The first answer (A) is correct!

1. 2. A 32 y.o. woman consulted a gynecologist about having abundant long menses

within 3 months. Bimanual investigation: the body of the uterus is enlarged
according to about 12 weeks of pregnancy, distorted, tuberous, of dense
consistence. Appendages are not palpated. Histological test of the uterus body
mucosa: adenocystous hyperplasia of endometrium. Optimal medical tactics:
A. Surgical treatment
B. Hormonetherapy
C. Phytotherapy
D. Radial therapy
E. Phase by phase vitamin therapy
2. 3. A woman was hospitalised with fullterm pregnancy. In survey: the uterus is
morbid, the abdomen is tense, heart sounds of the fetus are not auscultated. What is
the most probable complication of pregnancy?
A. Premature detachment of the normally posed placenta
B. Preterm labour
C. Back occipital presentation
D. Acute hypoxia of a fetus
E. Hydramnion
3. 4. By the end of the 1st period of physiological labour the clear amniotic waters
were given vent. Contractions lasted 35-40 sec every 4-5 min. Palpitation of the
fetus is 100 bpm. The AP is 140/90 mm Hg. Diagnosis:
A. Acute hypoxia of the fetus
B. Labors before term
C. Premature detachment of normally posed placenta
D. Back occipital presentation
E. Hydramnion
4. 6. Which gestational age gives the most accurate estimation of weeks of pregnancy
by uterine size?
A. Less that 12 weeks
B. Between 12 and 20 weeks
C. Between 21 and 30 weeks
D. Between 31 and 40 weeks
E. Over 40 weeks
5. 7. A number of viable fetuses per 1000 women at the age between 15 and 44 is
determined by:
A. Genital index
B. Reproductive level
C. Birth rate
D. Perinatal rate
E. Obstetric rate
6. 11. A woman in her 39-th week of pregnancy, the second labor, has regular birth
activity. Uterine contractions take place every 3 minutes. What criteria describe the
beginning of the II labor stage the most precisely?
A. Cervical dilatation by no less than 4 cm
 B. Cervical smoothing over 90%
C. Duration of uterine contractions more than 30 seconds
D. Presenting part is in the lower region of small pelvis
E. Rupture of membranes
7. 14. A 34 y.o. woman in her 29-th week of pregnancy, that is her 4-th labor to come,
was admitted to the obstetric department with complaints of sudden and painful
bloody discharges from vagina that appeared 2 hours ago. The discharges are
profuse and contain grumes. Cardiac funnction of the fetus is rhytmic, 150 strokes
in the minute, uterus tone is normal. The most probable provisional diagnosis will
be:
A. Placental presentation
B. Detachment of normally located placenta
C. Vasa previa
D. Bloody discharges
E. Disseminated intravascular coagulation syndrome
8. 21. A 40 y.o. woman has changes of mammary gland. What are the most often
symtomps that precede the malignization?
A. Skin induration with inverted nipple
B. Painful movable induration
C. Painless movable induration
D. Bloody discharges from the nipple
E. Pure discharges from the nipple
9. 34. A 40 weeks pregnant woman in intrinsic obstetric investigation: the cervix of a
uterus is undeveloped. The oxytocin test is negative. Upon inspection at 32 weeks it
is revealed: AP- 140/90 mm Hg, proteinuria 1 g/l, peripheric edemata. Reflexes are
normal. Choose the most correct tactics of guiding the pregnant:
A. Laborstimulation after preparation
B. Strict bed regimen for 1 month
C. Complex therapy of gestosis for 2 days
D. Cesarean section immediately
E. Complex therapy of gestosis for 7 days
10. 36. A woman had the rise of temperature up to 39oC on the first day after labour.
The rupture of fetal membranes took place 36 hours before labour. The
investigation of the bacterial flora of cervix of the uterus revealed hemocatheretic
streptococcus of group A. The uterus body is soft, tender. Discharges are bloody,
mixed with pus. Specify the most probable postnatal complication:
A. Metroendometritis
B. Thrombophlebitis of pelvic veins
C. Infected hematoma
D. Infection of the urinary system
E. Apostatis of junctures after the episiotomy
11. 37. A 24 y.o. patient 13 months after the first labour consulted a doctor about
amenorrhea. Pregnancy has concluded by a Cesarean section concerning to a
premature detachment of normally posed placenta hemorrhage has made low
fidelity 2000 ml owing to breakdown of coagulability of blood. Choose the most
suitable investigation:
 A. Determination of the level of gonadotropins
B. USI of organs of a small pelvis
C. Progesteron assay
D. Computer tomography of the head
E. Determination of the contents of Testosteron-Depotum in Serum of blood
12. 39. A 34 y.o. woman in the 10-th week of gestation (the second pregnancy)
consulted a doctor of antenatal clinic with purpose of statement on the dispensary
record. In the previous pregnancy there took place hydramnion, the child’s birth
weight was 4086. What method of examination is necessary for carrying out, first
of all?
A. The test for tolerance to glucose
B. Determination of the contents of fetoproteinum
C. Bacteriological investigation of discharge from the vagina
D. A cardiophonography of fetus
E. USI of the fetus
13. 77. The highest risk of congenital anomalies probably occurs when human embryos
or fetuses are exposed to ionizing radiation. During which part of gestational period
does it occur?
A. 18-45 days after conception
B. The first 7 days
C. 10-14 days after conception
D. 90-120 days after conception
E. The third trimester
14. 97. Laparotomy was performed to a 54 y.o. woman on account of big formation in
pelvis that turned out to be one-sided ovarian tumor along with considerable
omental metastases. The most appropriate intraoperative tactics involves:
A. Ablation of omentum, uterus and both ovaries with tubes
B. Biopsy of omentum
C. Biopsy of an ovary
D. Ablation of an ovary and omental metastases
E. Ablation of omentum and both ovaries
15. 107. A 14 y.o. girl complains of profuse bloody discharges from genital tracts
during 10 days after suppresion of menses for 1,5 month. Similiar bleedings recur
since 12 years on the background of disordered menstrual cycle. On rectal
examination: no pathology of the internal genitalia. In blood: Нb- 70 g/L, RBC- 2,
3 · 1012/L, Ht-20. What is the most probable diagnosis?
A. Juvenile bleeding, posthemorrhagic anemia
B.Werlholf’s disease
C. Polycyst ovarian syndrome
D. Hormonoproductive ovary tumor
E. Noncomplete spontaneous abortion
16. 112. A 43 y.o. woman complains of contact hemorrhages during the last 6 months.
Bimanual examination: cervix of the uterus is enlarged, its mobility is reduced.
Mirrors showed the following: cervix of the uterus is in the form of cauliflower.
Chrobak and Schiller tests are positive. What is the most probable diagnosis?
A. Cancer of cervix of the uterus
 B. Polypus of the cervis of the uterus
C. Cervical pregnancy
D. Nascent fibroid
E. Leukoplakia
17. 118. A patient was admitted to the hospital with complaints of periodical pain in the
lower part of abdomen that gets worse during menses, weakness, malaise,
nervousness, dark bloody smears from vagina directly before and after menses.
Bimanual examination revealed that uterus body is enlarged, appendages cannot be
palpated, posterior fornix has tuberous surface. Laparoscopy revealed: ovaries,
peritoneum of rectouterine pouch and pararectal fat have "cyanotic eyes". What is
the most probable diagnosis?
A. Disseminated form of endometriosis
B. Polycystic ovaries
C. Chronic salpingitis
D. Tuberculosis of genital organs
E. Ovarian cystoma
18. 121. An 18 y.o. woman consulted a gynecologist about the pain in the lower part of
abdomen, fever up to 37, 50C, considerable mucopurulent discharges from the
genital tracts, painful urination. Vaginal examination with mirrors: the urethra is
infiltrated, cervix of the uterus is hyperemic, erosive. The uterus is painful, ovaries
are painful, thickened; fornixes are free. Bacterioscopy test revealed diplococcus.
What diagnosis is the most probable?
A. Recent acute ascending gonorrhea
B. Trichomoniasis
C. Candydomycosis
D. Chronic gonorrhea
E. Chlamydiosis
19. 126. A woman consulted a doctor on the 14-th day after labor about sudden pain,
hyperemy and induration of the left mammary gland, body temperature rise up to
39oC, headache, indisposition. Objectively: fissure of nipple, enlargement of the
left mammary gland, pain on palpation. What pathology would you think about in
this case?
A. Lactational mastitis
B. Lacteal cyst with suppuration
C. Fibrous adenoma of the left mammary gland
D. Breast cancer
E. Phlegmon of mammary gland
20. 129. A girl 13 y.o. consulted the school doctor on account of moderate bloody
discharge from the genital tracts, which appeared 2 days ago. Secondary sexual
characters are developed. What is the most probable cause of bloody discharge?
A. Menarche
B. Juvenile hemorrhage
C. Haemophilia
D. Endometrium cancer
E. Werlhof’s disease
21. 145. A 30 y.o. primigravida woman has got intensive labor pain every 1-2 minutes
 that lasts 50 seconds. The disengagement has started. The perineum with the height
of 4 cm has grown pale. What actions are necessary in this situation?
A. Episiotomy
B. Perineum protection
C. Perineotomy
D. Vacuum extraction of fetus
E. Expectant management
22. 153. A 30 y.o. woman has the 2-nd labour that has been lasting for 14 hours.
Hearbeat of fetus is muffled, arrhythmic, 100/min. Vaginal examination: cervix of
uterus is completely opened, fetus head is level with outlet from small pelvis.
Saggital suture is in the straight diameter, small crown is near symphysis.What is
the further tactics of handling the delivery?
A. Use of obstetrical forceps
B. Stimulation of labour activity by oxytocin
C. Cesarean section
D. Cranio-cutaneous (Ivanov’s) forceps
E. Use of cavity forceps
23. 177. A 20 y.o. patient complains of amenorrhea. Objectively: hirsutism, obesity
with fat tissue prevailing on the face, neck, upper part of body. On the face there
are acne vulgaris, on the skin - striae cutis distense. Psychological and intellectual
development is normal. Gynecological condition: external genitals are moderately
hairy, acute vaginal and uterine hypoplasia. What diagnosis is the most probable?
A. Itsenko-Cushing syndrome
B. Turner’s syndrome
C. Stein-Levental’s syndrome
D. Shichan’s syndrome
E. Babinski-Froehlich syndrome
24. 191. A 22 y.o. patient complains of having boring pain in the right iliac region for
one week, morning sickness, taste change. Delay ofmenstruation is 3 weeks.
Objectively: AP- 110/70 mm Hg, Ps- 78/min, t0- 37, 00_. Bimanual examination
revealed that uterus is a little enlarged, soft, movable, painless. Appendages
palpation: a painful formation 3х4 cm large on the right, it is dense and elastic,
moderately movable. What is the most probable diagnosis?
A. Progressing tubal pregnancy
B. Interrupted tubal pregnancy
C. Cyst of the right ovary
D. Uterine pregnancy
E. Acute appendicitis
25. 193. A 30 y.o. parturient woman was taken to the maternity house with complaints
of having acute, regular labour pains that last 25-30 seconds every 1,5-2 minutes.
Labour activity began 6 hours ago. Uterus is in higher tonus, head of the fetus is
above the opening into the small pelvis. Fetal heartbeat is 136/min. P.V: cervical
dilatation is 4 cm, uterine fauces is spasming at a height of parodynia. Head is level
with opening into the small pelvis, it is being pushed off. What is the most probable
diagnosis?
A. Discoordinated labour activity
 B. Secondary powerless labour activity
C. Pathological preliminary period
D. Primary powerless labour activity
E. Normal labour activity
26. 194. A primigravida woman appealed to the antenatal clinic on the 22.03.03 with
complaints of boring pain in the lower part of abdomen. Anamnesis registered that
her last menstruation was on the 4.01.03. Bimanual examination revealed that
uterine servix is intact, external fauces is closed, uterus is enlarged up painless.
What complication can be suspected?
A. Risk of abortion in the 9-th week of pregnancy
B. Abortion that started in the 9-th week of pregnancy
C. Hysteromyoma
D. Vesicular mole
E. –
27. 199. A 33 y.o. woman survived two operations on account of extrauterine
pregnancy, both uterine tubes were removed. She consulted a doctor with a
question about possibility of having a child. What can be advised in this case?
A. Extracorporal fertilization
B. Insemination with her husband’s semen
C. Substitutional maternity
D. Artifical fertilization with donor’s semen
E. Induction of ovulation
28. 2. A woman complains of having slight dark bloody discharges and mild pains in
the lower part of abdomen for several days. Last menses were 7 weeks ago. The
pregnancy test is positive. Bimanual investigation: the body of the uterus indicates
for about 5-6 weeks of pregnancy, it is soft, painless. In the left appendage there is
a retort-like formation, 7 х 5 cm large, mobile, painless. What examination is
necessary for detection of fetus localization?
