Rapid Obstetrics Questions

Final Obest paper 1 1. During which of the following conditions would the serum PRL level be greatest? a- Hypothyroid b- Menopause c- Ovulation d. Parturition e- Sleep 2. During early pregnancy a pelvic examination may reveal that one adnexa is slightly enlarged. This is most commonly due to which of the following a. Corpus luteum cyst B- Fallopian tube hypertrophy c- Follicular cyst d- Ovarian neoplasm e- Par- ovarian cyst 3. A 32 year old woman is diagnosed with an ectopic pregnancy based on an hCG levels that have plateaued in the range of 1400mltJ/ml and no chorionic villi found on uterine curettage. She is given of methotrexate intramuscularly five days later she complains of increased lower abdominal pain. Her blood pressure and heart rate are normal, Her abdomen shows some tenderness in the lower quadrants without guarding or rebound. Which of the following is the best course of action a- Immediate laparotomy b. Repeat dose of methotrexate c. Observation d- Folic acid rescue e- Epidural analgesia An 18 year old pregnant woman is noted to have vaginal bleeding. She is bleeding from venipuncture sites, IV sites, and from her gums. Which of the following is the most likely underlying diagnosis a. Placental abruption b. Placenta previa c- Gestational diabetes d- Multifetal gestation e- Gestational trophoblastic disease Fetal complications due to materno-fetal RH incompatibility include a- Intrauterine jaundice b' Hydrocephalus c. Intrauterine hemolysis d- Delayed lung muturity e- Polyhydratnnios :Diagnostic features of severe preeclampsia include A. blood pressure equals or more than 160/100> b- Marked lower limb edema c. presence of proteinuria urine d. Increased RBC'S count e- Sudden severe lower abdominal pain A 25 years old primigravida at 32 weeks gestation was admitted to ER in eclamptic fits. Most appropriate management a- Heavy sedation b- Mouth gag and clear air way c- Immediate CPR d- General anesthesia e. endotracheal intubation and cesarean section Cauvalaire uterus is characterized by which of the following a- Enlargement and invasion by placental tissue b- Retroversion. retroflexion and adherence to the cui-de —sac peritoneum c- A congenital anomalus development d. Intramyometrial bleeding e- Metabolic abnormalities Regarding management of case with rheumatic heart during labor a- Excess IV fluids should be given (or hydration and nutrition b- Antibiotics are preferably avoided c. bearing down should be minimized— d- Diuretics are contradicted e- Oxytocin is given as IV shot Placenta previa, "'which is not true a. Shock out of proportion of bleeding b - Malpresentation c • Head not engaged d -Painless bleeding Treatment for severe abruptio placentae includes which of the following a- heparin b. blood replacement and expectant management c- steroid therapy for pulmonary maturity d. monitoring of plasma fibrinogen and tocolysis with calcium channel blocker e. Delivery The postpartum calls about a patient had uncojupiicated vaginal delivery 12 hours ago. She ig concerned that the patient lias the following findings Which of them should be of most concern to you a. abdominal rigidity b. leukocytosis of 16 000 c. proteinuria d- a pulse rate of 60 o single temperature of 100 :The most anomaly due to uncontrolled diabetes is a- Ventricular septal defect b- down syndrome c- Renal agenesis d. Sacral agenesis (caudal regression A G, P l, Previous CS had a for vagina; cervical became fully dilated, uterine contractions ceased off, slight vaginal .bleeding occurred and fetal head receded up what is your 1st differential diagnosis a- Uterine inertia b. accidental hemorrhage c. Obstructed tabor d. Rupture uterus e. Constriction ring opposite fetal neck After convulsions are controlled in an eclamptic patient, the therapy should be aimed at which of the following a. reducing edema with diuretics b- Giving hypotensive agents until the blood pressure 1 10/50 c- Giving 3 gm of magnesium sulphate every hours d- Obtaining a term infant