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Patho OB 2 > LE 1 > Flashcards

LE 1 Flashcards

1
Q
  1. Pregnant patients with BMI of 35 are most likely to end up with babies who are:

a. macrosomic
b. premature
c. malformed
d. asphyxiated

A

a. macrosomic

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2
Q
  1. A 42 y.o. primigravid came for prenatal check-up for the first time. Most pertinent to include in the history is:

a. menarche
b. illnesses incurred by the mother of the husband
c. age on first sexual contact
d. any work up for infertility

A

d. any work up for infertility

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3
Q
  1. Obstetric problem associated with oligohydramnios is:

a. intrauterine growth restriction
b. premature labor
c. abruption placenta
d. fetal anencephaly

A

a. intrauterine growth restriction

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4
Q
  1. A patient on her 40 weeks came to ER because of absence of fetal movement of 1 day duration. 2 days ago, a BPS done on her revealed 8/8. Intrauterine fetal demise was noted on repeat ultrasound for the absence of fetal movement. How can we explain such stillbirth/fetal death?

a. Negative predictive values of normal test is highly reassuring at 99.8%.
b. The BPS done 2 days ago wasa wrongly done.
c. Most likely the fetus had cord accident.
d. Utero-placental insufficiency could have caused the demise since the
pregnancy is postterm.

A

c. Most likely the fetus had cord accident.

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5
Q
  1. A patient on her 39-40 weeks AOG presented on prenatal check-up complaining of subjectively reduced fetal movement. As her medical attendant, you will

a. Assure her that fetal movements normally decline at term
b. Check for regularity of fetal heart tones by Doppler.

c. Advise admission for induction of labor.
d. Request for BPS so she can reassured of the fetal status.

A

d. Request for BPS so she can reassured of the fetal status.

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6
Q
  1. BPS done on a patient with preeclampsia with severe features on her 34th weeks AOG was 6/8 (-2 for fetal breathing). You will advise:

a. back up antepartum surveillance test like contraction stress test
b. immediate abdominal delivery
c. induction of labor
d. strict control of BP only 130-140/90

A

a. back up antepartum surveillance test like contraction stress test

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7
Q
  1. Most pertinent key to proper management of high risk pregnancies is:

a. proper referral to a perinatologist
b. knowledge of the true age of gestation
c. knowing the expectations attendant to the risk factors
d. giving the right medications to each corresponding illness

A

b. knowledge of the true age of gestation

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8
Q
  1. The only chronic marker among the biophysical variables in BPS is the:

a. amniotic fluid volume
b. fetal breathing
c. fetal tone
d. fetal movement

A

a. amniotic fluid volume

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9
Q
  1. Most efficient ultrasound measure for estimating fetal weight is the:

a. crown rump length
b. head circumference
c. biparietal diameter
d. abdominal circumference

A

d. abdominal circumference

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10
Q
  1. The umbilical Doppler waveform below suggests:

a. good fetal well being
b. fetus is at risk of asphyxia
c. there is a need to repeat the Doppler velocimetry in a week
d. a back up test like BPS is in order

A

a. good fetal well being

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11
Q
  1. The contraction stress test efficiently detects fetuses with:

a. compromised placental status
b. intact central nervous system
c. abnormal sleep-wake cycle
d. most likelihood to succumb to cord placenta

A

b. intact central nervous system

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12
Q
  1. A reactive non stress test will show:

a. at least 2 accelerations in 20 minute window
b. 2 late decelerations with 1 of the uterine contractions present
c. 0-5 bpm variabilityin fetal tracings
d. less than 50% of uterine contractions with late decelerations

A

a. at least 2 accelerations in 20 minute window

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13
Q
  1. Most appropriate antepartum surveillance testing for a 41 week gestation is the:

a. non-stress test
b. contraction stress test
c. biophysical profile
d. Doppler velocimetr

A

c. biophysical profile

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14
Q
  1. Modified biophysical scoring with perfect score of 8 is acceptable provided:

a. amniotic fluid volume is normal
b. non-stress test is reactive
c. age of gestation is 32 weeks and above
d. contraction stress test is positive

