HD 201 E3 Samplex 2015 Flashcards Preview

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Flashcards in HD 201 E3 Samplex 2015 Deck (51)
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1

True 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

D

2

True regarding the pelvic inlet, EXCEPT:

A. The transverse diameter is constructed at right angles to the obstetrical conjugate
B. The obstetrical conjugate can be measured directly by the examining fingers
C. Its posterior boundaries are the promontory and the alae of the sacrum
D. It is bounded laterally by the linea terminalis

B

3

. The true and false pelvis is demarcated by

A. Linea terminalis
B. Arcuate line anteriorly
C. Sacroiliac line posteriorly
D. Iliopectineal line

A

4

How can you evaluate the transverse diameter of the pelvic inlet?

A. Clinical or manual measurement
B. Imaging
C. Subtract 1.5-2cm from the diagonal conjugate
D. Caput formation in the baby

B

5

True of the anthropoid pelvis except:

A. Sacrum is inclined posteriorly/backward
B. Anteroposterior is greater than transverse diameter by >= 3cm
C. Anteroposterior is lesser than transverse diameter by >= 3cm
D. Ischial spines are not prominent

C

6

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

C

7

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

C

8

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

C

9

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

B

10

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

C

11

The following factors are predominant during Phase 3 of parturition EXCEPT:

A. Progesterone
B. Prostaglandin
C. Oxytocin
D. Relaxin

C

12

The following changes occur in the active segment of the uterus EXCEPT

A. successive lengthening of the muscle fibers
B. upper part of uterine becomes smaller with each successive conduction
C. progressive thickening
D. constant myometrial tension

A

13

The following are true regarding cervical changes EXCEPT

A. cervical ripening is an inflammatory procedure
B. cervical softening is preceded by a decrease in collagen solubility
C. before cervical ripening, collagen fibrils are uniform in size, well-packed, and organized
D. during cervical ripening, collagen fibrils are dispersed, resulting in loss of tissue integrity and increased tissue compliance

B

14

25 y/o G2P1 presents with fetus at 39 weeks AOG, with regular uterine contractions, intact membranes, 1 cm cervical dilatation, 50% cervical effacement. What is the functional division of labor? What phase of parturition?

A. Phase 0
B. Phase 1
C. Phase 2
D. Phase 3

D

15

25 y/o G2P1 presents with fetus at 39 weeks AOG, with regular uterine contracctions, intact membranes, 1 cm cervical dilatation, 50% cervical effacement. What is the functional division of labor?

A. Dilatational
B. Preparatory
C. Pelvic
D. Acceleration

B

16

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

C

17

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

18

A 27 year old G2P2 2-0-0-2 mother consulted for scanty milk flow. She started feeding her baby with supplemental milk formula. Her baby is always crying and fussy. What is the best advice for her?

A. Eat a lot of vegetables daily.
B. Drink plenty of milk.
C. Breastfeed more often.
D. Wear a nursing bra.

C

19

29-year old consulting for symmetric breast tenderness, without warmth, erythematous, cracked nipples. What is the most likely culprit?

A. Staphylococcus aureus
B. Pseudomonas sp.
C. Klebsiella sp.
D. Acinobacter sp.

A

20

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

21

A 2 year old baby was left in a nursing unit due to sepsis. The mother is afraid that her milk will dry up, so she used breast pump to collect milk, as advised by her OB. After the baby was discharged, the mother kept on using breast pump because it is more convenient for her. She then consulted her OB for decreased milk production. What could be causing this?

A. decrease in prolactin
B. lack in stimulation of nipple
C. oxytocin should be administered via IV
D. she just have low milk production

B

22

Main constituent of breast milk

A. Fats
B. Protein
C. Water
D. Carbohydrates

C

23

The mother has fever, cough and colds. What management is appropriate, considering the baby’s welfare?

A. Isolate the baby
B. Antibiotics
C. Warm bath
D. Continue breastfeeding, cover mother’s mouth

D

24

What is the most important antibody in breast milk?

A. IgE
B. IgA
C. IgG
D. IgM

B

25

What is the expected finding during the internal exam of a patient immediately postpartum?

A. Placental tissue fragments at external os
B. Still open after 2-3 days
C. Still fully dilated

A

26

What management should you give to a constipated breastfed baby who has had no bowel movement for 2 days?

A. Rectal laxative
B. Give water to baby
C. Advise mother to drink more water
D. Recommend for further observation

C

27

Changes in the urinary tract during the postpartum period EXCEPT:

A. Puerperal bladder has decreased capacity and sensitivity to intravesical pressure
B. Edema and hypertension of bladder wall
C. Overdistension, incomplete empyting and excessive residual urine are common
D. Postpartum patients are more prone to develop urinary tract infection.

A

28

Mode of action of combined OCP except:

A. Inflammatory endometrial response
B. Inhibit ovulation
C. Inhibit sperm migration through cervical mucus thickening
D. Create favourable endometrium

A

29

Endometrial regeneration occurs at which site of the endometrium?

A. Decidua basalis
B. Decidua spongiosum
C. Decidua vera

A

30

Low-dose contraceptive pills can be taken by all, EXCEPT:

A. Non-smoking, older than 35 y/o
B. Diabetic, no vascular disease
C. Maintained/controlled hypertension, smoker, younger than 35 y/o
D. Headache, normotensive, younger than 35 y/o

C

31

Mrs Cruz is using Yasmin, a 21 tablet combined oral contraceptive. When will the patient expect her menses while using this form of contraception?