A. Ultrasound
B. Hysteroscopy
C. Hromohydrotubation
D. Colposcopy
E. Cystoscopy
29. 3. A pregnant woman in her 40th week of pregnancy undergoes obstetric
examination: the cervix of uterus is undeveloped. The oxytocin test is negative.
Examination at 32 weeks revealed: AP 140/90 mm Hg, proteinuria 1 g/l, peripheral
edemata. Reflexes are normal. Choose the most
correct tactics:
A. Labour stimulation after preparation
B. Absolute bed rest for 1 month
C. Complex therapy of gestosis for 2 days
D. Caesarian section immediately
E. Complex therapy of gestosis for 7 days
30. 4. A 26 year old woman had the second labour within the last 2 years with oxytocin
application. The child’s weight is 4080 gr. After the placent birth there were
massive bleeding, signs of hemorrhagic shock. Despite the introduction of
 contractive agents, good contraction of the uterus and absence of any cervical and
vaginal disorders, the bleeding proceeds. Choose the most probable cause of
bleeding:
A. Atony of the uterus
B. Injury of cervix of the uterus
C. Hysterorrhexis
D. Delay of the part of placenta
E. Hypotonia of the uterus
31. 6. A woman of a high-risk group (chronic pyelonephritis in anamnesis) had vaginal
delivery. The day after labour she complained of fever and loin pains, frequent
urodynia. Specify the most probable complication:
A. Infectious contamination of the urinary system
B. Thrombophlebitis of veins of the pelvis
C. Infectious hematoma
D. Endometritis
E. Apostasis of sutures after episiotomy
32. 8. A 24 years old primipara was hospitalized with complaints about discharge of the
amniotic waters. The uterus is tonic on palpation. The position of the fetus is
longitudinal, it is pressed with the head to pelvic outlet. Palpitation of the fetus is
rhythmical, 140 bpm, auscultated on the left below the navel. Internal examination:
cervix of the uterus is 2,5 cm long, dense, the external os is closed, light amniotic
waters out of it. Point a correct component of the diagnosis:
A. Antenatal discharge of the amniotic waters
B. Early discharge of the amniotic waters
C. The beginning of the 1st stage of labour
D. The end of the 1st stage of labour
E. Pathological preterm labour
33. 11. A primagravida with pregnancy of 37-38 weeks complains of headache, nausea,
pain in epigastrium. Objective: the skin is acyanotic. Face is hydropic, there is short
fibrillar twitching of blepharons, muscles of the face and the inferior extremities.
The look is fixed. AP- 200/110 mm Hg; sphygmus of 92 bpm, intense. Respiration
rate is 32/min. Heart activity is rhythmical. Appreciable edemata of the inferior
extremities are present. Urine is cloudy. What medication should be administered?
A. Droperidolum of 0,25%- 2,0 ml
B. Dibazolum of 1%- 6,0 ml
C. Papaverine hydrochloride of 2% - 4,0ml
D. Hexenalum of 1% - 2,0 ml
E. Pentaminum of 5%- 4,0 ml
34. 14. An onset of severe preeclampsia at 16 weeks gestation might be caused by:
A. Hydatidiform mole
B. Anencephaly
C. Twin gestation
D. Maternal renal disease
E. Interventricular defect of the fetus
35. 27. A 40 year old woman has a selfdetected hard breast mass. The procedure of
choice for confirming the diagnosis is:
 A. Excision biopsy
B. Mammography
C. Thermography
D. Ultrasonography
E. Aspiration biopsy with cytology
36. 74. A pregnant woman may be diagnosed with hepatitis if it is confirmed by the
presence of elevated:
A. SGOT (ALT)
B. Sedimentation rates
C. WBCs
D. Alkaline phosphatase
E. BUN
37. 75. An endometrial adenocarcinoma that has extended to the uterine serosa would
be classified as stage:
A. IIIA
B. IC
C. IIA
D. IIB
E. IV AB
38. 101. A 40 year old patient complains of yellowish discharges from the vagina.
Bimanual examination revealed no pathological changes. The smear contains
Trichomonas vaginalis and blended flora. Colposcopy revealed two hazy fields on
the frontal labium, with a negative Iodine test. Your tactics:
A. Treatment of specific colpitis and subsequent biopsy
B. Diathermocoagulation of the cervix of the uterus
C. Specific treatment of Trichomonas colpitis
D. Cervix ectomy
E. Cryolysis of cervix of the uterus
39. 177. After delivery and revision of placenta there was found the defect of placental
lobule. General condition of woman is normal, uterus is firm, there is moderate
bloody discharge. Speculum inspection of birth canal shows absence of lacerations
and raptures. What action is nesessary?
A. Manual exploration of the uterine cavity
B. External massage of uterus
C. Introduction of uterine contracting agents
D. Urine drainage, cold on the lower abdomen
E. Introduction of hemostatic medications
40. 185. A 28 year old patient complained about prolongation of intermenstrual periods
up to 2 months, hirsutism. Gynaecological examination revealed that the ovaries
were enlarged, painless, compact, uterus had no pecularities. Pelvic ultrasound
revealed that the ovaries were 4-5 cm in diameter and had multiple enlarged
follicles on periphery. Roentgenography of skull base showed that sellar region was
dilated. What is the most probable diagnosis?
A. Stein-Leventhal syndrome
B. Algodismenorrhea
C. Sheehan’s syndrome
 D. Premenstrual syndrome
E. Morgagni-Stewart syndrome
41. 194. A parturient woman is 27 year old, it was her second labour, delivery was at
term, normal course. On the 3rd day of postpartum period body temperature is
36,8oC, Ps - 72/min, AP - 120/80 mm Hg. Mammary glands are moderately
swollen, nipples are clean. Abdomen is soft and painless. Fundus of uterus is 3
fingers below the umbilicus. Lochia are bloody, moderate. What is the most
probable diagnosis?
A. Physiological course of postpartum period
B. Subinvolution of uterus
C. Postpartum metroendometritis
D. Remnants of placental tissue after labour
E. Lactostasis
42. 197. A 30 year old patient complains about inability to become pregnant over 3
years of married life. The patient is of supernutrition type, she has hair along the
median abdominal line, on the internal thigh surface and in the peripapillary area.
Menses started at the age of 16, they are infrequent and non-profuse. US revealed
that the uterus was of normal size, ovaries were 4х5х5 cm large and had a lot of
cystic inclusions. What is the most probable diagnosis?
A. Polycystic ovaries
B. Ovarian cystoma
C. Chronic oophoritis
D. Menstrual irregularity
E. Bilateral ovarian tumours
43. 5. In the woman of 24 years about earlier normal menstrual function, cycles became
irregular, according to tests of function diagnostics - anovulatory. The contents of
prolactin in blood is boosted. Choose the most suitable investigation:
A. Computer tomography of the head
B. Determination of the level of gonadotropins
C. USI of organs of small pelvis
D. Progesterone assay
E. Determination of the contents of testosteron-depotum in blood serum
44. 63. Which of the methods of examination is the most informative in the diagnostics
of a tube infertility?
A. Laparoscopy with chromosalpingoscopy
B. Pertubation
C. Hysterosalpingography
D. Transvaginal echography
E. Bicontrast pelviography
45. 71. A 28 year old parturient complains about headache, vision impairment, psychic
inhibition. Objectively: AP- 200/110 mm Hg, evident edemata of legs and anterior
abdominal wall. Fetus head is in the area of small pelvis. Fetal heartbeats is clear,
rhythmic, 190/min. Internal investigation revealed complete cervical dilatation,
fetus head was in the area of small pelvis. What tactics of labor management should
be chosen?
A. Forceps operation
 B. Cesarean
C. Embryotomy
D. Conservative labor management with episiotomy
E. Stimulation of labor activity
46. 75. A 48 year old female patient complains about contact haemorrhage. Speculum
examination revealed hypertrophy of uterus cervix. It resembles of cauliflower, it is
dense and can be easily injured. Bimanual examination revealed that fornices were
shortened, uterine body was nonmobile. What is the most probable diagnosis?
A. Cervical carcinoma
B. Metrofibroma
C. Endometriosis
D. Cervical pregnancy
E. Cervical papillomatosis
47. 102. A 59 year old female patient applied to a maternity welfare clinic and
complained about bloody discharges from the genital tracts. Postmenopause is 12
years. Vaginal examination revealed that external genital organs had signs of age
involution, uterus cervix was not erosive, small amount of bloody discharges came
from the cervical canal. Uterus was of normal size, uterine appendages were
unpalpable. Fornices were deep and painless. What method should be applied for
the diagnosis specification?
A. Separated diagnosic curretage
B. Laparoscopy
C. Puncture of abdominal cavity through posterior vaginal fornix
D. Extensive colposcopy
E. Culdoscopy
48. 103. A 26 year old woman who delivered a child 7 months ago has been suffering
from nausea, morning vomiting, sleepiness for the last 2 weeks. She suckles the
child, menstruation is absent. She hasn’t applied any contraceptives.Whatmethod
should be applied in order to specify her diagnosis?
A. Ultrasonic examination
B. Roentgenography of small pelvis organs
C. Palpation of mammary glands and pressing-out of colostrum
D. Bimanual vaginal examination
49. 114. Immediately after delivery a woman had haemorrhage, blood loss exceeded
postpartum haemorrhage rate and was progressing. There were no symptoms of
placenta detachment. What tactics should be chosen?
A. Manual removal of placenta and afterbirth
B. Uterus tamponade
C. Instrumental revision of uterine cavity walls
D. Removal of afterbirth by Crede’s method
E. Intravenous injection of methylergometrine with glucose
50. 134. A 40 year old female patient has been observing excessive menstruation
accompanied by spasmodic pain in the lower abdomen for a year. Bimanual
examination performed during menstruation revealed a dense formation up to 5 cm
in diameter in the cervical canal. Uterus is enlarged up to 5-6 weeks of pregnancy,
movable, painful, of normal consistency. Appendages are not palpable. Bloody
 discharges are profuse. What is the most probable diagnosis?
A. Nascent submucous fibromatous node
B. Abortion in progress
C. Cervical carcinoma
D. Cervical myoma
E. Algodismenorrhea
51. 146. On the 5th day after labor body temperature of a parturient suddenly rose up to
38, 7oC. She complains about weakness, headache, abdominal pain, irritability.
Objectively: AP- 120/70 mm Hg, Ps- 92 bpm, to- 38,7oC. Bimanual examination
revealed that the uterus was enlarged up to 12 weeks of pregnancy, it was dense,
slightly painful on palpation. Cervical canal lets in 2 transverse fingers, discharges
are moderate, turbid, with foul smell. In blood: skeocytosis, lymphopenia, ESR- 30
mm/h.What is the most probable diagnosis?
A. Endometritis
B. Parametritis
C. Pelviperitonitis
D. Metrophlebitis
E. Lochiometra
52. 149. An 18 year old primigravida in her 27-28 week of pregnancy underwent an
operation on account of acute phlegmonous appendicitis. In the postoperative
period it is necessary to take measures for prevention of the following pegnancy
complication:
A. Noncarrying of pregnancy
B. Intestinal obstruction
C. Fetus hypotrophy
D. Premature placenta detachment
E. Late gestosis
53. 171. A 25 year old woman applied to a maternity welfare clinic and complained
about being unable to conceive within 3 years of regular sexual life. Examination
revealed weight gain, male pattern of hair distribution on the pubis, excessive
pilosis of thighs. Ovaries were dense and enlarged, basal temperature was
monophase. What is the most probable diagnosis?
A. Sclerocystosis of ovaries
B. Tubo-ovaritis
C. Adrenogenital syndrome
D. Premenstrual syndrome
E. Gonadal dysgenesis
54. 176. A 26 year old woman complains about edemata, swelling and painfulness of
mammary glands, headache, tearfulness, irritability. These signs turn up 5 days
before menstruation and disappear after its start. What clinical syndrome is it?
A. Premenstrual syndrome
B. Postcastration syndrome
C. Adrenogenital syndrome
D. Climacteric syndrome
E. Stein-Leventhal syndrome
55. 185. A woman is 34 years old, it is her tenth labor at full term. It is known from the
 anamnesis that the labor started 11 hours ago, labor was active, painful contractions
started after discharge of waters and became continuous. Suddenly the parturient
got knife-like pain in the lower abdomen and labor activity stopped. Examination
revealed positive symptoms of peritoneum irritation, illdefined uterus outlines.