A

a. amniotic fluid volume is normal

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15
Q
  1. Most appropriate blood vessel to use for doppler velocimetry in IUGR is the:

a. middle cerebral artery
b. uterine arteries
c. umbilical artery
d. fetal aorta

A

c. umbilical artery

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16
Q
  1. In biophysical profile, the following observation will get a score of 2:

a. amniotic fluid index is 4 cms.
b. 1 extension of extremities
c. 2 gross movements of the fetal trunk
d. One 30 seconds continuous breathing 30 minutes

A

d. One 30 seconds continuous breathing 30 minutes

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17
Q
  1. A hypertensive multigravida in with FH = 26 cms., FHT = 150/min. She cannot remember her exact LMP: To establish the age of gestation, it is wisest to:

a. correlate quickening
b. get 2 ultrasound age done 2-4 weeks apart
c. apply McDonald’s rule
d. use Naegel’s rule

A

c. apply McDonald’s rule

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18
Q
  1. In a fetal tracing where all types of decelerations are demonstrated, most important to consider is the presence of:

a. late decelerations
b. variable decelerations
c. early decelerations
d. variability

A

a. late decelerations

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19
Q
  1. The following is TRUE of fetal scalp stimulation:

a. It makes use of artificial larynx
b. It has very limited use in case of fetal tachycardia
c. It is done by applying pressure on the fetal scalp abdominally
d. It has high positive predictive value when done at all ages of gestation

A

a. It makes use of artificial larynx

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20
Q
  1. The following is true of fetal scalp pH:

a. It’s based on the theory of hypoxia cascade
b. Expected reaction of the fetus is a subsequent deceleration in the FHT
c. It assesses the presence of acidosis in the fetus
d. When pH is more than 7.2, immediate abdominal termination is warranted

A

c. It assesses the presence of acidosis in the fetus

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21
Q
  1. Auscultation of FHT using Doppler or stethoscope is capable also of diagnosing a non-reassuring fetal heart rate pattern by getting FHT which is:

a. persistently below 110-120 bpm
b. below 110 bpm
c. above 160 bpm during fetal movements
d. persistently above 160 bpm in a patient with hyperthermia

A

b. below 110 bpm

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22
Q
  1. Fetal auscultation methods include:

a. administration of oxygen directly to the fetus
b. putting parturient on supine lithotomy position
c. discontinuation of uterine stimulants as oxytocin
d. direct laryngeal suctioning of the fetus

A

c. discontinuation of uterine stimulants as oxytocin

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23
Q
  1. The following fetal tracing shows a variability of

a. 0-5 bpm
b. 5-10 bpm
c. 10-15 bpm
d. 15-20 bpm

  1. The fetal tracing shown in no.23 reveals uterine contractions coming every:

a. 1-2 minutes
b. 2-3 minutes
c. 3-4 minutes
d. 4-5 minutes

  1. The baseline heart rate in the fetal tracing in no.23 is:

a. 100 bpm
b. 110 bpm
c. 120 bpm
d. 130 bpm?

  1. The tracing in no.23 shows:

a. Persistent late decelerations
b. Prolonged early decelerations
c. Accelerations with uterine contractions
d. Isolated variable decelerations

A

23 b. 5-10 bpm

24 a. 1-2 minutes

25 d. 130 bpm?

26 a. Persistent late decelerations

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24
Q
  1. Among the low risk group, intermittent auscultation of fetal heart tones every 30 minutes during 1st stage and every ……..during the 2nd stage is equally efficient as continuous fetal monitoring with the fetal cardiograph, provided the following conditions are met:

a. There is 1:1 ratio of medical/paramedical attendant
b. Fetal heart tones are within normal limits 120-160 bpm
c. Bag of waters in intact
d. There should be normal progress of labor

A

a. There is 1:1 ratio of medical/paramedical attendant

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25
Q
  1. For prediction of fetal hypoxia, the most sensitive parameter in an antepartum fetal tracing is the:

a. Baseline fetal heart rate
b. Variability
c. Periodic fetal heart rate changes d. Prolonged decelerations

A

b. Variability

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26
Q
  1. Fetal tracing done on the patient with the following condition would likely show predominantly late and variable decelerations:

a. Diabetes mellitus
b. Placenta previa
c. premature rupture of membranes
d. severe intrauterine growth restriction

