Conduct of normal labor and delivery Flashcards

1
Q
Gravid patient, 38 weeks AOG, normal with labor pains. Upon internal exam, cervix is fully dilated with fetal hearts sounds, station at +2, brought to the delivery room. How often should fetal heart tones be monitored?
A.	Every 5 min
B.	Every 10 min
C.	Every 15 min
D.	Every 30 min
A

C

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2
Q
In the anthropoid pelvis, the fetus tends to descend through the pelvic inlet in what position?
A.	Occiput anterior 
B.	Occiput transverse
C.	Occiput posterior
D.	Oblique
A

C

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3
Q
The shortest AP diameter that the fetal head must pass while going through the pelvic inlet is 
A.	Intertuberous
B.	Interspinous
C.	Obstetric
D.	Diagonal
A

C

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4
Q
On IE of patient in labor, it was noted that ischial spines were prominent with convergent side walls and shallow sacrum. Which pelvis plane is likely contracted? 
A.	Inlet
B.	midplane 
C.	inlet and midplane
D.	midplane and outlet
A

B

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5
Q

The following describe a Schultze mechanism of placental separation EXCEPT:
A. glistening amnion presents at the vulva
B. blood escapes externally after extrusion of the placenta
C. maternal surface appears first
D. placental surface appears first

A

C

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6
Q
During labor in occiput posterior position, the head has to rotate to the symphysis pubis by how many degrees?
A.	45
B.	90
C.	135
D.	185
A

C

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7
Q
False positive results in the nitrazine test for ruptured membranes is due to the presence of
A.	Blood
B.	Cervical mucus
C.	Candida
D.	Chlamydia
A

A

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8
Q

The following are performed during vaginal delivery of the fetus, EXCEPT:
A. Infant should be placed above the introitus of the mother prior to clamping the cord.
B. Nuchal cord should be slipped over the head before delivery of the baby.
C. Nuchal cord should be cut between clamps before delivery of the baby.
D. Clamping of the cord should be done after 3 minutes to allow placental transfusion.

A

A

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9
Q
  1. True statements about asynclitism
    A. Severe degrees are common
    B. Severe forms may lead to CPD even in normal sized pelvis – kaya may mga multigravid na kung minsan nahihirapan manganak. CPD – cephalopelvic disproportion 
    C. Shifting from posterior to anterior aids in internal rotation
    D. With extreme posterior asynclitism the anterior parietal bone can be easily palpated
A

B

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10
Q
  1. Station _ corresponds to the head visible at the introitus?
    a. -1
    b. 0
    c. +3
    d. +5
A

*

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11
Q
  1. In a platypelloid pelvis, the head enters the pelvic inlet in what position?
    a. Anteroposterior
    b. Transverse
    c. Posterior
    d. Oblique
A

*

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12
Q

After cervical dilation, what produces the most important force in fetal expulsion?

a. Myometrial contraction and retraction
b. Maternal intraabdominal pressure
c. Amniotic fluid
d. Oxytocin

A

A

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13
Q

During labor in occiput posterior position, head has to rotate by how many degrees?

a. 45⁰
b. 90⁰
c. 135⁰
d. 180⁰

A

C

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14
Q

On Leopold’s, cephalic prominence felt on same side as fetal back. How would you describe the fetal head?

a. Engaged
b. Floating
c. Extended
d. Flexed

A

C

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15
Q

During abdominal exam, when the fetal head has descended into the pelvis, the anterior shoulder may be differentiated by the __ maneuver.

a. 1st
b. 2nd
c. 3rd
d. 4th

A

C

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16
Q

True of cardinal movements EXCEPT

a. After internal rotation, the flexed head enters the vulva and extends
b. After external rotation, the anterior shoulder is directly under the pubic symphisis
c. The base of the occiput is in contact with the inferior border if the symphysis pubis during restitution
d. Internal rotation is required for completion of labor unless fetus is unusually small

A

*

17
Q

A 30 year old primigravid at 38wk AOG with hypertonia and gestational diabetes mellitus was brought to the ER. Cervix dilated, fetal head station +2. How often should the fetal heart tones be auscultated?

a. 5 minutes
b. 10 minutes
c. 15 minutes
d. 30 minutes

A

A

18
Q
  1. True statements regarding the midpelvis except:
    A. Clinical estimation of its capacity by any form of direct measurement is not possible
    B. It is the plane of least pelvic dimensions
    C. It is measured at the level of the ischial spines
    D. It is important following internal rotation of the fetal head during obstructed labor
A

D

19
Q
The head of the average term fetus enters the pelvis inlet with the sagittal suture in the \_\_\_\_\_\_\_\_ position in the anthropoid pelvis. 
A. Transverse
B. Anteroposterior
C. Oblique
D. Posterior
A

B

20
Q

Which of the following is the correct sequence of the cardinal movements of labor?
A. engagement, flexion, extension, int rotation, ext rotation, descent, expulsion
B. descent, engagement, int rotation, flexion, ext rotation, extension, expulsion
*C. engagement, descent, flexion, int rotation, extension, ext rotation, expulsion
D. flexion, int rotation, engagement, extension, ext rotation, descent, expulsion

A

C

21
Q

Which phase is predictive of the outcome of labor?
A. Acceleration
B. Max. Slope
C. Deceleration

A

A

22
Q

Which suture approaches sacral promontory in anterior synclitism
A. Coronal
B. Lambdoid
C. Sagittal suture

A

C

23
Q
If the cephalic prominence palpated is at the side of fetal back
A. Engaged
B. Not engaged
C. Extension
D. Flexion
A

C

24
Q
What is the diameter of the fetal head when it is flexed?
A. Biparietal
B. Suboccipitobregmatic
C. Occipito-frontal
D. Mento-occipital
A

B

25
Q
What is the cardinal movement of labor wherein the bisacromial diameter of the fetus has rotated into the AP diameter of the pelvis?
A. Internal rotation
B. Extension
C. External rotation
D. Expulsion
A

C

26
Q

25 year old G2P1 (1001, admitted with PU, 39 AOG, cephalic presentation, in labor. In IE, cervix fully dilated with fetal head at station +1.

What stage in labor?
A. 0
B. 1
C. 2
D. 3
A

C

27
Q
25 year old G2P1 (1001, admitted with PU, 39 AOG, cephalic presentation, in labor.  In IE, cervix fully dilated with fetal head at station +1. Fetal heart tones should be monitored every:
A. 5 mins
B. 10 mins
C. 15 mins
D. 20 mins
A

C

28
Q
On IE in the delivery room, the fetal head was noted to be at station +2. The ff. must be done except:
A. Monitor fetal heart tone
B. Monitor fetal heart contraction
C. Perform an episiotomy
D. Check vital signs
A

C

29
Q
Laceration: anal sphincter
A. 1st degree
B. 2nd degree
C. 3rd degree
D. 4th degree
A

C

30
Q

The following are performed during vaginal delivery of the fetus, EXCEPT:
A. Infant should be placed above the introitus of the mother prior to clamping the cord.
B. Nuchal cord should be slipped over the head before delivery of the baby.
C. Nuchal cord should be cut between clamps before delivery of the baby.
D. Clamping of the cord should be done after 3 minutes to allow placental transfusion.

A

A