Fetus was easily palpable, movable. Fetal heartbeats wasn’t auscultable. What is the
most probable diagnosis?
A. Rupture of uterus
B. Uterine inertia
C. Discoordinated labor activity
D. Risk of uterus rupture
E. II labor period
56. 187. Examination of placenta revealed a defect. An obstetrician performed manual
investigation of uterine cavity, uterine massage. Prophylaxis of endometritis in the
postpartum period should involve following actions:
A. Antibacterial therapy
B. Instrumental revision of uterine cavity
C. Haemostatic therapy
D. Contracting agents
E. Intrauterine instillation of dioxine
57. 1. A 40-year-old patient complains of colic pains in the lower abdomen and profuse
bloody discharges from the genital tracts. Over the last 2 years she has been having
menses for 15-16 days, profuse, with clots, painful. In anamnesis there are 2
medical abortions. On bimanual investigation: in the canal of the uterine cervix
some fibromatous nodes are palpable, they are 3 cm in diameter, on the thin crus.
Discharges are bloody, moderate. Choose the correct treatment tactics:
A. Operation: untwisting of the nodes
B. Hormonal hemostasis
C. Step-by-step vitamin therapy
D. Supravaginal ablation of the uterus without appendages
E. Hysterectomy without appendages
58. 2. 13 months after the first labor a 24-year old patient complained of amenorrhea.
Pregnancy ended in Caesarian section because of premature detachment of
normally positioned placenta which resulted in blood loss at the rate of 2000 ml
owing to disturbance of blood clotting. Choose the most suitable investigation:
A. Estimation of gonadotropin rate
B. USI of small pelvis organs
C. Progesteron assay
D. Computer tomography of head
E. Estimation of testosteron rate in blood serum
59. 3. A 20-year-old patient was delivered to the hospital in summer from the street
with haemorrage from the brachial artery. First medical aid involved application of
a tourniquet for provisional arrest of bleeding. What is the maximal exposure of the
tourniquet?
A. 120 minutes
B. 15 minutes
C. 30 minutes
 D. 60 minutes
E. 180 minutes
60. 12. A baby was born at 36 weeks of gestation. Delivery was normal, by natural
way. The baby has a large cephalohematoma. The results of blood count are: Hb-
120g/l, Er- 3, 5 · 1012/l, total serum bilirubin - 123 mmol/l, direct bilirubin - 11
mmol/l, indirect - 112 mmol/l. What are causes of hyperbilirubinemia in this case?
A. Erythrocyte hemolysis
B. Intravascular hemolysis
C. Disturbance of the conjugative function of liver
D. Bile condensing
E. Mechanical obstruction of the bile Outflow
61. 52. Apgar test done on a newborn girl at 1st and 5th minute after birth gave the
result of 7-8 scores. During the delivery there was a short-term difficulty with
extraction of shoulder girdle. After birth the child had the proximal extremity
dysfunction and the armcouldn’t be raised from the side. The shoulder was turned
inwards, the elbow was flexed, there was also forearm pronation, obstetric palsy of
brachial plexus. What is the clinical diagnosis?
A. Duchenne-Erb palsy
B. Trauma of thoracic spine
C. Right hand osteomyelitis
D. Intracranial haemorrhage
E. Trauma of right hand soft tissues
62. 59. A 28-year-old patient underwent endometrectomy as a result of incomplete
abortion. Blood loss was at the rate of 900 ml. It was necessary to start
hemotransfusion. After transfusion of 60 ml of erythrocytic mass the patient
presented with lumbar pain and fever which resulted in hemotransfusion stoppage.
20 minutes later the patient’s condition got worse: she developed adynamia,
apparent skin pallor, acrocyanosis, profuse perspiration. to- 38, 5oC, Ps-110/min,
AP- 70/40 mm Hg. What is the most likely diagnosis?
A. Hemotransfusion shock
B. Hemorrhagic shock
C. Septic shock
D. Anaphylactic shock
E. DIC syndrome
63. 84. A primagravida in her 20th week of gestation complains about pain in her lower
abdomen, blood smears from the genital tracts. The uterus has an increased tonus,
the patient feels the fetus movements. Bimanual examination revealed that the
uterus size corresponded the term of gestation, the uterine cervix was contracted
down to 0,5 cm, the external orifice was open by 2 cm. The discharges were bloody
and smeary.Whatis the most likely diagnosis?
A. Incipient abortion
B. Risk of abortion
C. Abortion in progress
D. Incomplete abortion
E. Missed miscarriage
64. 88. A newborn’s head is of dolichocephalic shape, that is front-to-back elongated.
 Examination of the occipital region of head revealed a labour tumour located in the
middle between the prefontanel and posterior fontanel. The delivery tok place with
the following type of fetus head presentation:
A. Posterior vertex presentation
B. Anterior vertex presentation
C. Presentation of the bregma
D. Brow presentation
E. Face presentation
65. 103. A 30-year-old gravida consulted a gynecologist about bright red bloody
discharges from the vagina in the 32 week of gestation. She was hospitalized with
suspicion of placental presentation. Under what conditions is it rational to conduct
the internal examination for the diagnosis specification?
A. In the operating room prepared for the operation
B. In the examination room of antenatal clinic
C. In the admission ward of maternity hospital
D. In the delivery room keeping to all the aseptics regulations
E. The examination is not to be conducted because of risk of profuse haemorrhage
66. 126. A 27-year-old military servant was delivered to the regimental aid post 1,5
hour after getting an abdominal injury with an aerial bomb splinter. Objectively: the
patient is in grave condition, pale, Ps-132/min, AP- 80/60 mm Hg. Subcostal area
has a bandage on from the firstaid pack, the bandage is soaked with blood. The
abdomen is tense. Percussion revealed dullness in flat parts that changes its location
with the change of body position. There are symptoms of peritoneal irritation. What
department of the regimental aid post should provide medical care?
A. Dressing ward
B. Admission-and-sorting tent
C. Isolation ward
D. Evacuation
E. In the manner of self-help
67. 143. A 42-year-old woman has had hyperpolymenorrhea and progressing
algodismenorrhea for the last 10 years. Gynecological examination revealed no
changes of uterine cervix; discharges are moderate, of chocolate colour, uterus is
slightly enlarged and painful, appendages are not palpable, the fornices are deep
and painless. What is the most likely diagnosis?
A. Uterine endometriosis
B. Uterine carcinoma
C. Subserous uterine fibromyoma
D. Endomyometritis
E. Adnexal endmetriosis
68. 144. On the tenth day after discharge from the maternity house a 2-year-old patient
consulted a doctor about body temperature rise up to 39oC, pain in the right breast.
Objectively: the mammary gland is enlarged, there is a hyperemized area in the
upper external quadrant, in the same place there is an ill-defined induration,
lactostasis, fluctuation is absent. Lymph nodes of the right axillary region are
enlarged and painful. What is the most likely diagnosis?
A. Lactational mastitis
 B. Abscess
C. Erysipelas
D. Dermatitis
E. Tumour
69. 148. A 26-year-old woman complains of having bloody discharges from the
genitals for the last 14 days, abdominal pain, general fatiguability, weakness,
weight loss, body temperature rise, chest pain, obstructed respiration. 5 weeks ago
she underwent induced abortion in the 6-7 week of gestation. Objectively: the
patient is pale and inert. Bimanual examination revealed that the uterus was
enlarges up to 8-9 weeks of gestation. In blood: Hb- 72 g/l. Urine test for chorionic
gonadotropin gave the positive result. What is the most likely diagnosis?
A. Chorioepithelioma
B. Metroendometritis
C. Uterus perforation
D. Uterine fibromyoma
E. Uterine carcinoma
70. 156. A 30-year-old patient consulted a doctor about menstruation absence for 2
years after labour, loss of hair, body weight loss. The labour was complicated by a
haemorrhage caused by uterus hypotonia. Objectively: the patient is asthenic,
external genitals are hypoplastic, the uterus body is small and painless. The
appendages are not palpaple. What is the most likely diagnosis?
A. Sheehan’s syndrome
B. Ovarian amenorrhea
C. Turner’s syndrome
D. Exhausted overy syndrome
E. Galactorrhea-amenorrhea syndrome
71. 158. A 28-year-old patient has been admitted to the gynecological department three
days after a casual coitus. She complains about pain in her lower abdomen and
during urination, profuse purulent discharges from the vagina, body temperature
rise up to 37, 8oC. The patient was diagnosed with acute bilateral adnexitis.
Supplemental examination revealed: the 4th degree of purity of the vaginal
secretion, leukocytes within the whole visual field, diplococcal bacteria located
both intra- and extracellularly. What is the etiology of acute adnexitis in this
patient?
A. Gonorrheal
B. Colibacterial
C. Chlamydial
D. Trichomonadal
E. Staphylococcal
72. 162. A 32-year-old gravida complains about episodes of unconsciousness,
spontaneous syncopes that are quickly over after a change of body position. A
syncope can be accompanied by quickly elapsing bradycardia. There are no other
complications of gestation. What is the most likely reason for such condition?
A. Postcava compresseion by the gravid uterus
B. Pressure rise in the veins of extremities
C. Pressure fall in the veins of extremities
 D. Vegetative-vascular dystonia (cardial type)
E. Psychosomatic disorders
73. 163. A 49-year-old woman complains about headache, head and neck going hot,
increased perspiration, palpitation, arterial pressure rise up to 170/100 mm Hg,
irritability, insomnia, tearfulness, memory impairment, rare and scarce menses,
body weight increase by 5 kg over the last half a year. What is the most likely
diagnosis?
A. Climacteric syndrome
B. Premenstrual syndrome
C. Vegetative-vascular dystonia
D. Arterial hypertension
E. Postcastration syndrome
74. 173. A puerpera is 25 years old, it is her second day of postpartum period. It was
her first labour, it took place at full term. The lochia should be:
A. Bloody
B. Sanguino-serous
C. Mucous
D. Purulent
E. Serous
75. 174. A 32-year-old patient consulted a doctor about being inable to get pregnant for
5-6 years. 5 ago the primipregnancy ended in artificial abortion. After the vaginal
examination and USI the patient was diagnosed with endometrioid cyst of the right
ovary. What is the optimal treatment method?
A. Surgical laparoscopy
B. Anti-inflammatory therapy
C. Conservative therapy with estrogengestagenic drugs
D. Hormonal therapy with androgenic hormones
E. Sanatorium-and-spa treatment
76. 192. A 49-year-old patient undergoes regular medical check-up for uterine
fibromyoma. Within the last year the uterus has enlarged up to 20 weeks of
gestation. What is the rational way of treatment?
A. Surgical treatment
B. Hormonal therapy
C. Further surveillance
D. Embolization of uterine arteries
E. Treatment with prostaglandin inhibitors
77. 196. Forensic medical expertise of corpse of a newborn revealed: body weight 3500
g, body length 50 cm, the umbilical cord was smooth, moist, glossy, without any
signs of drying. Hydrostatic tests were positive. The test results are the evidence of:
A. Live birth
B. Stillbirth
C. Primary atelectasis
D. Secondary atelectasis
E. Hyaline membrane disease
78. 197. A maternity house has admitted a primagravida complaining of irregular,
intense labour pains that have been lasting for 36 hours. The woman is tired, failed
 to fall asleep at night. The fetus is in longitudinal lie, with cephalic presentation.
The fetus heartbeat is clear and rhythmic, 145/min. Vaginal examination revealed
that the uterine cervix was up to 3 cm long, dense, with retroflexion; the external
orifice was closed; the discharges were of mucous nature.What is the most likely
diagnosis?
A. Pathological preliminary period
B. Uterine cervix dystocia
C. Primary uterine inertia
D. Physiological preliminary period
E. Secondary uterine inertia
79. 15. A 58-year-old female patient came to the antenatal clinic with complaints of
bloody light-red discharges from the genital tracts. Menopause is 12 years.
Gynaecological examination found externalia and vagina to have age involution;
uterine cervix was unchanged, there were scant bloody discharges from uterine
cervix, uterus was of normal size; uterine appendages were not palpable; parametria
were free. What is the most likely diagnosis?
A. Uterine carcinoma
B. Atrophic colpitis
C. Abnormalities of menstrual cycle with climacteric character
D. Cervical carcinoma
E. Granulosa cell tumor of ovary
80. 33. A secundipara has regular birth activity. Three years ago she had cesarean
section for the reason of acute intrauterine hypoxia. During parodynia she
complains of extended pain in the area of postsurgical scar. Objectively: fetus pulse
is rhythmic - 140 bpm. Vaginal examination shows 5 cm cervical dilatation. Fetal
bladder is intact. What is the tactics of choice?