A. After intake of 7 pills
B. After intake of 14 pills
C. Same day as last pill has been taken
D. A few days after last pill has been taken

D

32

Main mechanism of action of copper intrauterine device (IUD)

A. Inflammatory actions in the uterus which is spermicidal
B. Inhibits ovulation
C. Inhibits sperm migration by thickening of cervical mucus
D. Interference with successful implantation of the fertilized ovum

A

33

Disadvantage of IUD EXCEPT:

A. Uterine cramping or pain
B. Perforation most likely to occur at the time of insertion
C. Ectopic pregnancy with a device in plac
D. Increased rate of fetal malformations

D

34

Mirena (levonorgestrel releasing) IUD was inserted today (March 1, 2010). When will you recommend this to be replaced?

A. 2015
B. 2018
C. 2020
D. 2023

A

35

Mrs. Reyes consulted at the clinic for amenorrhea (LMP: December 17,2009) with a positive pregnancy test. She had an IUD inserted a year ago. What will you recommend?

A. Remove the IUD immediately if the string is visible
B. Remove the IUD postpartum if the patient is asymptomatic
C. Remove the IUD when the fetus is viable
D. Administer intravenous antibiotics

A

36

True statements about male condoms EXCEPT

A. Safe and has no systemic side effects
B. No medical contraindications (except latex allergy)
C. Absolute protection against sexually transmitted diseases
D. Lower pregnancy rate than female condoms

C

37

True statements about diaphragms EXCEPT

A. Should be used with spermicide cream
B. May be inserted before intercourse
C. Remove immediately after intercourse to avoid toxic shock syndrome
D. Variable in size and may not remain in place if too small

C

38

True statements about the calendar or rhythm method

A. Requires recording of the duration of the 10 previous menstrual cycles
B. Shortest cycle minus 11 equals the first day of fertile period
C. Longest cycle minus 11 equals the last day of the fertile period
D. Shortest cycle minus 18 equals the last day of the fertile period

C

39

The last normal menstrual period of Ana is February 14 to 17, 2010. She is using the Basal Body Temperature (BBT) method of family planning. When will you tell her to abstain from sexual intercourse?

A. February 14 through the 3rd day after the increase in temperature
B. February 17 through the 5th day after the increase in temperature
C. On the 3rd day after the increase in temperature
D. On the 5th day after the increase in temperature

A

40

True statements about female sterilization EXCEPT

A. Increased risk of ectopic pregnancy
B. Highly effective (0.5 pregnancies per 100 women during first year of use)
C. Effective immediately
D. Decreased complication rate compared to vasectomy

D

41

Bilateral tubal ligation is best recommended for which cause?

A. 39 y/o G4P1 (0121) with history of hypertension during the last pregnancy
B. 38 y/o G3P3 (3003) with first pregnancy with her 2nd husband
C. 40 y/o G5P5 (5005) with completed family size
D. 20 y/o G2P1 (1001) with heart disease

C

42

Pregnancy after a vasectomy can be due to the following EXCEPT

A. Unprotected intercourse soon after ligation
B. Incomplete occlusion of the seminal vesicles
C. Recanalization
D. Sexual contact after 10 ejaculations

B

43

The pain in the first stage of labor is subserved by the ff. spinal segments:

A. T4-T9
B. T10-L1
C. L2-S1
D. S2-S4

B

44

What is the most common complication of spinal anesthesia?

A. spinal headache
B. aspiration
C.maternal hypertension
D. nausea and vomiting

D

45

A 30 year old G2P1-1001 patient comes in 6 cm dilated with strong and painful uterine contractions every 2-3 minutes. Which of the ff. will provide her with the best pain relief during the first stage of labor?

A. spinal
B. epidural
C. paracervical
D. pudendal

C

46

True statements about regional anesthesia during pregnancy EXCEPT

A. allow the patient to participate in the birth process
B. decreases likelihood of fetal depression
C. increases maternal aspiration pneumonia
D. allow rapid birth and early breastfeeding

C

47

Anesthesia for cesarean delivery:

A. General
B. Pudendal
C. Paracervical
D. Spinal

D

48

A 21 year old G1P1-1001 married, college graduate consulted the clinic with her husband for advice on whether she can have an IUD placed because she has no desire to get pregnant for the next couple of years. After doing a complete medical history and physical/gynecologic examination, what is the next best thing that you should do?

A. prescribe an IUD and schedule her for insertion
B. explain to her the disadvantages of having an IUD
C. layout all applicable contraceptive options and their benefits and risks
D. refer her to another physician because you do not practice artificial family planning

C

49

A 44 year old G5P5-5005, married, arrived alone in the ER in active labor. On examination, the fetal elbow and arm is palpable through a 4 cm dilated cervix and advised the patient that she will undergo an emergency cesarean section for transverse lie. The patient told you that she is desirable of bilateral tubal ligation. What will you do?

A. secure consent for cesarean section and bilateral tubal ligation as the patient requested and do the procedure
B. wait for the husband and secure his consent for bilateral tubal ligation
C. schedule for bilateral tubal ligation 6 weeks postpartum
D. advise the patient other options of artificial family planning methods

A

50

A young married couple consulted for prescriptions of combined oral contraceptive pills for the first time. On further history and PE, you found out that the patient has deep vein thrombosis which is a contraindication for this type of contraception. What will you do?

A. promote a low dose estrogen combined oral contraceptive pills
B. advise other forms of contraception
C. refer her to an internist for thrombolytic and prescribe the COCs
D. refer to another OB-GYN

B

51

Anesthesia related mortality occurs most often during

A. Epidural anesthesia for patients with heart disease
B. Local anesthesia for patients with hypertension
C. Spinal anesthesia for patients with hypertension
D. General anesthesia for caesarian section

D