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1
Q

question

A

answer

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2
Q

For single dose methotrexate therapy, resolution time is defined as serum b-hcg of

A. <100 miu/ml
B. <50 miu/ml
C. 20 miu/ml
D. 15 miu/ml

A

D. 15 miu/ml

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3
Q

A previous salphigectomy is a sp. Risk factor for this kind of ectopic pregnancy

A. Abdominal
B. Interstitial
C. Cervical
D. Ovarian

A

B. Interstitial

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4
Q

This type of congenital abnormality seen on sagittal view of an ultrasound showing a defect on dorsal aspect of cranio-axial view

A. Sacrococcygeal Teratoma
B. Lipoma
C. Open Neural Tube Defect

A

C. Open Neural Tube Defect

Sacrococcygeal Teratoma - sonographically
appears as a solid and/or cystic mass that arises
from the anterior sacrum and usually extends
inferiorly and externally as it grow
Neural Tube Defects include anencephaly,
myelomeningocele (also called spina bifida),
cephalocele, and other rare spinal fusion (or
schisis) abnormalities. They result from
incomplete closure of the neural tube by the
embryonic age of 26 to 28 days.
Women currently have the option of neural-tube
defect screening with MSAFP, sonography, or
both. Targeted sonography is the preferred
diagnostic test, and in addition to characterizing
the neural-tube defect, it may identify other
abnormalities or conditions that also result in
MSAFP elevation.

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5
Q

What is the detection rate in quadruple testing (MSAFP, Estriol, HCG and dimeric inhibin) in younger than 35 y.o patient

A. 65% (screen + 5%)
B. 75 % (screen + 5%)
C.85 % (screen + 5%)
D. 80% (screen + 5%)

A

A. 65% (screen + 5%)

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6
Q

MSAFP is best measured during this time:
A. 12-14 weeks
B. 14-16 weeks

A

B. 14-16 weeks

MSAFP

  • Routinely measured as a screening test for NTDs from 15-20 wks
  • After 12th wk- maternal serum level of AFP will now begin to rise
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7
Q

Based in FIGO what is the low risk for gestational tropho neoplasia

A. less than 4
B. less than 6
C. Less than 8
D. Less than 10

A

B. less than 6

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8
Q

Marked trophoblast atypia

A. Partial Mole
B. Complete Mole
C. Invasive Mole
D. Choriocarcinoma

A

B. Complete Mole

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9
Q

35y/o G3P2 (2002), 30 wks AOG. First pregnancy was delivered vaginally and second pregnancy by cesarian section because of footling breech presentation. She wants to know if she can undergo VBAC (vaginal birth after CS) and she asks her chance of having breech presentation again.

A. 1%
B. 5%
C. 10%
D. 28%

A

C. 10%

the recurrence rate for a second breech presentation was 10 percent, and for a subsequent third breech it was 28 percent

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10
Q

Vaginal delivery a breech baby, requesting ultrasound findings should associate w/ the ff. EXCEPT:

A. Fetal size
B. Degree of neck extension
C. Measurement of midpelvis is >/= 10cm
D. Type of breech

A

C. Measurement of midpelvis is >/= 10cm

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11
Q

Parametrial phlegmon that suppurates anteriorly may involve the

A. Urinary bladder
B. Iliac fossa
C. Vesicouterine fold
D. Poupart’s ligament

A

D. Poupart’s ligament

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12
Q

Septic thromboplebitis

A. Spiral arteries
B. Radial artery
C. Ovarian arteries

A

C. Ovarian arteries

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13
Q

This enzyme secreted by GBS degrades the cervical epithilium barrier favoring ascending infection to cause ptb

A. Glycosaminidase
B. Hyaluronidase
C. Neuraminidase
D. Glycan dessolvent

A

B. Hyaluronidase

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14
Q

Most common cause of acute glomerulonephritis

A. IgA nephropathy
B. Acute
C. PKD
D. HTN GN

A

A. IgA nephropathy

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15
Q

Acute kidney damage

A.diabetes
B. Hypermesis
C. Septicemia
C. Hypovolemia
D. Diabetes
A

C. Septicemia

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16
Q

What is the lower limit of uterine contraction pressure required to dilate the cervix

A. 45mmHg
B. 35mmHg
C. 25mmHg
D. 15mmHg

A

D. 15mmHg

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17
Q

Protraction disorder in cervical dilation

A

<1.2cm in nulli, <1.5cm in multi

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18
Q

How many hours after giving protaglandin gel can you start oxytocin

A. 30mins
B. 1hr
C. 2hrs
D. 6hrs

A

D. 6hrs

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19
Q

Use of oxytocin for induction of labor is contraindicated in

A. Fetal demise
B. Hypertonic uterine contraction
C. Hypotonic uterine contraction

A

C. Hypotonic uterine contraction

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20
Q

Which of the following would lead to a diagnosis of an incompetent cervix?