A. Cesarean section
B. Augmentation of labour
C. Obstetrical forceps
D. Waiting tactics of labor management
E. Vaginal delivery
81. 34. A 54-year-old female patient consulted a doctor about bloody discharges from
the genital tracts after 2 years of amenorrhea. USI and bimanual examination
revealed no genital pathology. What is the tactics of choice?
A. Fractional biopsy of lining of uterus and uterine mucous membranes
B. Styptic drugs
C. Contracting drugs
D. Estrogenic haemostasia
E. Hysterectomy
82. 69. A 40-year-old patient, the forester, complains of severe headache, body
temperature rise up to 39,5oC, trembling limbs. From the patient’s history we know
that he had seriously cut his hand during the dissection of a killed fox. Objectively:
depressed mood. The patient asks not to turn on the light or open the door. Any
noise causes apparent motor excitation. When he saw a carafe of water, he
developed convulsive throat spasms. What tactics should an emergency doctor
choose?
 A. Deliver the patient to the infectious disease hospital
B. Deliver the patient to the resuscitation department
C. Deliver the patient to the neurological department
D. Deliver the patient to the psychiatric hospital
E. Let him stay at home and consult a psychiatrist
83. 116. 10 minutes after delivery a woman discharged placenta with a tissue defect
5х6 cm large. Discharges from the genital tracts were profuse and bloody. Uterus
tonus was low, fundus of uterus was located below the navel. Examination of
genital tracts revealed that the uterine cervix, vaginal walls, perineum were intact.
There was uterine bleeding with following blood coagulation. Your actions to stop
the bleeding:
A. To make manual examination of uterine cavity
B. To apply hemostatic forceps upon the uterine cervix
C. To introduce an ether-soaked tampon into the posterior fornix
D. To put an ice pack on the lower abdomen
E. To administer uterotonics
84. 124. A 24-year-old female patient complains of acute pain in the lower abdomen
that turned up after a physical stress. She presents with nausea, vomiting, dry mouth
and body temperature 36, 6oC. She has a right ovarian cyst in history. Bimanual
examination reveals that uterus is dense, painless, of normal size. The left fornix is
deep, uterine appendages aren’t palpable, the right fornix is contracted. There is a
painful formation on the right of uterus. It’s round, elastic and mobile. It is 7х8 cm
large. In blood: leukocytosis with the left shit. What is the most likely diagnosis?
A. Ovarian cyst with pedicle torsion
B. Right-sided pyosalpinx
C. Subserous fibromyoma of uterus
D. Acute metritis
E. Extrauterine pregnancy
85. 131. A parturient woman is 23 years old. Vaginal obstetric examination reveals full
cervical dilatation. There is no fetal bladder. Fetal head is in the plane of pelvic
outlet. Sagittal suture is in mesatipellic pelvis, anterior fontanel is closer to pubes.
The fetal head diameter in such presentation will be:
A. Suboccipito-bregmaticus
B. Fronto-occipitalis recta
C. Biparietal
D. Suboccipitio-frontalis
E. Mento-occipitalis
86. 140. A 28-years-old woman complains of nausea and vomiting about 10 times per
day. She has been found to have body weight loss and xerodermia. The pulse is 100
bpm. Body temperature is 37,2oC. Diuresis is low. USI shows 5-6 weeks of
pregnancy. What is the most likely diagnosis?
A. Moderate vomiting of pregnancy
B. Mild vomiting of pregnancy
C. I degree preeclampsia
D. Premature abortion
E. Food poisoning
87. 141. A full-term baby was born with body weight of 3200 g, body length of 50 cm,
Apgar score - 8-10 points. What is the optimum time for the first breast-feeding?
A. First 30 minutes
B. First 6 hours
C. First 24 hours
D. First 48 hours
E. After 48 hours
88. 150. A 22-year-old female patient complains of dull pain in her right iliac area that
she has been experiencing for a week, morning sickness and gustatory change. She
has a histrory of menstruation delay for 3 weeks. Objectively: AP-80/50 mm Hg,
pulse is 78 bpm, body temperature is 37oC. Bimanual examination reveals that
uterus is enlarged, soft, mobile and painless. Uterine appendages are palpable on
the right, there is a dense, elastic and moderately painful formation 3x4 cm large.
What is the most likely diagnosis?
A. Progressing fallopian pregnancy
B. Interrupted fallopian pregnancy
C. Right ovarian cyst
D. Uterogestation
E. Acute appendicitis
89. 154. A 25-year-old female patient complains about having amenorrhea for 3 years.
She associates it with difficult labour complicated by massive hemorrhage. She also
complains of loss of weight, hair fragility and loss, lack of appetite and depression.
Objective examination reveals no pathological changes of uterus and its
appendages. What is the desease pathogenesis?
A. Hypoproduction of gonadotropin
B. Hyperproduction of estrogens
C. Hyperproduction of androgens
D. Hypoproduction of progesterone
E. Hyperproduction of prolactin
90. 160. A 54-year-old female patient consulted a gynaecologist about bloody
discharges from the vagina for 1 month. Last menstruation was 5 years ago.
Gynaecological examination revealed no pathological changes. What is the tactics
of choice?
A. Diagnostic fractional curettage of uterine cavity
B. Colposcopy
C. USI
D. Cytosmear
E. Symptomatic therapy
91. 162. An ambulance delivered a 21-year-old woman to the gynaecological
department with complaints of colicky abdominal pain and bloody discharges from
the genital tracts. Bimanual examination revealed that uterus was soft, enlarged to
the size of 6 weeks of gestation, a gestational sac was palpated in the cervical canal.
Uterine appendages weren’t palpable. Fornices are free, deep and painless.
Discharges from the genital tracts are bloody and profuse. What is the most likely
diagnosis?
A. Abortion in progress
 B. Cervical pregnancy
C. Threat of abortion
D. Incipient abortion
E. Interrupted fallopian pregnancy
92. 164. On the fifth day after a casual sexual contact a 25-year-old female patient
consulted a doctor about purulent discharges from the genital tracts and itch.
Vaginal examination showed that vaginal part of uterine cervix was hyperemic and
edematic. There was an erosive area around the external orifice of uterus. There
were mucopurulent profuse discharges from the cervical canal, uterine body and
appendages exhibited no changes. Bacterioscopic examination revealed bean-
shaped diplococci that became red after Gram’s staining. What is the most likely
diagnosis?
A. Acute gonorrheal endocervicitis
B. Trichomonal colpitis
C. Candidal vulvovaginitis
D. Clamydial endocervicitis
E. Bacterial vaginism
93. 166. A 30-year-old female patient has been delivered to the gynaecological
department with complaints of acute pain in the lower abdomen and body
temperature 38, 8oC. In history: sexual life out of wedlock and two artificial
abortions. Gynaecological examination reveals no changes of uterine. The
appendages
are enlarged and painful on both sides. Vaginal discharges are purulent and
profuse.What study is required to confirm a diagnosis?
A. Bacteriological and bacterioscopic analysis
B. Hysteroscopy
C. Curettage of uterine cavity
D. Colposcopy
E. Laparoscopy
94. 194. A primigravida is 22 years old. She has Rh(-), her husband has Rh(+).
Antibodies to Rh weren’t found at 32 weeks of pregnancy. Redetermination of
antibodies to Rh didn’t reveal them at 35 weeks of pregnancy as well. How often
should the antibodies be determined hereafter?
A. Once a week
B. Once in two weeks
C. Once in three weeks
D. Montly
E. There is no need in further checks
95. 196. A 14-year-old girl complains of pain in vaginal area and lower abdomen that
last for 3-4 days and have been observed for 3 months about the same time. Each
time pain is getting worse. Objectively: mammary glands are developed, hairiness
corresponds to the age. The virginal membrane is intact, cyanotic and protruded.
She has never had menstruation. She has been diagnosed with primary amenorrhea.
What is the reason of amenorrhea?
A. Hymen atresia
B. Turner’s syndrome
 C. Babinski-Frohlich syndrome
D. Pregnancy
E. Sexual development delay
96. 14. A woman, primagravida, consults a gynecologist on 05.03.2012. A week ago
she felt the fetus movements for the first time. Last menstruation was on
10.01.2012. When should she be given maternity leave?
A. 8 August
B. 25 July
C. 22 August
D. 11 July
E. 5 September
97. 42. A 27-year-old woman presents at the maternity welfare centre because of
infertility. She has had sexual life in marriage for 4 years, doesn’t use
contraceptives. She hasn’t get pregnant. On examination: genital development is
without pathology, uterine tubes are passable, basal (rectal) temperature is one-
phase during last 3 menstrual cycles. What is the infertility cause?
A. Anovular menstrual cycle
B. Chronic adnexitis
C. Abnormalities in genital development
D. Immunologic infertility
E. Genital endometriosis
98. 50. A 25-year-old woman complains of profuse foamy vaginal discharges, foul,
burning and itching in genitalia region. She has been ill for a week. Extramarital
sexual life. On examination: hyperemia of vaginal mucous, bleeding on touching,
foamy leucorrhea in the urethral area. What is the most probable diagnosis?
A. Trichomonas colpitic
B. Gonorrhea
C. Chlamydiosis
D. Vagina candidomicosis
E. Bacterial vaginosis
99. 107. During the dynamic observation over a parturient woman in the second stage
of labor it was registered that the fetal heart rate fell down to 90-100/min and didn’t
come to normal after contractions. Vaginal examination revealed the complete
cervical dilatation, the fetal head filling the entire posterior surface of the pubic
symphysis and sacral hollow; the sagittal suture lied in the anteroposterior diameter
of the pelvic outlet, the posterior fontanelle was in front under the pubic arch. What
plan for further labour management should be recommended?
A. Application of forceps minor
B. Caesarean section
C. Episiotomy
D. Application of cavity forceps
E. Stimulation of labour activity by intravenous injection of oxytocin
100. 115. A child is 2 days old. He was born with a weight of 2900 kg, body length of 50
cm. On examination the skin is intensely red, elastic, with preserved turgor. Puerile
respiration is present. Respiration rate - 40/min, cardiac sounds are rhythmic,
sonorous. HR- 138/min. The abdomen is soft. The liver extends 2 cm below the
 costal margin. Diuresis is sufficient. Stool is in form of meconium. What is the
most likely diagnosis?
A. Physiological erythema of the newborn
B. Toxic erythema of the newborn
C. Neonatal phlegmon
D. Erysipelas
E. Exfoliative Ritter’s dermatitis
101. 117. A 28-year-old patient complains of discomfort, acute pain in the lower third of
the left labia majora. The disease began suddenly after menstruation. Objectively:
body temperature is 38oC. The left labia majora has a formation to 3 cm diameter,
with hyperemic surface, extremely painful to the touch, with symptoms of
fluctuation. What is the most likely diagnosis?
A. Acute bartholinitis
B. Vulvar cancer
C. Vulvar fibroid
D. Bartholin gland cyst
E. Hypertrophy of the labia
102. 118. A 40 week pregnant secundipara is 28 years old. Contractions are very active.
Retraction ring is at the level of navel, the uterus is hypertonic, in form of
hourglass. On auscultation the fetal heart sounds are dull, heart rate is 100/min. AP
of the parturient woman is 130/80 mm Hg. What is the most likely diagnosis?
A. Risk of hysterorrhexis
B. Mazolysis
C. Disturbed labour
D. Complete hysterorrhexis
E. Attack of eclampsia
103. 126. A 51-year-old patient complains of having intensive bloody discharges from
vagina for 15 days after delay of menstruation for 2,5 months. In anamnesis:
disorders of menstrual function during a year, at the same time she felt extreme
irritability and had sleep disorders. US examination results: uterus corresponds with
age norms, appendages have no pecularities, endometrium is 14 mm thick. What is
the doctor’s tactics?
A. Diagnostic curettage of uterine cavity
B. Conservative treatment of bleeding
C. Hysterectomy
D. Supravaginal amputation of uterus without appendages
E. TORCH-infection test
104. 137. A 28-year-old female patient complains of having haemorrhage from the
genital tracts for 1 month. 6 months ago she had natural delivery and gave birth to a
girl weighing 3100 g. Objectively: the uterus is enlarged to 9-10 weeks, mobile,
painless, of heterogenous consistency. Examination reveals vaginal cyanosis,
anaemia and body temperature rise up to 37, 8oC. There is a significant increase in
hCG concentration in the urine. What is your provisional diagnosis?
A. Uterine chorionepithelioma
B. Pregnancy
C. Hydatidiform mole
 D. Endometritis
E. Uterine fibromyoma
105. 152. The head of prenatal care department intends to complete expert evaluation of
compliance with medical and technological standards of pregnancy follow-up.