A

d. severe intrauterine growth restriction

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27
Q
  1. Acceleration evident after doing fetal scalp stimulation means:

a. There is utero-placental insufficiency
b. Labor may still be allowed to progress
c. Oligohydramnios is most likely present
d. Immediate delivery is warranted

A

c. Oligohydramnios is most likely present

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28
Q
  1. Acceleration evident after doing fetal scalp stimulation means:

a. There is utero-placental insufficiency
b. Labor may still be allowed to progress
c. Oligohydramnios is most likely present
d. Immediate delivery is warranted

A

c. Oligohydramnios is most likely present

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29
Q
  1. Fetal tracing’s indeterminate features include:

a. Persistent late decelerations
b. Variable decelerations
c. Baseline heart rate of 145-155 bpm
d. variability of 15 beats

A

b. Variable decelerations

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30
Q
  1. If only 1 scan is allowed for the entire pregnancy, it is best done on:

a. 10-14 weeks
b. 18-22 weeks
c. 28-32 weeks
d. 34-38 weeks

A

b. 18-22 weeks

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31
Q
  1. Recurrent immature pregnancy losses is most likely due to:

a. preeclampsia
b. abruption placenta
c. gestational DM
d. incompetent cervix

A

d. incompetent cervix

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32
Q
  1. Advantage of biophysical profile as first line antepartum test is:

a. It enables medical attendant to see contiguous structures as placenta and amniotic fluid
b. It is very easy to interpret
c. It can show fetal heart rate response to fetal movements
d. It shows adequacy or blood flows into important fetal vessels

A

a. It enables medical attendant to see contiguous structures as placenta and amniotic fluid

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33
Q
  1. A 33 y.o. G1, 33 weeks pregnant was noted to have FH of 25 cms., though with active fetal movements. Pelvic ultrasound done revealed biometry consistent with 25 4/7 weeks with amniotic fluid index of 14.2 cms. The following statement is appropriate for this patient:

a. The true gestation is 25-26 weeks.
b. Intrauterine growth restriction is evident.
c. A second ultrasound 2-4 weeks apart from 1st should be done.
d. Patient should be sent for contraction stress test.

A

c. A second ultrasound 2-4 weeks apart from 1st should be done.

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34
Q
  1. A feature of Category 3 fetal tracing is:

a. Variable decelerations
b. Absent variability
c. Early decelerations
d. Accelerations

A

b. Absent variability

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35
Q
  1. Uterine contractions are said to be adequate when:

a. Contractions come every 1-2 minutes, 30-45 seconds duration, moderate- strong
b. Contractions come every 5-8 minutes, 30-60 seconds duration, moderate- strong
c. There is at least 200 Montevideo units on fetal trace
d. There is at most 200 Montevideo units on fetal trace

A

c. There is at least 200 Montevideo units on fetal trace

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36
Q
  1. Intrapartum test which does not require a ruptured bag of waters:

a. Indirect fetal cardiotocography
b. Fetal O2 determination
c. fetal scalp pH
d. determination of meconium staining

A

a. Indirect fetal cardiotocography

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37
Q
  1. Prominent features of an intrapartum fetal tracing of a patient with anhydramnios due to PROM are:

a. Persistent variable decelerations
b. Persistent late decelerations
c. Early decelerations
d. Acceleration

A

a. Persistent variable decelerations

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38
Q
  1. When the fetal tracing shows Category 2 or non-reassuring fetal heart pattern, one must do the following:

a. Immediate cesarean delivery
b. Forceps delivery
c. Stop any uterotonics
d. Sedate the patient to relieve patient’s stress

A

c. Stop any uterotonics

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39
Q
  1. Most appropriate antepartum test for term growth restricted fetuses is:

a. Biophysical profile scoring
b. Contraction stress test
c. non-stress test
d. Doppler velocimetr