A. painless vaginal bleeding

b. cramping abdominal painc
c. dysuria, fever, and vaginal bleeding
d. watery vaginal discharge

A

A. painless vaginal bleeding

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21
Q

Which of the following directly stimulates myometrium?

Mifepristone
methotrexate
misoprostol
mithramycin

A

misoprostol

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22
Q

What is the most common indication of therapeutic abortion?

A

fetal deformity

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23
Q

Which is associated with first trimester abortion?

A. intraamnionic hyperosmotic fluid

b. menstrul aspiration, oxytocin
c. vaccum aspiration, prostaglandin
d. hysterotomy, laparotomy

A

c. vaccum aspiration, prostaglandin

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24
Q

Management for patient with incompetent cervix?

A. mcdonald at 8 weeks
b. shirodkar at 12 weeks

A

b. shirodkar at 12 weeks

any cerclage should be done 12-14 weeks

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25
What are the causes of preterm brith
. Spontaneous preterm labor with intact membranes . Idiopathic preterm premature rupture of membranes . Delivery for maternal or fetal indications . Twins and higher-order multifetal births
26
What are the 3 most common reasons for preterm birth?
. Spontaneous pretern labor, 40-45% | . Indicated and preterm membrane rupture
27
Which causes of preterm labor often have multiple factors?
PPROM and spontaneous
28
What genetic alteration may lead to preterm birth?
inherited mutations in genes regulating collagen assembly may lead to cervical insufficiency or PPROM
29
How many preterm births are due to higher order pregnancy?
1 in 6
30
When is group b streptococcal prophylaxis not recommended? >34 weeks 32-33 weeks 24-31 weeks <24 weeks
<24 weeks
31
Sepsis due to this responds well to prolonged antimicrobial therapy?
group b streptococcus
32
define PPROM
spontaneous rupture before 37 weeks and before labor onset
33
what are major predisposing events to PPROM
infection, oxidative stress-induced DNA damage, premature cellular senescence
34
What are risk factors for PPROM?
socioeconomic status, BMI <19.8, nutritional deficiency, smoking, and prior PPROM
35
apoptosis in PPROM is likely regulated by
bacterial endotoxin, IL-ib, and TNF-a
36
what is the likely reason why gbs predisposes to preterm birth?
ability to secrete hyaluronidase
37
moa of b-adrenergic receptor agonist in preterm labor
reducee intracellular ionized calcium level and prevent activation of myometrial contractile proteins
38
moa of magnesium sulfate
calcium agonist that can alter myometrial contractility
39
moa of prostagladin inhibitors
act by inhibiting prostagladin synthesis or by blocking their action on target organs; prostagladin synthase is responsible for the conversation of free arachidonic acid to prostagladin aetylsalicylate and indomethacin
40
moa of NO donors
potent smooth muscle relaxants affect the vasculature, gut, and uterus;
41
moa of calcium channel blockers
myometrial activity is directly related to cytoplasmic free calcium and reduced calcium concentrations inhibit contractions; inhbit calcium entry through cell membrane channels
42
substance released by streptococcus that can result in preterm birth a. hyaluronic acid b. hyaluronidase
b. hyaluronidase
43
With an intact membrane, the chance for preterm birth is high when fetal fibronectin level is ___ a. 60 b. 28
a. 60
44
at 31 weeks, Mrs. X was given 2 doses of 12 mg corticosteroid therapy for fetal lung maturity every 24 hours. What type of steroid did she receive? a. Dexamethasone b. betamethasone
b. betamethasone
45
pregnant women who indulge in Zumba exercises are at increased risk for preterm labor a. true b. false
a. true
46
shape of the cervix which has a higher risk for cervical dilatation a. U shape b. Y shape
a. U shape
47
A neuroprotective agent given to pregnant women at risk for preterm birth a. Nifedipine b. MgSO4
b. MgSO4
48
most important risk factor for preterm birth a. Maternal infection b. Prior TB
b. Prior TB
49