What documents must be verified for this
purpose?
A. Individual records of pregnant and postpartum women
B. Prenatal records
C. Medical records of outpatients
D. Labour and delivery record
E. Neonatal record
106. 161. A 10 week pregnant woman was admitted to a hospital for recurrent pain in
the lower abdomen, bloody discharges from the genital tracts. The problems turned
up after ARVI. The woman was registered for antenatal care. Speculum
examination revealed cyanosis of vaginal mucosa, clean cervix, open cervical canal
discharging blood and blood clots; the lower pole of the gestational sac was visible.
What tactics should be chosen?
A. Curettage of the uterus
B. Pregnancy maintenance therapy
C. Expectant management, surveillance
D. Hysterectomy
E. Antiviral therapy
107. 162. A 29-year-old patient complains of absent menstruation for a year, milk
discharge from the nipples when pressed, loss of lateral visual fields. X-ray shows
an expansion of the sella turcica. What is the most likely cause of this condition?
A. Pituitary tumour
B. Mammary tumour
C. Functional disorder of the hypothalamic-pituitary-ovarian system
D. Ovarian tumor
E. Pregnancy
108. 164. A patient with uterine fibromyoma sized up to 8-9 weeks of pregnancy
consulted a gynaecologist about acute pain in the lower abdomen. Examination
revealed pronounced positive symptoms of peritoneal irritation, high leukocytosis.
Vaginal examination revealed that the uterus was enlarged up to 9 weeks of
pregnancy due to the fibromatous nodes, one of which was mobile and extremely
painful. Appendages were not palpable. Discharges were mucous, coming in
moderate amounts. What is the treatment tactics?
A. Urgent surgery (laparotomy)
B. Surveillance and spasmolytic therapy
C. Fractional diagnostic curettage of the uterine cavity
D. Surgical laparoscopy
E. Surveillance and antibacterial therapy
109. 179. A multigravida with Rh-isosensitization was found to have a decrease in anti-
Rh titer from 1:32 to 1:8 at 33-34 weeks of gestation. Ultrasound revealed double
contour of head, ebnlargement of fetal liver, placental thickness of 50 mm. The
patient has indication for:
 A. Premature delivery
B. Course of desensitizing therapy
C. Plasmapheresis
D. Repeated (after 2 weeks) USI
E. Administration of anti-Rh gamma globulin
110. 182. A 27-year-old patient complains of irritability, tearfulness, depression, and
sometimes aggressiveness, headache, nausea, vomiting, swelling of the mammary
glands. The mentioned problems arise 5-6 days before menstruation and gradually
progress until menstruation, 3 days after it the problems disappear. What is the
most likely diagnosis?
A. Premenstrual syndrome
B. Premature pathological climacterium
C. Secondary psychogenic amenorrhea
D. Preclimacterium syndrome
E. Algomenorrhea
111. 187. On the 10th day postpartum a puerperant woman complains of pain and
heaviness in the left mammary gland. Body temperature is 38,8oC, Ps- 94 bpm. The
left mammary gland is edematic, the supero-external quadrant of skin is hyperemic.
Fluctuation symptom is absent. The nipples discharge drops of milk when pressed.
What is a doctor’s further tactics?
A. Antibiotic therapy, immobilization and expression of breast milk
B. Compress to both mammary glands
C. Inhibition of lactation
D. Physiotherapy
E. Opening of the abscess and drainage of the mammary gland
112. 188. A 30-year-old female patient complains of milk discharge from the mammary
glands, 5-month absence of menstruation. She had one physiological labour four
years ago. Objectively: mammary glands are normally developed. Bimanual
examination reveals that the uterus is decreased in size, the ovaries are of normal
size. MRI-scan shows no cerebral pathologies. Concentration of thyroid-stimulating
hormone is normal. The serum prolactin level is increased. What is the most likely
diagnosis?
A. Hyperprolactinemia
B. Hypothyroidism
C. Polycystic ovary syndrome
D. Pituitary adenoma
E. Sheehan syndrome
113. 189. During self-examination a 22-year old patient revealed a mammary tumour.
Palpation revealed a firm, painless, freely mobile formation up to 2 cm, peripheral
lymph nodes were not changed. USI results: in the superior external quadrant of the
right mammary gland there was a big formation of increased echogenicity, sized
18x17 mm. The patient was provisionally diagnosed with fibroadenoma. What is a
doctor’s further tactics?
A. Surgical removal of the tumour prior to pregnancy
B. Dynamic follow-up
C. Surgical treatment after pregnancy
 D. Radical mastectomy
E. Nonsteroid anti-inflammatory drugs, oral contraceptives
114. 1. A 28-year-old patient complains of infertility. The patient has been married for 4
years, has regular sexual life and does not use contraceptives but has never got
pregnant. Examination revealed normal state of the genitals, tubal patency. Basal
body temperature recorded over the course of 3 consecutive menstrual cycles
appeared to have a single phase. What is the most likely cause of infertility?
A. Anovulatory menstrual cycle
B. Immunological infertility
C. Genital endometriosis
D. Chronic salpingoophoritis
E. Ovulatory menstrual cycle
115. 26. Full-term pregnancy. Body weight of the pregnant woman is 62 kg. The fetus
has the longitudinal position, the fetal head is pressed against the pelvic inlet.
Abdominal circumference is 100 cm. Fundal height is 35 cm. What is the
approximate weight of the fetus?
A. 3 kg 500 g
B. 4 kg
C. 2 kg 500 g
D. 3 kg
E. 4 kg 500 g
116. 73. A 30-year-old multigravida has been in labour for 18 hours. 2 hours ago the
pushing stage began. Fetal heart rate is clear, rhythmic, 136/min. Vaginal
examination reveals the completecervical dilatation, the fetal head in the pelvic
outlet plane. Sagittal suture in line with obstetric conjugate, the occipital fontanel is
near the pubis. The patient has been diagnosed with primary uterine inertia. What is
the further tactics of labour management?
A. Outlet forceps
B. Labour stimulation
C. Cesarean section
D. Skin-head Ivanov’s forceps
E. Vacuum extraction of the fetus
117. 77. During her first visit to the prenatal clinic a pregnant woman was referred to
other doctors for mandatory consultation. The patient was refered to:
A. Internist, dentist
B. Internist, surgeon
C. Dentist, surgeon
D. Surgeon, oculist
E. Therapist, oculist
118. 98. A 28-year-old patient complains of profuse, painful and prolonged
menstruation. Before and after the menstrual period there is spotting lasting for 4-6
days. Vaginal examination reveals that the uterus is enlarged corresponding to 5-6
weeks of pregnancy, has limited mobility, is painful. Appendages are not palpable.
On the 15th day of the menstrual cycle, the uterus was of normal size, painless. On
account of stated problems and objective examination the patient has been
diagnosed with internal endometriosis. Which drug should be used for the efective
 treatment of this patient?
A. Duphaston
B. Synoestrolum
C. Parlodel
D. Ovidon
E.-
119. 109. A 27-year-old sexually active female complains of numerous vesicles on the
right sex lip, itch and burning. Eruptions regularly turn up before menstruation and
disappear 8-10 days later. What is the most likely diagnosis?
A. Herpes simplex virus
B. Bartholinitis
C. Primary syphilis
D. Cytomegalovirus infection
E. Genital condylomata
120. 137. A 37-year-old patient complains of acute pain in the region of genitals,
swelling of the labia, pain when walking. Objectively: body temperature is 38, 7oC,
Ps- 98/min. In the interior of the right labia there is a dense, painful tumour-like
formation 5,0x4,5 cm large, the skin and mucous membrane of genitals is
hyperemic, there are profuse foulsmelling discharges. What is the most likely
diagnosis?
A. Acute bartholinitis
B. Labial furuncle
C. Acute vulvovaginitis
D. Bartholin gland cyst
E. Carcinoma of vulva
121. 155. A multigravida at 39 weeks of gestation has been delivered to a hospital
having a regular labour activity for 8 hours, the waters burst an hour ago. She
complains of headache, seeing spots. AP is of 180/100 mm Hg. Urine test results:
protein - 3,3 g/l, hyaline cylinders. Fetal heart rate is 140/min, rhythmical. Vaginal
examination reveals complete crevical dilatation, the fetal head is on the pelvic
floor, sagittal suture is in line with obstetric conjugate, the occipital fontanel is
under the pubis. What is the optimal tactics of labour management?
A. Outlet forceps
B. Cavity forceps
C. Cesarean section
D. Vacuum extraction of the fetus
E. Conservative labour management
122. 159. A patient complains of being unable to get pregnant for 5 years. A complete
clinical examination gave the following results: hormonal function is not impaired,
urogenital infection hasn’t been found, on hysterosalpingography both tubes were
filled with the contrast medium up to the isthmic segment, abdominal contrast was
not visualized. The patient’s husband is healthy. What tactics will be most
effective?
A. In-vitro fertilization
B. Insemination with husband’s sperm
C. ICSI within in-vitro fertilization program
 D. Hydrotubation
E. Laparoscopic tubal plasty
123. 167. A 13-year-old girl was admitted to the gynecological department with heavy
bleeding, which appeared after a long delay of menstruation. Shortly before, the girl
suffered a serious psychotrauma. Her menarche occurred at the age of 11, she has a
30-day cycle with 5 to 6 days of moderate, painless bleeding. The patient is
somatically healthy, of normosthenic constitution with height of 160 cm, weight of
42 kg. The patient is pale. Rectoabdominal examination revealed that the uterus
was of normal size and consistency, anteflexio-versio, the appendages were not
changed. What is the most likely diagnosis?
A. Juvenile bleeding
B. Ovarian cyst
C. Hysteromyoma
D. Girl is healthy
E. Amenorrhea
124. 170. A 22-year-old patient complains of amenorrhea for 8 months. Menarche
occured at the age of 12,5. Since the age of 18 the patient has a history of irregular
menstruation. The patient is nulligravida. The mammary glands are developed
properly, nipples discharge drops of milk when pressed. Gynecological study
results: prolactin level is 2 times higher than normal. CT reveals a bulky formation
with a diameter of 4 mm in the region of sella. What is the most likely diagnosis?
A. Pituitary tumour
B. Lactational amenorrhea
C. Stein-Leventhal syndrome
D. Sheehan’s syndrome
E. Pituitary basophilia
125. 171. A 38-year-old female patient complains about hot flashes and feeling of
intense heat arising up to 5 times a day, headaches in the occipital region along with
high blood pressure, palpitations, dizziness, fatigue, irritability, memory
impairment. 6 months ago the patient underwent extirpation of the uterus with its
appendages. What is the most likely diagnosis?
A. Post-castration syndrome
B. Premenstrual syndrome
C. Early pathological menopause
D. Secondary psychogenic amenorrhea
E. Physiological premenopause
126. 177. 20 minutes after a normal delivery at 39 weeks a puerpera had a single
temperature rise up to 38oC. Objectively: the uterus is dense, located between the
navel and the pubis, painless. Lochia are bloody, of small amount. Breasts are
moderately soft and painless. What is the optimal tactics?
A. Further follow-up
B. Antibiotic therapy
C. Appointment antipyretic
D. Manual examination of the uterine cavity
E. Expression of breast
127. 180. A 55-year-old patient whose menstruation stopped 5 years ago complains of
 vaginal dryness, frequent and painful urination. Gynecologist revealed signs of
atrophic colpitis. Urine analysis revealed no peculiarities. Which locally acting
product will provide the proper therapeutic effect?
A. Vaginal suppositories "Ovestin"
B. Vaginal tablets "Tergynan"
C. Vaginal cream "Meratin Combi"
D. Vaginal gel "Metronidazole"
E. Vaginal cream "Dalacin"
128. 189. A 49-year-old patient complains of itching, burning in the external genitals,
frequent urination. The symptoms has been present for the last 7 months. The
patient has irregular menstruation, once every 3-4 months. Over the last 2 years she
presents with hot flashes, sweating, sleep disturbance. Examination revealed no
pathological changes of the internal reproductive organs. Complete blood count and
urinalysis showed no pathological changes. Vaginal smear contained 20- 25
leukocytes in the field of vision, mixed flora. What is the most likely diagnosis?
A. Menopausal syndrome
B. Cystitis
C. Trichomonas colpitis
D. Vulvitis
E. Bacterial vaginosis
129. 191. 2 weeks after labour a parturient woman developed breast pain being observed
for 3 days. Examination revealed body temperature at the rate of 39oC, chills,
weakness, hyperaemia, enlargement, pain and deformity of the mammary gland. On
palpation the infiltrate was found to have an area of softening and fluctuation. What
is the most likely diagnosis?
