. On bimanual examination the uterus is non-tender and of
normal size, axial and mobile. There are no adnexal masses. Hemoglobin count is 12,7 g/dL.
You performed transvaginal sonography and found well-defined, echogenic, smooth,
intracavitary masses that is isoechoic to the endometrium. What is the likely diagnosis?

a. Submucous myoma

b. Endometrial polyp

c. Ectropion

d. Endometrial hyperplasia

e. Irregular bleeding related to the contraceptive pill

89. A 39 years old female G2P1A0, 15 weeks pregnant presents to your clinic for having routine
ANC. On physical examination, you found her fundal height equals umbilical point. You
performed ultrasound and saw a multilocular hypoechoic mass sized 10 cm (in diameter) in her
left adnexa. No free fluid in her abdomen and pelvis. What is your consideration in this case?

a. The incidence of adnexal masses in pregnancy is 1%

b. The incidence of ovarian cancers in pregnancy is between 1:1000

c. The most common type of benign ovarian cyst in pregnancy is a mature teratoma

d. The most common histopathological subtype for malignant ovarian tumor in

pregnancy is epithelial ovarian tumor

e. The resolution rate of adnexal masses in the second trimester of pregnancy is 60-70%

90. Mrs. P, 45 year old pregnant woman at term collapses in front of the nursing staff
whilewaiting in the delivery room. She is unresponsive and has no pulse. The midwife activates
the emergency response system and begins chest compressions. A team of 2 doctors and 2
nurses arrive with the emergency equipment.

a. The first thing one should do is displace the uterus to the left whilst chest
compressions is ongoing

b. One should follow BLS guidelines and perform chest compressions on the sternum at the
inter-nipple line

c. One should do 2 minutes of CPR before considering defibrillation in this patient.

d. The doctors should transfer the patient to theatre for an urgent Caesarean delivery

e. Intubation should only be considered after return of spontaneous circulation

91. A 29 year old woman with a positive pregnancy test presents with a good history of passing
tissue per vagina. A transvaginal ultrasound scan shows an empty uterus with an endometrial
thickness of 11 mm. Regarding her diagnosis, you consider that :

a. She has had a complete miscarriage and needs no further treatment

b. She has a pregnancy of unknown location and needs further investigations

c. She should be offered a hysteroscopy

 d. She should be offered medical management of miscarriage

e. A laparoscopy should be performed to exclude an ectopic pregnancy

92. A patient who underwent an abdominal hysterectomy a few days ago complains of
numbness over the skin over the anterior aspect of the upper thigh. This could be attributed to
neuropathy of the:

a. Femoral nerve

b. Obturator nerve

c. Peroneal nerve

d. Pudendal nerve

e. Sciatic nerve

93. A 45-year-old woman undergoes an abdominal hysterectomy for a large fibroid uterus. She
is found to have a fibroid in broad ligament, and there is a concern that her ureter may have
been damaged during the difficult surgery. Which of the following is the least possible site of
ureteric injury in this surgery?
a. At the level of the uterosacral ligament

b. Lateral to the uterine vessels

c. Renal pelviureteric junction

d. The area of the ureterovesical junction close to the cardinal ligaments

e. The base of the infundibulopelvic ligament as the ureters cross the pelvic brim at the
ovarian fossa

94. A full-term neonate has the following blood results from the umbilical artery, obtained
immediately after delivery: pH 6.95, pCO2 11 kPa, BDecf (Base Deficit in extracellular fluid
component) 12,3 mmol/l. What is the correct interpretation of this result?