Uterine stretch from multifetal pregnancy activates this substance to cause preterm labor a. Interleukin B b. CRH
b. CRH
50
management of preterm birth due to cervical insufficiency a. McDonalds procedure b. Micronized progesterone
a. McDonalds procedure
51
question
answer
52
For single dose methotrexate therapy, resolution time is defined as serum b-hcg of A. <100 miu/ml B. <50 miu/ml C. 20 miu/ml D. 15 miu/ml
D. 15 miu/ml
53
A previous salphigectomy is a sp. Risk factor for this kind of ectopic pregnancy A. Abdominal B. Interstitial C. Cervical D. Ovarian
B. Interstitial
54
This type of congenital abnormality seen on sagittal view of an ultrasound showing a defect on dorsal aspect of cranio-axial view A. Sacrococcygeal Teratoma B. Lipoma C. Open Neural Tube Defect
C. Open Neural Tube Defect Sacrococcygeal Teratoma - sonographically appears as a solid and/or cystic mass that arises from the anterior sacrum and usually extends inferiorly and externally as it grow Neural Tube Defects include anencephaly, myelomeningocele (also called spina bifida), cephalocele, and other rare spinal fusion (or schisis) abnormalities. They result from incomplete closure of the neural tube by the embryonic age of 26 to 28 days. Women currently have the option of neural-tube defect screening with MSAFP, sonography, or both. Targeted sonography is the preferred diagnostic test, and in addition to characterizing the neural-tube defect, it may identify other abnormalities or conditions that also result in MSAFP elevation.
55
What is the detection rate in quadruple testing (MSAFP, Estriol, HCG and dimeric inhibin) in younger than 35 y.o patient A. 65% (screen + 5%) B. 75 % (screen + 5%) C.85 % (screen + 5%) D. 80% (screen + 5%)
A. 65% (screen + 5%)
56
MSAFP is best measured during this time: A. 12-14 weeks B. 14-16 weeks
B. 14-16 weeks MSAFP - Routinely measured as a screening test for NTDs from 15-20 wks - After 12th wk- maternal serum level of AFP will now begin to rise
57
Based in FIGO what is the low risk for gestational tropho neoplasia A. less than 4 B. less than 6 C. Less than 8 D. Less than 10
B. less than 6
58
Marked trophoblast atypia A. Partial Mole B. Complete Mole C. Invasive Mole D. Choriocarcinoma
B. Complete Mole
59
35y/o G3P2 (2002), 30 wks AOG. First pregnancy was delivered vaginally and second pregnancy by cesarian section because of footling breech presentation. She wants to know if she can undergo VBAC (vaginal birth after CS) and she asks her chance of having breech presentation again. A. 1% B. 5% C. 10% D. 28%
C. 10% the recurrence rate for a second breech presentation was 10 percent, and for a subsequent third breech it was 28 percent
60
Vaginal delivery a breech baby, requesting ultrasound findings should associate w/ the ff. EXCEPT: A. Fetal size B. Degree of neck extension C. Measurement of midpelvis is >/= 10cm D. Type of breech
C. Measurement of midpelvis is >/= 10cm
61
Parametrial phlegmon that suppurates anteriorly may involve the A. Urinary bladder B. Iliac fossa C. Vesicouterine fold D. Poupart’s ligament
D. Poupart’s ligament
62
Septic thromboplebitis A. Spiral arteries B. Radial artery C. Ovarian arteries
C. Ovarian arteries
63
This enzyme secreted by GBS degrades the cervical epithilium barrier favoring ascending infection to cause ptb A. Glycosaminidase B. Hyaluronidase C. Neuraminidase D. Glycan dessolvent
B. Hyaluronidase
64
Most common cause of acute glomerulonephritis A. IgA nephropathy B. Acute C. PKD D. HTN GN
A. IgA nephropathy
65
Acute kidney damage ``` A.diabetes B. Hypermesis C. Septicemia C. Hypovolemia D. Diabetes ```
C. Septicemia
66
What is the lower limit of uterine contraction pressure required to dilate the cervix A. 45mmHg B. 35mmHg C. 25mmHg D. 15mmHg
D. 15mmHg
67
Protraction disorder in cervical dilation
<1.2cm in nulli, <1.5cm in multi
68
How many hours after giving protaglandin gel can you start oxytocin A. 30mins B. 1hr C. 2hrs D. 6hrs
D. 6hrs
69
Use of oxytocin for induction of labor is contraindicated in A. Fetal demise B. Hypertonic uterine contraction C. Hypotonic uterine contraction
C. Hypotonic uterine contraction
70