A. Infiltrative-purulent mastitis
B. Phlegmonous mastitis
C. Lactostasis
D. Serous mastitis
E. Mastopathy
130. 195. A puerpera breastfeeding for 1,5 weeks consulted a doctor about uniform
breast engorgement. Breasts are painful. The body temperature is of 36, 6oC. Milk
expressing is difficult. What is the most likely diagnosis?
A. Lactostasis
B. Infiltrative mastitis
C. Purulent mastitis
D. Fibrocystic mastopathy
E. Gangrenous mastitis
131. 199. Examination of a Rh-negative pregnant woman at 32 weeks of gestation
revealed a four-time rise of Rh-antibody titer within 2 weeks, the titer was 1:64. In
the first two pregnancies the patienthad experienced antenatal fetal death due to
hemolytic disease. What is the optimal tactics of pregnancy management?
A. Early delivery
B. Delivery at 37 weeks of gestation
C. Screening for Rh-antibodies 2 weeks later and early delivery in case of further
titer rise
 D. Introduction of anti-Rh (D) immunoglobulin
E. Ultrasound for signs of hemolytic disease of the fetus
132. 2. A 50-year-old female patient complains of aching pain in the lower abdomen.
She has a history of normal menstrual cycle. At the age of 40, the patient underwent
a surgery for gastric ulcer. Examination findings: abdomen is soft, in the
hypogastrium there is a welldefined nodular tumor of limited mobility. Vaginal
examination findings: the cervix is clean, of cylindrical shape. Body of the uterus
cannot be palpated separately. On both sides of the uterus palpation reveals tight
tumors with an uneven surface. The tumors are immobile andl fill the whole pelvic
cavity. What is the most likely diagnosis?
A. Krukenberg tumor
B. Ovarian fibroid
C. Ovarian granulosa cell tumor
D. Bilateral pioovarium
E. Subserous metrofibroma
133. 11. A 13-year-old girl was admitted to the gynecology department for having a
signifi- cant bleeding from the genital tract for 10 days. The patient has a history of
irregular menstrual cycle since menarche. Menarche occurred at the age of 11.
Recto-abdominal examination revealed no pathology. What is the provisional
diagnosis?
A. Juvenile uterine bleeding
B. Adenomyosis
C. Injury of the external genitalia
D. Werlhof’s disease
E. Endometrial polyp
134. 18. A 21-year-old female patient consulted a gynecologist about itching, burning,
watery vaginal discharges with a fish-like smell. Speculum examination revealed
that the cervical and vaginal mucosa was of a normal pink color. Vaginal
examination revealed no alterations of the uterus and appendages. Gram-stained
smears included clue cells. What is the most likely pathology?
A. Bacterial vaginosis (gardnerellosis)
B. Chlamydiosis
C. Gonorrhea
D. Trichomoniasis
E. Candidiasis
135. 20. A 26-year-old secundipara at 40 weeks of gestation arrived at the maternity
ward after the beginning of labor activity. 2 hours before, bursting of waters
occurred. The fetus was in a longitudinal lie with cephalic presentation. Abdominal
circumference was 100 cm, fundal height - 42 cm. Contractions occurred every 4-5
minutes and lasted 25 seconds each. Internal obstetric examination revealed
cervical effacement, opening by 4 cm. Fetal bladder was absent. Fetal head was
pressed against the pelvic inlet. What complication arose in childbirth?
A. Early amniorrhea
B. Primary uterine inertia
C. Secondary uterine inertia
D. Discoordinated labor
 E. Clinically narrow pelvis
136. 34. A 25-year-old female patient complains of marked weakness, sleepiness,
blackouts, dizziness, taste disorder. The patient has a history of menorrhagia.
Objectively: the patient has marked weakness, pale skin, cracks in the corners of
mouth, peeling nails, systolic apical murmur. Blood test results: RBC - 3, 4 ·
1012/l, Hb- 70 g/l, color index - 0,75, platelets - 140 · 109/l, WBC- 6, 2 · 109/l.
What is the most likely diagnosis?
A. Chronic posthemorrhagic anemia
B. Acute leukemia
C. Acute posthemorrhagic anemia
D. B12-deficiency anemia
E. Werlhof’s disease
137. 58. A 28-year-old female patient has been admitted to the gynecology department
for abdominal pain, spotting before and after menstruation for 5 days. The disease
is associated with the abortion which she had 2 years ago. Anti-inflammatory
treatment had no effect. Bimanual examination findings: the uterus is enlarged,
tight, painful, smooth. Hysteroscopy reveals dark red holes in the fundus with dark
blood coming out of them. What diagnosis can be made on the grounds of these
clinical presentations?
A. Inner endometriosis
B. Polymenorrhea
C. Hypermenorrhea
D. Submucous fibromatous node
E. Dysfunctional uterine bleeding
138. 77. A woman at 30 weeks pregnant has had an attack of eclampsia at home. On
admission to the maternity ward AP- 150/100 mm Hg. Predicted fetal weight is
1500 g. There is face and shin pastosity. Urine potein is 0, 66o/oo. Parturient canal
is not ready for delivery. An intensive complex therapy has been started. What is
the correct tactics of this case management?
A. Delivery by cesarean section
B. Continue therapy and prolong pregnancy for 1-2 weeks
C. Continue therapy and prolong pregnancy for 3-4 weeks
D. Labor induction by intravenous oxytocin or prostaglandins
E. Treat preeclampsia and achieve the delivery by way of conservative management
139. 103. A 36-year-old female pesented to a gynecological hospital with a significant
bleeding from the genital tract and a 1-month delay of menstruation. Bimanual
examination revealed soft barrel-shaped cervix. Uterus was of normal size,
somewhat softened. Appendages were unremarkable on both sides. Speculum
examination revealed that the cervix was cyanotic, enlarged, with the the external
orifice disclosed up to 0,5 cm. Urine hCG test was positive. What is the most likely
diagnosis?
A. Cervical pregnancy
B. Uterogestation
C. Abortion in progress
D. Threatened miscarriage
E. Ectopic pregnancy
140. 114. An 18-year-old girl complains of breast pain and engorgement, headaches,
irritability, swelling of the lower extremities. These symptoms have been observed
since menarche and occur 3-4 days before the regular menstruation. Gynecological
examination revealed no pathology. Make a diagnosis:
A. Premenstrual syndrome
B. Neurasthenia
C. Renal disease
D. Mastopathy
E. Cardiovascular disorder
141. 120. A 25-year-old female presented to a women’s welfare clinic and reported the
inability to get pregnant within 3 years of regular sexual activity. Examination
revealedincreased body weight, male pattern of pubic hair growth, excessive pilosis
of thighs, dense enlarged ovaries, monophasic basal temperature. What is the most
likely diagnosis?
A. Polycystic ovarian syndrome
B. Adnexitis
C. Adrenogenital syndrome
D. Premenstrual syndrome
E. Gonadal dysgenesis
142. 122. A 23-year-old female consulted a gynecologist on the 20th day postpartum
period about pain in the left breast, purulent discharge from the nipple. Objectively:
Ps- 120/min, t - 39 C. The left breast is painful, larger than the right one,
hyperemic. In the upper quadrant there is an infiltrate sized 10x15 cm with a
softening inside. Blood test results: ESR- 50 mm/h, WBC- 15, 0 · 109/l. What is the
tactics of choice?
A. Refer to the surgical department for operative treatment
B. Refer to the gynecology department
C. Refer to the postpartum department
D. Refer to a polyclinic surgeon for conservative treatment
E. Lance the breast abscess in the women’s health clinic
143. 129. A puerperant is 28 years old. It’s the 3rd day post-partum after a second,
normal, term delivery. The body temperature is of 36, 8oC, Ps- 72/min, AP- 120/80
mm Hg. Mammary glands are moderately engorged, the nipples are clean.
Abdomen is soft, painless. The fundus is 3 fingers’ breadth below the navel.
Moderate bloody lochia are present. What diagnosis can be made?
A. Physiological course of the postpartum period
B. Subinvolution of uterus
C. Postpartum metroendometritis
D. Remains of placental tissue after childbirth
E. Lactostasis
144. 130. A 29-year-old unconscious patient has been delivered to a hospital.
Objectively: skin and mucous membranes are pale, cyanotic, breath sounds are
dramatically diminished on the right and cannot be auscultated in the lower parts, at
the level of the 6 rib along the anterior axillary line there is a wound hole with
moderate bleeding and passage of air during inspiration. Radiography reveals a
bullet in the pleural cavity. What is the medical tactics of choice?
 A. Emergency thoracotomy
B. Thoracoscopy with removal of bullet
C. Converting a tension pneumothorax into a simple (open) pneumothorax
D. Thoracostomy
E. Tight bandage on a wound
145. 135. As a result of a road accident a 45- year-old male patient got multiple injuries,
namely closed fractures of the right humerus and the left antebrachial bones with a
displacement of bone fragments, a closed blunt abdominal injury. The patient was
delivered to the emergency department 30 minutes after the injury. Objectively: the
skin is pale. AP- 90/20 mm Hg, there is pain and deformation at the fracture sites.
Abdomen is tense, palpation causes severe pain, there is rebound tenderness
(positive Blumberg’s sign). What is the treatment tactics of choice?
A. Urgent diagostic laparotomy
B. Infusion therapy to stabilize blood pressure
C. Fracture immobilization, analgesia
D. Local anesthetic blockade of fractures
E. Additional tests to specify the diagnosis
146. 141. A puerperant is 32 years old, it’s her first childbirth, term precipitate labor, the
III period is unremarkable, the uterus is contracted, tight. Examination of the birth
canal revealed a rupture in the left posterior vaginal wall that was closed with
catgut. Two hours later, the patient complained of a feeling of pressure on the anus,
pain in the perineum, minor vaginal discharges, edema of the vulva. These clinical
presentations are indicative most likely of:
A. Vaginal hematoma
B. Hysterocervicorrhexis
C. Hemorrhoids
D. Hysterorrhesis
E. Hypotonic bleeding
147. 144. A 31-year-old female patient complains of infertility, amenorrhea for 2 years
after the artificial abortion that was complicated by endometritis. Objectively:
examination of the external genitalia revals no pathology, there is female pattern of
hair distribution. According to the functional tests, the patient has biphasic
ovulatory cycle. What form of infertility is the case?
A. Uterine
B. Ovarian
C. Pituitary
D. Hypothalamic
E. Immunological
148. 161. A 19-year-old primiparous woman with a body weight of 54,5 kg gave birth at
38 weeks gestation to a full-term live girl after a normal vaginal delivery. The girl’s
weight was 2180,0 g, body length - 48 cm. It isknown from history that the woman
has been a smoker for 8 years, and kept smoking during pregnancy. Pregnancy was
complicated by moderate vomiting of pregnancy from 9 to 12 weeks pregnant,
edemata of pregnancy from 32 to 38 weeks. What is the most likely cause of low
birth weight?
A. Fetoplacental insufficiency
 B. Low weight of the woman
C. Woman’s age
D. First trimester preeclampsia
E. Third trimester preeclampsia
149. 177. A 23-year-old primigravida at 39 weeks gestation has been admitted to the
maternity ward with irregular contractions. The intensity of uterine contractions is
not changing, the intervals between them stay long. Bimanual examination reveals
that the cervix is centered, soft, up to 1,5 cm long. There is no cervical dilatation.
What diagnosis should be made?
A. Pregnancy I, 39 weeks, preliminary period
B. Pregnancy I, 39 weeks, labor I, 1 period, the latent phase
C. Pregnancy I, 39 weeks, labor I, period 1, the active phase
D. Pregnancy I, 39 weeks, birth I, 1 period, the acceleration phase
E. Pregnancy I, 39 weeks, pathological preliminary periodrvical dilatation
150. 184. During the breast self-exam a 37-year-old female patient revealed a lump in
the lower inner quadrant of her left breast. Palpation confirms presence of a mobile
well-defined neoplasm up to 2 cm large. Peripheral lymph nodes are not changed.
What is the way of further management?
A. Ultrasound examination of breasts, mammography, fine-needle aspiration biopsy
B. Anti-inflammatory therapy, physiotherapy
C. Radical mastectomy
D. Ultrasound monitoring of genitals during the entire course of antiestrogens
therapy, systemic enzyme therapy, phytotherapy
E. Case follow-up
151. 186. A 25-year-old female has a self-detected tumor in the upper outer quadrant of
her right breast. On palpation there is a painless, firm, mobile lump up to 2 cm in
diameter, peripheral lymph nodes are not changed. In the upper outer quadrant of
the right breast ultrasound revealed a massive neoplasm with increased
echogenicity sized 21x18 mm. What is the most likely diagnosis?