A

a. Biophysical profile scoring

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40
Q
  1. The following statement/s is/are TRUE regarding preterm labor, EXCEPT?
    a. Regular uterine contractions
    b. Associated with cervical change
    c. Occurs before 37 completed weeks
    d. Occurs after 37 completed weeks
A

d. Occurs after 37 completed weeks

41
Q
  1. The following statement/s is/are TRUE regarding preterm infant, EXCEPT?

a. Birthweight <2500 g
b. Not associated with respiratory distress syndrome
c. Those delivered before 37 completed weeks
d. Prematurity represents incomplete development of various organ systems at
birth

A

b. Not associated with respiratory distress syndrome

42
Q
  1. The term appropriate for gestational age describes newborns whose weights are between what percentiles?

a. 10% and 50%
b. 10% and 75%
c. 10% and 80%
d. 10% and 90%

A

d. 10% and 90%

43
Q
  1. Estimation of due date based on menstrual cycle:

a. subtract 7 days to the first day of the last menstrual period then add 3 months
b. add 3 days to the first day of the last menstrual period then subtract 7 months
c. subtract 3 days to the first day of the last menstrual period then add 7 months
d. add 7 days to the first day of the last menstrual period then subtract 3 months

A

d. add 7 days to the first day of the last menstrual period then subtract 3 months

44
Q
  1. To determine the gestational age during the 1st trimester, which parameter is the most accurate?

a. Biparietal diameter
b. Gestational sac
c. Femur length
d. Crown rump length

A

d. Crown rump length

45
Q
  1. The following lifestyle factors have been associated with spontaneous preterm labor, EXCEPT?

a. Cigarette smoking
b. Poverty
c. Obesity
d. Inadequate maternal weight gain

A

c. Obesity

46
Q
  1. Which of the following statement is NOT TRUE regarding uterine distention as a cause of spontaneous preterm labor?

a. acts to initiate expression of contraction associated proteins (CAPs) in the myometrium
b. activation of placental-fetal endocrine cascade
c. increased stretch and endocrine acivity may initiate activation and
premature cervical ripening
d. absence of regular uterine contractions

A

d. absence of regular uterine contractions

47
Q
  1. The following routes of infection may cause spontaneous preterm labor, EXCEPT?

a. Transplacental transfer of maternal systemic infection
b. Retrograde flow of infection into the peritoneal cavity via fallopian tube
c. Ascending infection with bacteria from vagina and cervix
d. Respiratory droplets

A

d. Respiratory droplets

48
Q
  1. Recurrent midtrimester pregnancy loss associated with painless cervical dilatation

a. Cervical deficiency
b. Cervical incompetence
c. Cervical ineffectiveness
d. Cervical inability

A

b. Cervical incompetence

49
Q
  1. Possible indication/s in performing cerclage include which of the following?

a. Recurrent midtrimester losses
b. Threatened preterm labor with cervical dilatation
c. Short cervix identified during sonography?
d. AOTA

A

d. AOTA

50
Q
  1. Possible indication/s in performing cerclage include which of the following?

a. Recurrent midtrimester losses
b. Threatened preterm labor with cervical dilatation
c. Short cervix identified during sonography?
d. AOTA

A

d. AOTA

51
Q
  1. What is the most reliable indicator of clinical chorioamnionitis in women with preterm ruptured membranes?

a. Fetal tachycardia
b. Positive vaginal cultures
c. Leukocytosis
d. Fever

A

d. Fever

52
Q
  1. What is the most appropriate management of preterm rupture of membranes at or beyond 34 weeks gestation?

a. Expectant management
b. Expectant management unless fetal lung maturity is confirmed
c. Expedited delivery
d. A course of corticosteroids followed by delivery

A

c. Expedited delivery

53
Q
  1. Corticosteroids administered to women at risk for preterm birth have been demonstrated to decrease rates of neonatal respiratory distress if the birth is delayed for at least how many hours after administration?

a. 8 hours
b. 10 hours
c. 12 hours
d. 24 hours

A

d. 24 hours

54
Q
  1. Characteristics of Braxton Hicks contractions include the following, EXCEPT?

a. Irregular pattern
b. Painful
c. non rhythmical
d. Cervical dilatation

A

d. Cervical dilatation

55
Q
  1. What is the risk of occurrence for women who have one prior spontaneous preterm delivery at or before 34 weeks?

