HD 201 E2 Samplex 2018 (No Answers) Flashcards

1
Q

Hemoglobin/Hematocrit is rechecked at ___ weeks AOG for anemia surveillance in pregnancy.

a. 18-22
b. 23-27
c. 28-32
d. 33-37

A

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2
Q

Adverse outcomes linked to smoking include the following, EXCEPT:

a. Abortion
b. Fetal macrosomia
c. Infant death
d. Placental abruption

A

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3
Q

Softening of the uterine isthmus during 8 weeks AOG:

a. Chadwick’s Sign
b. Goodell sign
c. Hegar Sign
d. Cullen Sign

A

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4
Q

Common concerns of pregnant women that do not have a serious sequelae, EXCEPT:

a. Excessive Vaginal discharge
b. Heartburn
c. Headache during the first trimester
d. Blurring of vision

A

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5
Q

Woman who had a previous abortion is a:

a. Nulligravida
b. Nullipara
c. Multigravida
d. Primipara

A

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6
Q

A 28-year old follows-up at the OPD for her prenatal check-up. Her last normal menstrual period was in July 31, 2013. Her family, medical and personal/social histories are unremarkable. Her eldest daughter was delivered term 2 years ago, followed by a miscarriage. Her first pregnancy was an ectopic. Based on her LMNP, she’s in her ___ trimester. (This exam was taken Feb 12, 2014)

a. First
b. Second
c. Third
d. Fourth

A

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7
Q

A 28-year old follows-up at the OPD for her prenatal check-up. Her last normal menstrual period was in July 31, 2013. Her family, medical and personal/social histories are unremarkable. Her eldest daughter was delivered term 2 years ago, followed by a miscarriage. Her first pregnancy was an ectopic. Based on her LMNP, she’s in her ___ trimester. (This exam was taken Feb 12, 2014)

Where can the uterine fundus be palpated?

a. Above the pubic symphysis
b. Midway between the pubic symphysis and umbilicus
c. At the umbilicus
d. Midway between the umbilicus and sternum

A

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8
Q

A 28-year old follows-up at the OPD for her prenatal check-up. Her last normal menstrual period was in July 31, 2013. Her family, medical and personal/social histories are unremarkable. Her eldest daughter was delivered term 2 years ago, followed by a miscarriage. Her first pregnancy was an ectopic. Based on her LMNP, she’s in her ___ trimester. (This exam was taken Feb 12, 2014)

What is her OB score?

a. G3P1 (1011)
b. G4P2 (1111)
c. G4P1 (1021)
d. G3P1 (1101)

A

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9
Q

A 28-year old follows-up at the OPD for her prenatal check-up. Her last normal menstrual period was in July 31, 2013. Her family, medical and personal/social histories are unremarkable. Her eldest daughter was delivered term 2 years ago, followed by a miscarriage. Her first pregnancy was an ectopic. Based on her LMNP, she’s in her ___ trimester. (This exam was taken Feb 12, 2014)

When is her expected date of delivery? (This exam was taken Feb 12, 2014)

a. May 7, 2014
b. April 24, 2014
c. May 31, 2014
d. April 21, 2014

A

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10
Q

A 28-year old follows-up at the OPD for her prenatal check-up. Her last normal menstrual period was in July 31, 2013. Her family, medical and personal/social histories are unremarkable. Her eldest daughter was delivered term 2 years ago, followed by a miscarriage. Her first pregnancy was an ectopic. Based on her LMNP, she’s in her ___ trimester. (This exam was taken Feb 12, 2014)

Physical exam and laboratory findings of the patient are normal. She is advised to come back for her next prenatal visit on her __ weeks AOG.

a. 24
b. 29
c. 30
d. 32

A

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11
Q

A gravid woman with a singleton pregnancy and a pre-pregnant BMI of 27 should have a total weight gain (KG) of

a. 12.5-18
b. 11.5-18
c. 7-11.5
d. <7

A

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12
Q

When can the fetal heart sounds first be appreciated in most women using a standard stethoscope?