a. Normal acidebase status

b. Respiratory acidosis

c. Metabolic acidosis

d. Combined metabolic acidosis with a respiratory component

e. Compensated combined acidosis

95. A 29 year old, P0A0, woman with regular menses (every 28 days lasting 5 days) is currently
trying to conceive. She has not used contraception for 6 months. Her ovulation predictor kit
revealed an luteinizing hormone (LH) surge 7 days ago. She presents with acute abdominal/
pelvic pain now. This clinical picture is most consistent with :

a. Cystic teratoma

b. Ectopic pregnancy

c. Follicular cyst

d. Hemorrhagic corpus luteum cyst

 e. Serous cystadenoma

96. Mrs. XY is in theatre for repair of a 3C perineal tear. She has been given spinal anaesthetic
and antibiotics. Which suturing technique is most suited for the torn IAS (internal anal
sphincter)?

a. Continuous locked 3–0 PDS

b. Continuous unlocked 3–0 PDS

c. End-to-end technique (interrupted)

d. Figure-of-8 stitches

e. Overlap technique
97. A 31-year-old G1P0A0 at 24 weeks 2 days by last menstrual period (LMP) dating with no
prenatal care presents to the emergency department for vaginal bleeding after intercourse. She
denies any loss of fluid and reports normal fetal movements. On examination, fundal height is 25
cm, and fetal heart tones by Doppler are 140 bpm. Sterile speculum examination reveals scant
dark blood in the posterior vaginal vault and a friable appearing cervix. Combined cervical
cytology with human papillomavirus (HPV) DNA is done, and the results show high-grade
squamous intraepithelial lesion (HGSIL) . What is the next step in the management for this
patient?

a. Repeat combined cervical cytology in 4 to 6 months

b. Repeat combined cervical cytology in 12 months

c. Immediate colposcopic examination

d. Colposcopic examination at 6-week postpartum visit

e. Immediate endocervical curettage

98. You are called to the emergency room (ER) to evaluate a 25-year-old woman, P 1A0, with
moderate left lower quadrant pain. The pain woke her from sleep and is described as throbbing
but constant 4/10 . Her last menstrual period (LMP) was 6 weeks ago. She has regular monthly
periods and uses condoms inconsistently. She became sexually active at age 16 and has had
five lifetime male partners, the present one for almost a year. She has a history of chlamydia
treated at age 18. She has not had any regular gynecologic care since then. She appears to be
in no distress and her vital signs are as follows: BP 120/72 mmHg, P 88 beats/min, RR 18
breaths/min, and BMI 27. Her abdomen is non tender, but her pelvic examination reveals mild
tenderness in the left adnexal area. What is your next step?

a. Qualitative hCG

b. Quantitative hCG

c. Vaginal ultrasound

d. Abdominal ultrasound

e. Laparoscopy

99. A 32-year-old woman, with a body mass index of 36 and type 2 diabetes, underwent an
emergency caesarean section at full dilatation after a failed forceps attempt. The blood loss was
1500 ml, and LMWH was withheld until further assessment. Twelve hours after surgery, she
collapses. The blood pressure is 50/30 mmHg, pulse is 130 bpm, and oxygen (O 2) saturation is
88% on air. The next management is :
 a. Assume it is a massive pulmonary embolism and send to accident and emergency for
thrombolytic drugs and give them as soon as they arrive.

b. Fast bleep the cardiology registrar to carry out a bedside echocardiogram.

c. Conduct an arterial blood gas analysis to assess O2 partial pressure and haemoglobin.

d. Exclude internal bleeding, then start a loading dose of unfractionated heparin

e. Exclude internal bleeding, then start therapeutic LMWH

100. A 24-year-old woman presents to clinic with an atypical squamous cells of undetermined
significance (ASCUS) Pap. She had a Pap about 2 to 3 years ago, and it was normal. She
became sexually active at age 17 and has had two lifetime partners. She and her male partner
have been together for over a year. She started having periods at age 13 and has regular cycles
on her own. Her last period was 1 week ago on oral contraceptives. She has a history of herpes
simplex virus well controlled with daily acyclovir. Her physical examination is normal. What is the
next step?

a. Repeat the Pap

b. Get high-risk human papillomavirus (HPV) typing

c. Get low-risk HPV typing

d. Perform colposcopy

e. Perform a conization