a. 8%
b. 16%
c. 24%
d. 45%

A

b. 16%

56
Q
  1. Which of the following statement is NOT TRUE regarding fetal fibronectin assay?

a. detection in cervicovaginal secretions prior to membrane rupture
b. marker for impending preterm labor
c. values exceeding 50 ng/dL are considered positive
d. identification of ferning pattern

A

d. identification of ferning pattern

57
Q
  1. Preterm birth prevention includes the following, EXCEPT:

a. Cervical cerclage
b. Progestin compounds
c. Cesarean section
d. Public health care program

A

c. Cesarean section

58
Q
  1. Which of the following statement is NOT TRUE regarding corticosteroid administration?

a. Accelerates fetal lung maturity
b. single course with preterm membrane rupture between 24 to 32 weeks
c. Betamethasone and dexamethasone are the most widely used
d. Treatment of infection

A

d. Treatment of infection

59
Q
  1. Beta adrenergic receptor agonists as tocolytic agents, EXCEPT

a. reduce intracellular ionized calcium levels
b. accelerate fetal lung maturity
c. prevent myometrial contractile proteins
d. can cause pulmonary edema

A

b. accelerate fetal lung maturity

60
Q
  1. Adverse neonatal outcomes in preterm delivery includes the following, EXCEPT

a. necrotizing enterocolitis
b. intracranial hemorrhage
c. respiratory distress
d. periodontal process

A

d. periodontal process

61
Q
  1. A 24-year old. G1P0 at 30 weeks gestation complains of fluid leakage from the vagina. The following test/s will aid in diagnosis of premature ruptured membranes, EXCEPT?

a. pH determination of vaginal fluid
b. Nitrazine test
c. Fern test
d. Gram stain

A

d. Gram stain

62
Q
  1. After confirming your diagnosis for no.63, what is/are your plan of management?

a. Expectant management
b. Corticostreoid administration and antimicrobial therapy
c. Both A & B
d. Nether A nor B

A

c. Both A & B

63
Q
  1. A 32-year old. G3P1 (0111) at 35 weeks gestation complains of regular uterine contractions associated with watery vaginal discharge. What is your plan of management?

a. Give tocolytic agents
b. Induction of labor
c. Corticosteroid administration
d. Bed rest

A

b. Induction of labor

64
Q
  1. A 28-year old G2P1 (1001) at 32 weeks gestation complains of regular uterine contractions, FHT = 135 bpm, 2 cm cervical dilatation. What is/are your plan of management?

a. Give tocolytic agents and corticosteroids
b. Induction of labor
c. Send patient home
d. Expectant management

A

a. Give tocolytic agents and corticosteroids

65
Q
  1. Which of the following is NOT TRUE regarding Magnesium sulfate?

a. calcium antagonist which may inhibit labor
b. administered IV - loading dose 4 g then continuous infusion 2 g/hr
c. adverse effect: fetal bone thinning and fractures when exposed for more
than 5-7 days
d. accelerates fetal lung maturity

A

d. accelerates fetal lung maturity

66
Q
  1. Nifedipine is NOT used concurrently with MgSO4 due to which of the following adverse effect?

a. Nifedipine can cause fetal bone thinning and fractures
b. Nifedipine acts to inhibit calcium entry through cell membrane channels to
arrest preterm labor
c. Nifedipine is safe and more effective than beta agonists
d. Nifedipine enhances the neuromuscular blocking effects of
magnesium that can interfere with pulmonary and cardiac function

A

d. Nifedipine enhances the neuromuscular blocking effects of

magnesium that can interfere with pulmonary and cardiac function

67
Q
  1. A 35-year old patient at 26 weeks gestation diagnosed with cervical insufficiency was noted to have a short cervix during sonographic examination. What is your plan of management?

a. Corticosteroid administration
b. Cervical cerclage
c. Tocolysis
d. Antimicrobial therapy

A

b. Cervical cerclage

68
Q
  1. A 24-year old G2P1 (1001) at 31 weeks gestation complains of regular uterine contractions, FHT = 143 bpm, 1 cm cervical dilatation. What is/are your plan of management?