a. 5 weeks AOG
b. 16-19 weeks AOG
c. 21 weeks AOG
d. 22-24 weeks AOG

A

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13
Q

Which of the following may be used to assess gestational age?

a. Quickening
b. Cervical Consistency
c. Maternal Weight Gain
d. Onset of Nausea and Vomiting

A

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14
Q

How should you advise a pregnant woman in terms of nutrition?

a. She should eat what she wants in amounts she desires and salted to taste.
b. If she has normal BMI, she should gain approximately 40-45 lbs
c. Low salt, low fat, sugar free diet is recommended
d. Vegetarians eat the most nutritious food deemed complete so they don’t need additional supplements

A

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15
Q

Which of the following vaccines is recommended to all pregnant women during the pregnancy?

a. Varicella
b. Rubella
c. Influenza
d. Hepatitis B

A

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16
Q

Which is not a positive sign of pregnancy?

a. Hegar Sign
b. 3 missed menses
c. Positive Pregnancy test
d. NOTA

A

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17
Q

Usually, the earliest age at which the fetal skeleton is visible on x-ray is

a. 2 lunar months
b. 4 lunar months
c. 6 lunar months
d. 8 lunar months

A

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18
Q

Positive signs of pregnancy include:

a. Enlargement of uterus
b. Changes in the cervix
c. Ballotment
d. None of the Above

A

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19
Q

During pregnancy the uterus increases in size. This is not normally due to:

a. Increase in volume of uterine content
b. Some increase in numbers of muscle cells
c. Muscle cell hypertrophy
d. Growth of intrauterine fibroids

A

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20
Q

The relation of the fetal parts to one another determines the:

a. Presentation of the fetus
b. Lie of the fetus
c. Attitude of the fetus
d. Position of the fetus

A

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21
Q

The relationship of the long axis of the fetus to the long axis of the mother is call the ___.

a. Lie
b. Presentation
c. Position
d. Attitude

A

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22
Q

Of the following methods, which determine fetal presentations:

a. Cullen’s maneuver
b. Leopold’s maneuver
c. Mauriceau-Smellie-Velt maneuver
d. McDonald’s maneuver

A

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23
Q

Sonography is valuable is pregnancy except in

a. Diagnosing early preganancy
b. Determining pelvic adequacy
c. Identifying fetal anomalies
d. Localizing the placenta

A

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24
Q

Braxton Hick’s Contraction is not:

a. Palpable
b. Painless
c. Irregular
d. Purposeful

A

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25
Q

Chadwick’s sign of pregnancy is:

a. Softening of the isthmus uteri
b. Bluish discolouration of cervix and vagina
c. An enlargement of the fundus of the uterus
d. An irregularity of the uterine fundus during pregnancy

A

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26
Q

Softening of the isthmus

a. Hegar’s Sign
b. Cullen’s Sign
c. Goodell’s Sign
d. Hick’s Sign

A

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27
Q

At the 12th weeks of gestation the uterus in a normal pregnancy is:

a. Not palpable abdominally
b. Palpable just above the symphysis pubis
c. Palpable midway between the umbilicus and the sternum
d. Palpable at the level of the xiphoid

A

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28
Q

Pregnant uterus has the following characteristics:

a. Contracts only at the onset of labor
b. Can markedly enlarge and return to normal size
c. Has the most marked growth in the lower uterine segment
d. Both A and C

A

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29
Q

Anemia for both mother and fetus is most commonly found in the following EXCEPT:

a. Early Pregnanct
b. Patients of high parity
c. Young gravidas
d. Inadequate prenatal care

A

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30
Q

Large uterine blood vessels from pregnancy normally undergo changes post partum. These changes include all, EXCEPT:

a. Thrombosis
b. Slow Reabsorption
c. Hyalinization
d. Calcification

A

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31
Q

Which of the following is normally found in the immediate post partum period?