A. Fibroadenoma
B. Lactocele
C. Diffuse mastopathy
D. Mammary cancer
E. Mastitis
152. 193. On admission a 35-year-old female reports acute abdominal pain, fever up to
38, 8oC, mucopurulent discharges. The patient is nulliparous, has a history of 2
artificial abortions. The patient is unmarried, has sexual contacts. Gynecological
examination reveals no uterus changes. Appendages are enlarged, bilaterally
painful. There is profuse purulent vaginal discharge. What study is required to
confirm the diagnosis?
A. Bacteriologic and bacteriascopic studies
B. Hysteroscopy
C. Curettage of uterine cavity
D. Vaginoscopy
E. Laparoscopy
153. 194. A 20-year-old female consulted a gynecologist about not having menstrual
 period for 7 months. History abstracts: early childhood infections and frequent
tonsillitis, menarche since 13 years, regular monthly menstrual cycle of 28 days,
painless menstruation lasts 5-6 days. 7 months ago the patient had an emotional
stress. Gynecological examination revealed no alterations in the uterus. What is the
most likely diagnosis?
A. Secondary amenorrhea
B. Primary amenorrhea
C. Algomenorrhea
D. Spanomenorrhea
E. Cryptomenorrhea
154. 195. A 48-year-old female has been admitted to the gynecology department for pain
in the lower right abdomen and low back pain, constipations. Bimanual
examination findings: the uterus is immobile, the size of a 10-week pregnancy, has
uneven surface. Aspirate from the uterine cavity contains atypical cells. What
diagnosis can be made?
A. Hysterocarcinoma
B. Cervical cancer
C. Metrofibroma
D. Colon cancer
E. Chorionepithelioma
155. 4. A primagravida with pregnancy of 37-38 weeks complains of headache, nausea,
pain in epigastrium. Objectively: the skin is acyanotic. Face is hydropic, there is
short fibrillar twitching of blepharons, muscles of the face and the inferior
extremities. The stare is fixed. BP - 200/110 mm Hg; sphygmus is of 92 bpm,
intense. Respiration rate is 32/min. Heart activity is rhythmical. Appreciable
edemas of the inferior extremities are present. Urine is cloudy. What medication
should be administered?
A. Droperidolum of 0,25% - 2,0 ml
B. Dibazolum (Bendazole hydrochloride) of 1% - 6,0 ml
C. Papaverine hydrochloride of 2% - 4,0 ml
D. Hexenalum of 1% - 2,0 ml
E. Pentaminum of 5% - 4,0 ml
156. 70. A 28-year-old woman has bursting pain in the lower abdomen during
menstruation; chocolate-like discharges from vagina are observed. It is known from
the anamnesis that the patient suffers from chronic adnexitis. Bimanual
examination revealed a tumour-like formation of heterogenous consistency 7х7 cm
large to the left from the uterus. The formation is restrictedly movable, painful
when moved. What is the most probable diagnosis?
A. Endometrioid cyst of the left ovary
B. Follicular cyst of the left ovary
C. Fibromatous node
D. Exacerbation of chronic adnexitis
E. Tumour of sigmoid colon
157. 81. A 30-year-old parturient woman was delivered to a maternity hospital with full-
term pregnancy. She complains of severe lancinating pain in the uterus that started
1 hour ago, nausea, vomiting, cold sweat. Anamnesis states cesarean section 2 years
 ago. Uterine contractions stopped. Skin and mucous membranes are pale. Heart rate
is 100/min, BP is 90/60 mm Hg. Uterus has no clear margins, is sharply painful. No
heartbeat can be auscultated in the fetus. Moderate bloody discharge from the
uterus can be observed. Uterus cervix is 4 cm open. Presenting part is not visible.
The most likely diagnosis is:
A. Uterine rupture
B. Initial uterine rupture
C. Threatened uterine rupture
D. Premature detachment of normally positioned placenta
E. Compression of inferior pudendal vein
158. 101. A 26-year-old woman has attended maternity center complaining of her
inability to become pregnant despite 3 years of regular sex life. Examination
revealed the following: increased body weight; male-type pubic hair; excessive
pilosis of thighs; ovaries are dense and enlarged; basal body temperature is
monophasic. The most likely diagnosis is:
A. Ovaries sclerocystosis
B. Inflammation of uterine appendages
C. Adrenogenital syndrome
D. Premenstrual syndrome
E. Gonadal dysgenesis
159. 104. A woman consulted a therapeutist about fatigability, significant weight loss,
weakness, loss of appetite. She has been having amenorrhea for 8 months. A year
ago she born a full-term child. Haemorrhage during labour made up 2 l. She got
blood and blood substitute transfusions. What is the most probable diagnosis?
A. Sheehan’s syndrome
B. Stein-Leventhal syndrome
C. Shereshevsky-Turner’s syndrome
D. Homological blood syndrome
E. Vegetovascular dystonia
160. 154. A 20-year-old parturient woman has the I labor stage. The pregnancy is full-
term. Labors occur every 3 minutes and last for 55 seconds. Fetus presentation is
polar, the head is pressed to the small pelvis entrance. Heart rate of the fetus is
150/min, distinct and rhythmic. Vagina examination: uterus cervix is smoothed out;
mouth of the womb is 2 cm open; fetal bladder is intact; the head is presented over
the I plane of small pelvis; moderate mucous-bloody discharge is observed. What
phase of the I labor stage is it?
A. Latent
B. Active
C. Slowing-down
D. Physiological preliminary period
E. Primary uterine inertia
161. 170. A 22-year-old patient complains of 8-months-long delay of menstruation.
Anamnesis: menarche since the age of 12,5. Since the age of 18 menstruations are
irregular. No pregnancies. Mammary glands have normal development; when the
nipples are pressed, milk drops are discharged. On gynecological examination:
moderate uterus hypoplasia. On hormonal examination: prolactin level exceeds the
 norm two times. On computed tomogram of the sellar region: a space-occupying
lesion 4 mm in diameter is detected. The most likely diagnosis is:
A. Pituitary tumor
B. Lactation amenorrhea
C. Stein–Leventhal syndrome (Polycystic ovary syndrome)
D. Sheehan’s syndrome
E. Cushing’s disease
162. 181. A 25-year-old patient during selfexamination detected a tumor in the upper
external quadrant of the right mammary gland. On palpation: painless, dense,
mobile growth 2 cm in diameter is detected in the mammary gland; no changes in
the peripheral lymph nodes are observed. On mammary glands US: in the upper
external quadrant of the right mammary gland there is a space-occupying lesion of
increased echogenicity 21х18 mm in size. The most likely diagnosis is:
A. Fibrous adenoma
B. Lacteal cyst
C. Diffuse mastopathy
D. Breast cancer
E. Mastitis
163. 190. An Rh-negative woman with 32-weeklong term of pregnancy has been
examined. It was observed that Rh-antibodies titer had increased four times within
the last 2 weeks and was 1:64. First two pregnancies ended in antenatal death of
fetus caused by hemolytic disease. What tactics of pregnancy management should
be chosen?
A. Preterm delivery
B. Delivery at 37 weeks term
C. Rh-antibody test in 2 weeks; if Rh-antibodies increase in number conduct
delivery
D. Introduction of anti-Rh immunoglobulin
E. US examination to determine signs of fetal erythroblastosis
164. 98. A 30-year-old woman complains of irregular copious painful menstruations,
pain irradiates to the rectum. Anamnesis states 10- year-long infertility. On
bimanual examination: uterus is of normal size; uterine appendages on the both
sides are corded, with rectricted mobility, painful; there are dense nodular painful
growths detected in the posterior fornix. A doctor suspects endometriosis. What
method allows to verify this diagnosis?
A. Laparoscopy
B. Diagnostic curettage of uterine cavity
C. Paracentesis of posterior fornix
D. Uterine probing
E. Hysteroscopy
165. 200. A 30-year-old woman complains of infertility during her 10-year-long married
life. Menstruations occur since she was 14 and are irregular, with delays up to a
month and longer. Body mass is excessive. Hirsutism is observed. On bimanual
examination: uterine body is decreased in size; ovaries are increased in size, dense,
painless, and mobile. The most likely diagnosis is:
A. Stein–Leventhal syndrome (Polycystic ovary syndrome)
 B. Follicular cyst of ovaries
C. Genital endometriosis
D. Genital tuberculosis
E. Inflammatory tumor of ovaries
166. 5. A woman complains of muscle weakness and general fatigue, dyspnea, vertigo,
brittleness of her hair and nails, an urge to eat chalk. Anamnesis states uterine
fibroid. Common blood analysis: erythrocytes - 2,8 Т/l, Hb- 80g/l, color index-
0,78, anisocytosis, poikilocythemia, serum iron - 10 mcmol/l. What diagnosis is
most likely?
A. Iron-deficiency anemia
B. B12-deficientanemia
C. Autoimmune hemolytic anemia
D. Aplastic anemia
E. Hypoplastic anemia
167. 13. A pregnant woman is 28 years old. Anamnesis: accelerated labor complicated
by the II degree cervical rupture. The following two pregnancies resulted in
spontaneous abortions at the terms of 12 and 14 weeks. On mirror examination: the
uterine cervix is scarred from previous ruptures at 9 and 3 hours, the cervical canal
is gaping. On vaginal examination: the cervix is 2 cm long, the external orifice is
open 1cm wide, the internal orifice is half-open; the uterus is enlarged to the 12th
week of pregnancy, soft, mobile, painless, the appendages are without changes.
What diagnosis would you make?
A. Isthmico-cervical insufficiency, habitual noncarrying of pregnancy
B. Threatened spontaneous abortion
C. Incipient abortion, habitual noncarrying of pregnancy
D. Cervical hysteromyoma, habitual noncarrying of pregnancy
E. Cervical pregnancy, 12 weeks
168. 25. An infant has been born at the 41st week of gestation. The pregnancy was
complicated with severe gestosis of the second semester. The weight of the baby is
2400 g, the height is 50cm. Objectively: the skin is flabby, the layer of
subcutaneous fat is thin, hypomyotonia, neonatal reflexes are weak. The internal
organs are without pathologic changes. This newborn can be estimated as a:
A. Full-term infant with prenatal growth retardation
B. Premature infant
C. Immature infant
D. Postmature infant
E. Full-term infant with normal body weight
169. 45. A full term baby born from the 1st noncomplicated pregnancy with complicated
labor was diagnosed with cephalohematoma. On the 2nd day of life the child
developed jaundice; on the 3rd day of life there appeared neurological changes:
nystagmus, Graefe syndrome. Urine is yellow, feces are goldenyellow. The
mother’s blood group is А (II) Rh−, the child’s - А (II) Rh+. On the 3rd day the
results of the child’s blood test are as follows: Hb- 200g/l, erythrocytes-6,1·1012/l,
blood bilirubin - 58 mcmol/l due to the presence of its unconjugated fraction, Ht-
0,57. In this case the jaundiceis caused by:
A. Craniocerebral birth injury
 B. Physiologic jaundice
C. Hemolytic disease of newborn
D. Atresia of bile passages
E. Fetal hepatitis
170. 50. A 26-year-old woman, who gave birth 7 months ago, has been suffering from
nausea, morning sickness, somnolence for the last 2 weeks. The patient breasfeeds;
no menstruation. She has been using no means of contraception. What method
would be most efficient in clarification of the diagnosis?
A. Ultrasound
B. Small pelvis radiography
C. Palpation of mammary glands and squeezing out colostrum
D. Bimanual abdominovaginal examination
E. Mirror examination
171. 90. A parturient woman is 23 years old. Internal obstetric examination shows the
uterine cervix to be completely open. Fetal bladder is absent. Cephalic presentation
is observed in the plane of the small pelvic outlet. Sagittal suture is at the
longitudinal section of the small pelvic outlet, small fontanel is situated closer to
the uterus. What cephalic position will the newborn have during birth in this case?
A. Minor oblique lie
B. Longitudinal lie
C. Transverse lie
D. Medium oblique lie
E. Major oblique lie
172. 93. A 16-year-old girl has primary amenorrhea, no pubic hair growth, normally
developed mammary glands; her genotype is 46 ХY; uterus and vagina are absent.
What is your diagnosis?
A. Testicular feminization syndrome
B. Mayer-Rokitansky-Kuster-Hauser syndrome
C. Cushing’s syndrome
D. Sheehan syndrome
E. Cushing’s disease
173. 96. A 35-year-old woman addressed a gynecological in-patient department with
complaints of regular pains in her lower abdomen, which increase during
menstruation, and dark-brown sticky discharge from the genital tracts. On bimanual
examination: the uterine body is slightly enlarged, the appendages are not palpated.