a. Give Bethamethasone two 12 mg doses administered intramuscularly 24 hours apart
b. Give Dexamethasone two 6 mg doses administered intramuscularly every 24 hours
c. BothA&B
d. Neither A nor B

A

a. Give Bethamethasone two 12 mg doses administered intramuscularly 24 hours apart

69
Q
  1. A 22-year old G1P0 at 32 weeks gestation complains of watery vaginal discharge for 48 hours associated with uterine contractions. Patient was febrile (Temp 380C) with fetal tachycardia, uterine tenderness and malodorous vaginal discharge. What is your impression?

a. Cervical incompetence
b. Chorioamnionitis
c. Placenta previa
d. Abruptio placenta

A

b. Chorioamnionitis

70
Q
  1. Which among the following patients fulfill the definition of a postterm pregnancy?

a. A patient whose LNMP is on September 15, 2016
b. A patient whose Expected Date of Delivery is July 10, 2017
c. A patient with an age of gestation of 41 weeks and 6 days
d. A patient who felt quickening at February 14, 2017

A

a. A patient whose LNMP is on September 15, 2016

71
Q
  1. What are the components of the modified biophysical score?

a. fetal tone, fetal movement, respiration, amniotic fluid index, non-stress test
b. amniotic fluid index, non-stress test
c. amniotic fluid index, contraction stress test
d. fetal tone, fetal movement, respiration, amniotic fluid index, contraction
stress test

A

b. amniotic fluid index, non-stress test

72
Q
  1. Which among the following patients is most likely to have a postterm pregnancy?

a. A Caucasian, with two previous preterm births
b. A patient who had a Congenital Anomaly Scan of anencephaly
c. A multifetal gestation
d. A patient with uterine didelphys

A

b. A patient who had a Congenital Anomaly Scan of anencephaly

73
Q
  1. A postterm pregnancy with a healthy large infant is indicative of?

a. Dysmaturity Syndrome
b. Gestational DM
c. Macrosomia Syndrome
d. Normal pregnancy

A

c. Macrosomia Syndrome

74
Q
  1. A postterm pregnancy with placental insufficiency is indicative of?

a. Dysmaturity Syndrome
b. Gestational DM
c. Macrosomia Syndrome
d. Normal pregnancy

A

a. Dysmaturity Syndrome

75
Q
  1. Your patient, past her due date (July 13, 2017), goes to the Emergency Room to be examined if she is in labor. Internal Examination showed cervix closed, uneffaced. What is the best thing to do?

a. admit the patient and induce vaginal delivery
b. admit the patient and do stat cesarean section
c. reassure patient and await spontaneous labor
d. admit the patient for close fetal monitoring

A

c. reassure patient and await spontaneous labor

76
Q
  1. Your patient, past her due date (July 13, 2017), goes to the Emergency Room to be examined if she is in labor. Internal Examination showed cervix closed, uneffaced. She noted decreased fetal movement. What is the best thing to do?

a. admit the patient and induce vaginal delivery
b. reassure patient and await spontaneous labor
c. admit the patient and do stat cesarean section
d. request for a modified biophysical score

A

d. request for a modified biophysical score

77
Q
  1. Which is a component of your bishop score?

a. position of the fetal head
b. status of amniotic fluid
c. consistency
d. lie

A

c. consistency

78
Q
  1. A patient came in, term by size, unsure of her menses, which among the following clinical information will be most beneficial to determine age of gestation?

a. fundic height
b. force her to remember her LMP
c. quickening
d. estimated fetal weight

A

c. quickening

79
Q
  1. Which is the most reliable indicator for age of gestation in the first trimester?

a. non biometric parameters
b. FL
c. BPD
d. CRL

A

d. CRL

80
Q
  1. Your patient’s in no.80 has internal examination findings of: 1 cm, beginning effacement, station -2, firm and posterior. What is the Bishop Score?

a. 0
b. 1
c. 2
d. 3

A

c. 2

81
Q
  1. What Bishop Score indicates a favorable cervix?

a. 5
b. 6
c. 7
d. 8

A

d. 8

82
Q
  1. Amniotic Fluid peaks at ___________ weeks?

a. 36
b. 37
c. 38
d. 39

A

a. 36

83
Q
  1. Internal Examination showed a closed, firm, posterior cervix, station -2, beginning effacement in a 42 week patient. What will be your management?