e. Keeping the patient free of convulsions, coma and acidosis Pregnancy should be avoided within I month of receiving which of the following vaccinations a. Measles, mumps, rubella (MMR— b- Influenza c. Hepatitis B d- Tetanus e. Pneumococcus -Which of the following situations has the greatest risk for the mother and infant a. Rupture of an intact uterus b- Rupture of a previous uterine seas c. contraction ring d. Dehiscence of u uterine scat e. Cervical laceration Warning signs or impending rupture cesarean section scar include a- Infrequent uterine contractions b. Tender scar c- Increased fetal movements d. Severe vaginal bleeding e- Meconium stained liquor Initial management of retained placenta includes a- hysterectomy b- Bilateral internal iliac artery ligation c- Wait for spontaneous autolysis d. Brandt-Andrews maneuver followed by manual separation of placenta e. Curettage of placenta under anesthesia The most common cause of puerperal pyrexia is a- Puerperal sepsis b. Breast engorgement c- Respiratory tract infection d. Urinary tract infection e- Deep vein thrombosis Regarding intrauterine fetal growth restriction: A. Symmetric type has a better prognosis than asymmetric type b. Fetal anomalies ace more common in asymmetric type c- In asymmetric type; brain growth is spared d- In asymmetric type; the baby remains short statured later on e- In asymmetric type; oligohydramnios is the rule 22- A 30 years old G3P2 with previous myomectomy, at 20 weeks gestation, presents with gush of fluid I week ago with no pain Ultrasound revealed AFI Of I cm Temperature if 37.5 C, TLC is 18000. The fetus is living by ultrasound. How would you manage this case . a- Vaginal misoprostol b- Hysterotomy c. Emergency cerclage d. Antibiotics and fellow up )e- Non stress test (NST) Of the following, "'which is the most common cause of death ?from eclampsia .a. Infection b- Uremia ,c- Congestive head failure .d- Fever .e. Cerebral hemorrhage The Commonest ovarian neoplasm complicated with torsion during pregnancy a- fibroma b. teratoma c- simple Serous cyst d- thecoma which of the following factors not favouring long anterior rotation a- Correction of the deflexion b- Adequate pelvis c, pelvic floor" d. rupture of membranes Consumptive coagulopathy is a Known complication of which of the following a—placental abruption— b- Severe preeclampsia c- Acute cystitis d- Multiple gestations in the presence of hydramnios e- Postdates (>42 weeks gestation) in the presence of meconium passage What is the usual method of diagnosing placental abruptiona, Clinical diagnosis— b- D-dimer test c- Kleihauer test d- Trans abdominal e- Transvaginal ultrasound Which of the following cardiac conditions carries the highest independent risk or perioperative complications a. Aortic stenosis b- Pulmonary stenosis c- Mitral valve prolapse d- Tricuspid regurgitation What is the most thrombogenic heritable coagulopathy a- Protein C deficiency b. Antithrombin deficiency c- Factor V Leiden mutation d- prothrombin A 24 ears old PG is admitted to the labour ward. P V : cx is soft,central, effaced˃80% and 6 cm dilated. The presentation is cephalic, vertex, LOA and station 0. Her Bishop score is a. 5 b. 7 c. 11 d. 13 Which of the following is the most warning sign/ symptom ?of an eclamptic seizure a- Proteinuria b. Severe headache c-Facial edema d- Increased blood pressure 160/ t 20 e- Epigastric pain ?Which of the following is not feature of puerperal sepsisa- Acute suppurative inflammation b. caused by streptococcus haemolyticus c- follow labour or abortion d. uterus is atrophic and firm... e- The endometrium is infiltrated by many polymorphs The chocolate ovarian cyst refers to Follicular cyst b- Theca lutein cyst c. Endometriotic cyst d. Mucinous cystadenoma e. Serous cystadenoma ;The commonest site of ectopic pregnancy is a- vagina b- Cervix e- Peritoneal cavity d- Ovary e. Fallopian tubes which of the following does not show chorionic villi a- Abortion b- Partial mole c- Complete mole d.Choriocarcinoma— e- invasive mole