Which of the following would lead to a diagnosis of an incompetent cervix? A. painless vaginal bleeding b. cramping abdominal painc c. dysuria, fever, and vaginal bleeding d. watery vaginal discharge
A. painless vaginal bleeding
71
Which of the following directly stimulates myometrium? Mifepristone methotrexate misoprostol mithramycin
misoprostol
72
What is the most common indication of therapeutic abortion?
fetal deformity
73
Which is associated with first trimester abortion? A. intraamnionic hyperosmotic fluid b. menstrul aspiration, oxytocin c. vaccum aspiration, prostaglandin d. hysterotomy, laparotomy
c. vaccum aspiration, prostaglandin
74
Management for patient with incompetent cervix? A. mcdonald at 8 weeks b. shirodkar at 12 weeks
b. shirodkar at 12 weeks any cerclage should be done 12-14 weeks
75
What are the causes of preterm brith
. Spontaneous preterm labor with intact membranes . Idiopathic preterm premature rupture of membranes . Delivery for maternal or fetal indications . Twins and higher-order multifetal births
76
What are the 3 most common reasons for preterm birth?
. Spontaneous pretern labor, 40-45% | . Indicated and preterm membrane rupture
77
Which causes of preterm labor often have multiple factors?
PPROM and spontaneous
78
What genetic alteration may lead to preterm birth?
inherited mutations in genes regulating collagen assembly may lead to cervical insufficiency or PPROM
79
How many preterm births are due to higher order pregnancy?
1 in 6
80
When is group b streptococcal prophylaxis not recommended? >34 weeks 32-33 weeks 24-31 weeks <24 weeks
<24 weeks
81
Sepsis due to this responds well to prolonged antimicrobial therapy?
group b streptococcus
82
define PPROM
spontaneous rupture before 37 weeks and before labor onset
83
what are major predisposing events to PPROM
infection, oxidative stress-induced DNA damage, premature cellular senescence
84
What are risk factors for PPROM?
socioeconomic status, BMI <19.8, nutritional deficiency, smoking, and prior PPROM
85
apoptosis in PPROM is likely regulated by
bacterial endotoxin, IL-ib, and TNF-a
86
what is the likely reason why gbs predisposes to preterm birth?
ability to secrete hyaluronidase
87
moa of b-adrenergic receptor agonist in preterm labor
reducee intracellular ionized calcium level and prevent activation of myometrial contractile proteins
88
moa of magnesium sulfate
calcium agonist that can alter myometrial contractility
89
moa of prostagladin inhibitors
act by inhibiting prostagladin synthesis or by blocking their action on target organs; prostagladin synthase is responsible for the conversation of free arachidonic acid to prostagladin aetylsalicylate and indomethacin
90
moa of NO donors
potent smooth muscle relaxants affect the vasculature, gut, and uterus;
91
moa of calcium channel blockers
myometrial activity is directly related to cytoplasmic free calcium and reduced calcium concentrations inhibit contractions; inhbit calcium entry through cell membrane channels
92
substance released by streptococcus that can result in preterm birth a. hyaluronic acid b. hyaluronidase
b. hyaluronidase
93
With an intact membrane, the chance for preterm birth is high when fetal fibronectin level is ___ a. 60 b. 28
a. 60
94
at 31 weeks, Mrs. X was given 2 doses of 12 mg corticosteroid therapy for fetal lung maturity every 24 hours. What type of steroid did she receive? a. Dexamethasone b. betamethasone
b. betamethasone
95
pregnant women who indulge in Zumba exercises are at increased risk for preterm labor a. true b. false
a. true
96
shape of the cervix which has a higher risk for cervical dilatation a. U shape b. Y shape
a. U shape
97
A neuroprotective agent given to pregnant women at risk for preterm birth a. Nifedipine b. MgSO4
b. MgSO4
98
most important risk factor for preterm birth a. Maternal infection b. Prior TB
b. Prior TB
99
Uterine stretch from multifetal pregnancy activates this substance to cause preterm labor a. Interleukin B b. CRH
b. CRH
100
management of preterm birth due to cervical insufficiency a. McDonalds procedure b. Micronized progesterone
a. McDonalds procedure

Patho OB (12 decks)

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