FINALS OB Flashcards
A 32-week pregnant woman presents with watery vaginal discharge and occasional uterine contractions. Examination shows a fundal height of 31 cm, fetal heart tones at 138 bpm, gross pooling of clear amniotic fluid on speculum exam, and 2 cm cervical dilation. What is the appropriate management?
Choices:
A. Give tocolytics
B. Proceed to delivery
C. Send the patient home
D. Expectant management unless fetal lung maturity is documented
A contracted mid-pelvis includes which of the following findings?
Choices:
A. Sacral promontory is easily accessible
B. The sub-pubic angle is less than 90°
C. The sacrum is flat
D. The sacro-sciatic notch admits three fingerbreadths
What is the appropriate treatment regimen for pulmonary tuberculosis (PTB) in pregnant women with active disease?
Choices:
A. Isoniazid + Rifampin + Pyrazinamide for 2 months only
B. Isoniazid + Rifampin + Pyrazinamide for 2 months, followed by Isoniazid + Rifampin for 4 months
C. Isoniazid + Pyridoxine + Rifampin for 2 months, followed by Isoniazid + Rifampin for 4 months
D. Isoniazid + Pyridoxine + Rifampin for 2 months only
A 30-year-old G4P3 (2103) at 28 weeks gestation presents with headache, dizziness, and joint pains. BP is 180/100 mmHg, PR is 92/min, and urinalysis shows no proteinuria. What is the most likely diagnosis?
Choices:
A. Preeclampsia with severe features
B. HELLP syndrome
C. Gestational hypertension
D. Chronic hypertension with superimposed preeclampsia
A multigravida presents to the ER with dysuria, fever, chills, vomiting, and costovertebral angle tenderness. Urinalysis reveals pyuria. What is the most probable diagnosis?
Choices:
A. Asymptomatic bacteriuria
B. Cystitis
C. Urethritis
D. Pyelonephritis
A 26-year-old G1P0 at 8 weeks gestation presents with nausea and vomiting for 1 week, severe retching, weight loss of 8 lbs, and occasional coffee-ground vomitus. What is the most likely diagnosis?
Choices:
A. Mallory-Weiss syndrome
B. Boerhaave syndrome
C. Cushing’s syndrome
D. Wernicke’s encephalopathy
Which of the following is a severe feature of preeclampsia?
Choices:
A. Creatinine > 1.1 mg/dL
B. Oligohydramnios
C. Non-dependent edema
D. Intrauterine growth restriction
The only chronic marker among the biophysical variables in fetal surveillance is:
Choices:
A. Amniotic fluid volume
B. Fetal tone
C. Fetal breathing
D. Fetal movement
What is the best method for monitoring fetal weight estimates in twins?
Choices:
A. Palm method
B. Johnson’s rule
C. Fundal height measurement
D. Ultrasound estimates every 4 weeks
What is the most effective method of predicting preeclampsia?
Choices:
A. sFlt-1 with maternal characteristics
B. MAP in combination with maternal risk factors
C. MAP, Uterine artery Doppler velocimetry & PlGF
D. Maternal risk factors alone
A Bishop score of 2 would indicate which cervical findings?
Choices:
A. Cervix 1 cm dilated, 30% effaced, firm, posterior, station -2
B. Cervix 2cm, 20% effaced, soft, posterior
C. Cervix 2cm, 30% effaced, firm, anterior
D. Cervix 1cm, beginning effacement, station -1, firm and posterior
A. Cervix 1 cm dilated, 30% effaced, firm, posterior, station -2
Score Breakdown for Option A:
Dilatation: 1 cm → 1 point
Effacement: 30% → 0 points
Consistency: Firm → 0 points
Position: Posterior → 0 points
Station: -2 → 1 point
➡️ Total = 1 + 1 = 2 points
A 34-year-old G3P2 at 32 weeks of gestation presents with labor pains and a random blood sugar of 240 mg/dL. She was given betamimetic tocolytics and corticosteroids, then became obtunded. What is the cornerstone of management?
Choices:
A. Epinephrine
B. Diuresis and Furosemide
C. Magnesium sulfate
D. Insulin and vigorous rehydration with crystalloid solution
What is the therapeutic level of Magnesium Sulfate (MgSO₄)?
Choices:
A. 1-3 meq/L
B. 4-7 meq/L
C. 8-10 meq/L
D. 10-12 meq/L
A 30-year-old at 32 weeks gestational age presents with chest pain and temporary loss of consciousness. Persistent arrhythmia is noted, and echocardiography shows an aortic valve area <1.5 cm². What is the appropriate management?
Choices:
A. Beta-blocking agents
B. Diuresis
C. Catheter-based valvuloplasty
D. Maintain adequate end-diastolic ventricular filling pressure to maintain cardiac output
A 27-year-old G1P0 at 28 weeks gestation presents with anxiety, palpitations, atypical chest pain, and dyspnea on exertion. Myxomatous degeneration of the mitral valve chordae tendineae is noted. What is the diagnosis?
Choices:
A. Mitral stenosis
B. Mitral valve endocarditis
C. Mitral valve prolapse
D. Membranous ventricular septal defect
Which of the following is NOT affected by maternal hyperinsulinemia in the developing fetus?
Choices:
A. Kidneys
B. Brain
C. Liver
D. Fat deposition in the trunk
A 21-year-old G1P0 at 30 weeks gestation experiences increased afterload and decreased cardiac return due to:
Choices:
A. Compression of the aorta and the vena cava
B. Increase in circulating estrogen and progesterone
C. Compression of the common iliac artery and veins
D. Increase in nitric oxide and prostacyclin
Which of the following is the treatment of choice for glomerular disease?
Choices:
A. Edema, Proteinuria, Hypoalbuminemia, Hyperlipidemia
B. Edema, Polycythemia, Hypoalbuminemia, Hyperlipidemia
C. Edema, Proteinuria, Hyperalbuminemia, Hypolipidemia
D. Edema, Porphyria, Hyperalbuminemia, Hypolipidemia
What is the biggest single cause of maternal deaths in the Philippines?
Choices:
A. Hypertension
B. Malignancy
C. Hemorrhage
D. Infection
Q: A 25-year-old woman, 32 weeks pregnant, with diagnosed intrauterine growth restriction (IUGR) presents with the following umbilical artery Doppler waveform showing absent end-diastolic flow. What is the most appropriate management?
A:
A. Request a back-up test like biophysical profile
B. Admit the patient for closer monitoring
C. Immediate termination of pregnancy is in order
D. Continue expectant management with left lateral rest and increased food intake
Q: A 34-week pregnant woman shows diastolic notching on uterine artery Doppler velocimetry. What does this finding indicate?
A:
A. Deterioration of maternal and fetal status should be watched for
B. The pregnant woman will not be hypertensive
C. There is adequate blood flow going to the fetus
D. Pregnancy termination must be done at the soonest possible time
Q: Which of the following patients is at highest risk for preterm labor or delivery?
A:
A. 32 weeks, G4P2(0212) with UTI
B. 34 weeks, G1P0, with history of bacterial vaginosis before pregnancy
C. 36 weeks, G2P1(1001) with oligohydramnios
D. 31 weeks, G1P0, breech presentation
Q: A primigravida comes in for a routine prenatal check-up. Urine culture reveals >70,000 gram-negative rods, though she is asymptomatic. What is the most likely diagnosis?
A:
A. Pyelonephritis
B. Cystitis
C. Urethritis
D. Asymptomatic bacteriuria
Q: During pregnancy, the functional residual capacity (FRC) of the lungs:
A:
A. Increases
B. Decreases
C. Remains unchanged
D. Is unaffected