Mirror examination of the uterine cervix reveals bluish spots. What diagnosis is
most likely?
A. Cervical endometriosis
B. Cervical erosion
C. Cervical polyp
D. Cervical cancer
E. Cervical fibroid
174. 98. A baby was born by a young smoker. The labour was complicated by uterine
inertia, difficult delivery of the baby’s head and shoulders. The baby’s Apgar score
was 4. Which of the following is a risk factor for a spinal cord injury?
A. Difficult delivery of the head and shoulders
 B. Young age of the mother
C. Pernicious habits
D. Uterine inertia
E. Chronic hypoxia
175. 103. A 25-year-old woman complains of menstruation retention lasting for 3 years.
The patient explains it by a difficult childbirth complicated with profuse
hemorrhage, weight loss, brittleness and loss of hair, loss of appetite, depression.
Objective examination reveals no pathologic changes of uterus and uterine
appendages. What pathogenesis is characteristic of this disorder?
A. Decreased production of gonadotropin
B. Hyperproduction of estrogen
C. Hyperproduction of androgen
D. Decreased production of progesterone
E. Hyperproduction of prolactin
176. 108. A woman addressed a gynecologist on the 20th day of puerperal period with
complaints of pain in the left mammary gland, puruent discharge from the nipple.
Objectively: Ps- 120/min., body temperature is 39 0C. The left mammary gland is
painful, larger than the right one, the skin there is hyperemic; in the upper quadrant
there is an infiltrate 10x15 cm in size with soft center. Blood test: ESR50 mm/hour,
leukocytes - 15,0·10 9/l. What would be the treatment tactics?
A. Transfer to a surgical department for surgical treatment
B. Refer to a gynecology department
C. Refer to a postnatal department
D. Refer to a surgeon for conservative treatment
E. Lance the mammary gland abscess in a maternity department
177. 145. An 18-year-old woman complains of pains in her lower abdomen, purulent
discharge from the vagina, temperature rise up to 37,8oC. Anamnesis states that she
had random sexual contact the day before the signs appeared. She was diagnosed
with acute bilateral adnexitis. On additional examination: leukocytes in the all field
of vision, bacteria, diplococci with intracellular and extracellular position. What
agent is most likely in the given case?
A. Gonococcus
B. Colibacillus
C. Chlamydia
D. Trichomonad
E. Staphylococcus
178. 149. A 32-year-old woman addressed a maternity clinic with complaints of
infertility that has been lasting for 7 years. Her menstrual cycle occurs in two
phases. Hysterosalpingography reveals obstruction of the uterine tubes in the
ampullar areas, an adhesive process in the small pelvis can be observed. What
treatment is most advisable in this case?
A. Laparoscopy
B. Laparotomy
C. Tubectomy
D. Adnexectomy
E. Hydrotubation
179. 154. A child from primipregnancywas bornin a term labor and has body weight of
4000 g and body length of 57 cm. When born, he was nonresponsive to
examination. Diagniosis is diffuse. Heartrate is 80/min. What resuscitation
measures should be taken?
A. Begin ALV with mask
B. Introduce 100% oxygen
C. Intubate and begin ALV
D. Tactile stimulation
E. Administer naloxone
180. 157. A 6-year-old girl attended a general practitioner with her mother. The child
complains of burning pain and itching in her external genitalia. The girl was taking
antibiotics the day before due to her suffering from acute bronchitis. On
examination: external genitalia are swollen, hyperemic, there is white deposit
accumulated in the folds. The most likely diagnosis is:
A. Candidal vulvovaginitis
B. Trichomoniasis
C. Nonspecific vulvitis
D. Helminthic invasion
E. Herpes vulvitis
181. 184. An 18-year-old woman complains of mammary glands swelling, headaches,
tearfulness, abdominal distension occurring the day before menstruation. The
symptoms disappear with the beginning of menstruation. Menstruations are regular,
last for 5-6 days with interval of 28 days in between. Gynecological examination
revealed no changes of internal genitals. What is your diagnosis?
A. Premenstrual syndrome
B. Sheehan syndrome
C. Stein-Leventhal syndrome
D. Asherman’s syndrome
E. Adrenogenital syndrome
182. 198. On the 9th day after childbirth the obstetric patient developed high fever up to
38 0C. She complains of pain in the right mammary gland. The examination
revealed the following: a sharply painful infiltrate can be palpated in the right
mammary gland, the skin over the infiltrate is red, subareolar area and nipple are
swollen and painful. What is your diagnosis?
A. Abscess of the right mammary gland
B. Mastopathy
C. Cancer of the right mammary gland
D. Serous mastitis
E. Fibrous cystic degeneration of the right mammary gland
183. 4. A 28-year-old woman has been delivered to a hospital with acute pain in the
lower abdomen. There was a brief syncope. The delay of menstruation is 2 months.
Objectively: the patient has pale skin, BP- 90/50 mm Hg,Ps-110/min. Lower
abdomen is extremely painful. Vaginal examination reveals uterus enlargement.
Promtov’s sign (pain during bimanual gynecological examination) is positive. Right
uterine appendages are enlarged and very painful. Posterior vault hangs over. What
is the most likely diagnosis?
 A. Right-sided tubal pregnancy
B. Right ovary apoplexy
C. Acute right-sided salpingoophoritis
D. Pelvioperitonitis
E. Incipient abortion
184. 10. A parturient woman complains of pain in her mammary gland. In the painful
area there is an infiltration 3x4 cm in size with softened center. Body temperature is
38,5 0C. What is the most likely diagnosis?
A. Acute suppurative mastitis
B. Pneumonia
C. Pleurisy
D. Milk retention
E. Birth trauma
185. 16. A 29-year-old woman came to a gynecologist with complaints of irritability,
tearfulness, headache, nausea, occasional vomiting, pain in the heart area,
tachycardia attacks, memory impairment, meteorism. These signs appear 6 days
before menstruation and disappear the day before menstruation or during its first 2
days. On vaginal examination: the uterus and uterine appendages are without
alterations. What diagnosis is the most likely?
A. Premenstrual syndrome
B. Algodismenorrhea
C. Ovarian apoplexy
D. Genital endometriosis
E. Neurosis
186. 28. A primigravida at the term of 20 weeks complains of pain in her lower
abdomen, smearing blood-streaked discharge from the genital tracts. Uterine tone is
increased, fetus is mobile. On vaginal examination: the uterus is enlarged according
to the term, uterine cervix is shortened to 0,5 cm, external cervical orifice is open
by 2cm. What is the most likely diagnosis?
A. Risk of late abortion with hemorrhage
B. Risk of late abortion without hemorrhage
C. The process of late abortion
D. Incomplete late abortion
E. Attempted late abortion
187. 61. Vaginal examination reveals the head of the fetus, which fills the posterior
surface of symphysis pubis and hollow of the sacrum. The lower edge of symphysis
pubis, ischiadic spines, and sacrococcygeal joint can be palpated. Where in the
lesser pelvis is the fetal headsituated?
A. In the narrow plane of lesser pelvis
B. In the wide plane of lesser pelvis
C. Above pelvic inlet
D. In the area of brim
E. In the area of pelvic outlet
188. 68. A 20-year-old woman on the 10th day after her discharge from the maternity
ward developed fever up to 39oC and pain in her left mammary gland. On
examination the mammary gland is enlarged, in its upperouter quadrant there is a
 hyperemic area. In this area a dense spot with blurred margins can be palpated. The
patient presents with lactostasis and no fluctuation. Lymph nodes in the right
axillary crease are enlarged and painful. Specify the correct diagnosis:
A. Lactational mastitis
B. Abscess
C. Erysipelas
D. Dermatitis
E. Tumor
189. 75. A 46-year-old woman came to a maternity clinic with complaints of moderate
blood discharge from the vagina, which developed after the menstruation delay of
1,5 months. On vaginal examination: the cervix is clean; the uterus is not enlarged,
mobile, painless; appendages without changes. Make the diagnosis:
A. Dysfunctional uterine bleeding
B. Adenomyosis
C. Ectopic pregnancy
D. Submucous uterine myoma
E. Cancer of the uterine body
190. 87. A multigravida on the 38th week of her pregnancy complains of increased BP
up to 140/90 mm Hg, edema of the shins for 2 weeks. In the last month she gained
3,5 kg of weight. Urine analysis: protein - 0,033 g/l. Make the diagnosis:
A. Mild preeclampsia
B. Moderate preeclampsia
C. Pregnancy hypertension
D. Severe preeclampsia
E. Pregnancy edema
191. 105. A 14-year-old girl has been delivered to a gynecological department with
complaints of profuse blood discharge from her genital tract for 2 weeks.
Anamnesis: menstruation since 13, irregular, painful, profuse; the last one was 2
months ago. Objectively: pale skin and mucosa, BP- 100/60 mm Hg, Hb- 108 g/l.
The abdomen is soft and painless on palpation. Rectal examination revealed no
pathologies of reproductive organs. What condition is it?
A. Juvenile uterine hemorrhage (Dysfunctional)
B. Hypomenstrual syndrome
C. Inflammation of uterine appendages(Pelvic inflammatory disease)
D. Pelviperitonitis
E. Endometritis
192. 127. An 18-year-oldwoman complains of pain in her lower abdomen, profuse
purulent discharge from the vagina, temperature rise up to 37,8 0C. Anamnesis
states that she had a random sexual contact the day before the signs appeared. She
was diagnosed with acute bilateral adnexitis. On additional examination: leukocytes
are present throughout all vision field, bacteria, diplococci with intracellular and
extracellular position. What is the most likely agent in the given case?
A. Neisseria gonorrhoeae
B. Escherichia coli
C. Chlamydia trachomatis
D. Trichomona vaginalis
 E. Staphylococcus aureus
193. 132. It is the 3rd day after the normal term labor; the infant is rooming-in with the
mother and is on breastfeeding. Objectively: the mother’s general condition is
satisfactory. Temperature is 36,4 0C, heart rate is 80/min., BP is 120/80 mm Hg.
Mammary glands are soft and painless; lactation is moderate, unrestricted milk
flow. The uterus is dense, the uterine fundus is located by 3 fingers width below the
navel. Lochia are sanguino-serous, moderate in volume. Assess the dynamics of
uterine involution:
A. Physiological involution
B. Subinvolution
C. Lochiometra
D. Pathologic involution
E. Hematometra
194. 176. A 55-year-old woman came to a gynecologist with complaints of leukorrhea
and bloody discharge from the vagina after 5 years of menopause. Anamnesis states
no pregnancies. Bimanual examination: the uterus and uterine appendages are
without changes. During diagnostic curettage of the uterine cavity the physician
scraped off enchephaloid matter. What is the most likely diagnosis in this case?
A. Endometrial carcinoma
B. Adenomyosis
C. Subserous uterine myoma
D. Cervical carcinoma
E. Ovarian carcinoma
195. 182. A 24-year-old pregnant woman on her 37th week of pregnancy has been
delivered to a maternity obstetric service with complaints of weak fetal movements.
Fetal heartbeats are 95/min. On vaginal examination the uterine cervix is tilted
backwards,2 cm long, external orifice allows inserting a fingertip. Biophysical
profile of the fetus equals 4 points. What tactics of pregnancy management should
be chosen?
A. Urgent delivery via a cesarean section
B. Treatment of placental dysfunction and repeated analysis of the fetal biophysical
profile on the next day
C. Doppler measurement of blood velocity in the umbilical artery
D. Urgent preparation of the uterine cervix for delivery
E. Treatment of fetal distress, if ineffective, then elective cesarean section on the
next day
196. 183. During regular preventive gynecological examination a 30-year-old woman
was detected to have dark blue punctulated ”perforations” on the vaginal portion of
the uterine cervix. The doctor suspects endometriosis of the vaginal portion of the
uterine cervix. What investigation method would be most informative for diagnosis
confirmation?
A. Colposcopy, target biopsy of the cervix
B. US of small pelvis
C. Hysteroscopy
D. Curettage of the uterine cavity
E. Hormone testing
197. 184. A 26-year-old woman came to a gynecologist for a regular check-up. She has
no complaints. Per vaginum: the uterus lies in anteflexion, not enlarged, dense,
mobile, painless. On the left from the uterus in the area of uterine appendages there
is a mobile painless outgrowth that can be moved independently from the uterus.
On the right the appendages cannot be detected. What additional investigation
would be informative for diagnosis clarification?
A. US of lesser pelvis
B. Metrosalpingography
C. Examination for urogenital infection
D. Colposcopy
E. Colonoscopy