a. start labor induction by giving cervical ripening agent
b. do a cesarean section
c. give oxytocin
d. advise patient to walk around

A

a. start labor induction by giving cervical ripening agent

84
Q
  1. Which is a complication of postterm pregnancy?

a. polyhydramnios
b. oligohydramnios
c. Respiratory Distress Syndrome
d. Retinopathy

A

b. oligohydramnios

85
Q
  1. Characteristic of a postmature baby?

a. Infant full of vernix
b. Wrinkled patchy skin
c. Short nails
d. Closed eyed baby

A

b. Wrinkled patchy skin

86
Q
  1. Your patient, 37 weeks AOG, has internal examination findings of: 3 cm, 80% effaced, station 0, soft and anterior. What is the next best step?

a. reassure the patient and admit once in spontaneous labor
b. admit and do cesarean section
c. admit and monitor progress of labor
d. do cervical ripening

A

c. admit and monitor progress of labor

87
Q
  1. A 28-year old primigravid woman comes to your office for the first time for antenatal checp-up. Her antenatal records show ultrasound performed at 16 weeks which is consistent with the date of her last menstrual period. She is at 42 weeks AOG. On physical examination, fundic height is consistent with dates, and the cervix is not favorable. Repeat ultrasound shows a fetus weighing 3700 grams and an amniotic fluid of 10. Fetal heart racing is reassuring. What is the most appropriate step in the management of the patient?

a. twice weekly NST and BPS
b. amnioinfusion and wait for spontaneous delivery
c. Immediate induction of labor
d. Cesaerean section

A

a. twice weekly NST and BPS

88
Q
  1. Which is most likely to have a postterm delivery

a. Intrauterine growth restriction
b. multifetal gestation
c. cervical incompetence
d. black race

A

a. Intrauterine growth restriction

89
Q
  1. What are the acceptable methods of cervical ripening?

a. Hyoscine Butylbromide
b. Prostaglandin
c. Oxytocin
d. Calcium channel blockers

A

b. Prostaglandin

90
Q
  1. Which fulfills the definition of a postterm pregnancy?

a. 40 weeks
b. 41 weeks
c. 42 weeks
d. 43 weeks

A

c. 42 weeks

91
Q
  1. The postterm baby is at risk for

a. respiratory distress syndrome
b. meconium aspiration syndrome
c. hyaline membrane distress
d. jaundice

A

b. meconium aspiration syndrome

92
Q
  1. Fundic height is at the level of the umbilicus, what is the age of gestation?

a. 18 weeks
b. 19 weeks
c. 20 weeks
d. 21 weeks

A

c. 20 weeks

93
Q
  1. Quickening was felt by a multipara at July 13, 2017, what is your estimate of her LMP?

a. March 3
b. March 17
c. March 30
d. cannot be estimated

A

a. March 3

Multi 16-18 weeks
Nulli 20

94
Q
  1. Which patient is indicated to have labor induction?

a. Amniotic Fluid Index of 8
b. estimated fetal weight of 5 kg
c. 41 weeks 5 days
d. A patient whose EDD is June 29, 2017

A

d. A patient whose EDD is June 29, 2017

95
Q
  1. The incidence of postterm delivery is decreasing because?

a. more accurate determination of age of gestation
b. increasing cesarean rates at term
c. development of drugs that are effective in preventing postterm deliveries
d. the incidence is not decreasing

A

a. more accurate determin

96
Q
  1. The CRL is the most accurate marker for age of gestation because

a. there is less genetic variation and insults at the early trimester
b. the CRL is not the most accurate marker
c. it is easier to measure
d. it is backed up by literature

A

a. there is less genetic variation and insults at the early trimester

97
Q
  1. Neural tube defects usually deliver

a. prematurely
b. term
c. postterm
d. not a significant factor

A

c. postterm

98
Q
  1. What is the incidence (%) of postterm delivery?

a. 5
b. 10
c. 15
d. 20

A

b. 10

Patho OB 2 (10 decks)

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