a. Leucopenia
b. Elevated erythrocyte sedimentation rate
c. Rapid fall of plasma fibrinogen
d. All of the Above

A

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32
Q

Normal ovarian changes during pregnancy incude:

a. Luteoma
b. Decidual reaction on the surface
c. Corpus Luteum of pregnancy
d. AOTA

A

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33
Q

The corpus luteum of pregnancy functions maximally during

a. 4-5 weeks AOG
b. 5-6 weeks AOG
c. 6-7 weeks AOG
d. 7-8 weeks AOG

A

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34
Q

Which of the following coagulation factors remain unchanged during pregnancy?

a. Clotting time
b. D-dimer concentration
c. Plasma Fibrinogen levels
d. Platelet count

A

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35
Q

The following increases are noted in pregnancy EXCEPT:

a. Erythropoietin levels
b. Hemoglobin and hematocrit
c. Plasma and RBCs
d. Reticulocyte count

A

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36
Q

Pregnancy induced hypervolemia serves to

a. Protect the mother against blood loss during parturition
b. Meet the demands of the enlarged uterus with its greatly hypertrophied vascular system
c. Protects the mother and fetus against the effects of impaired venous return in supine and erect positions
d. AOTA

A

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37
Q

“Accelerated starvation” in pregnancy pertains to:

a. increased lipolysis with liberation of free fatty acids as a result of placental lactogen production
b. pregnancy-induced switch in fuels from glucose to lipids during the fasting state
c. progesterone and estrogen mediated peripheral insulin resistance
d. prolonged hyperglycemia and hyperinsulinemia with greater suppression of glucagons after a meal

A

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38
Q

Relaxin is secreted by the following organs EXCEPT:

a. Corpus luteum
b. Heart
c. Myometrium
d. Placenta

A

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39
Q

The following are effects of hyperestrogenemia EXCEPT:

a. Vascular spiders
b. Palmar erythema
c. Hyperreactio luteinalis
d. Chloasma

A

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40
Q

Which of the following minerals remain unchanged during pregnancy?

a. Phosphate
b. Magnesium
c. Iron
d. Calcium

A

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41
Q

Which of the following are true regarding serum NA and K levels in pregnancy EXCEPT:

a. Increase in the renal secretion rate of NA and K
b. Increased in Glomerular filtration rate of NA and K
c. Enhanced tubular reabsorption of Na and K
d. NOTA

A

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42
Q

The total iron requirement during pregnancy is:

a. 500 mg
b. 1000 mg
c. 1500 mg
d. 2000 mg

A

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43
Q

Which of the following is true regarding the peptide hormone leptin?

a. May be related to preeclampsia and fetal growth restriction
b. Increase in pregnancy is due to maternal weight gain and placental weight
c. Primarily secreted by adipose tissue
d. AOTA

A

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44
Q

The average blood loss during vaginal delivery of twins is:

a. 500 ml
b. 800 ml
c. 1000 ml
d. 1500 ml

A

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45
Q

The major storage depots that are intimately involved with the storage hormone Insulin in the metabolism of nutrients absorbed from the maternal gut are:

a. Adipose tissue
b. Liver
c. Muscle
d. AOTA

A

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46
Q

The state that best describes a health system

a. A health system is the sum total of all organizations to improve health
b. A health system comprised of services that are not responsive and financially fair to people
c. A health system has the purpose of improving well being
d. A health system does not need staff, funds, information, supplies, transport and communications

A

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47
Q

Maternal Health Care delivery system:

a. Care for father and children
b. Care for children
c. Care for nursing and expectant mothers
d. Care for grandmothers

A

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48
Q

Part of the Maternal Health Care system

a. Insurers, employers, providers, government, patients
b. Insurers, employers, providers, patients
c. Insurers, providers, government, patients
d. Employers, providers, government, patients

A

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49
Q

The providers include:

a. Physicians, pregnant women, midwives
b. Physicians, employers, midwives
c. Physicians, birth attendants, midwives
d. Physicians, pregnant women, government

A

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50
Q

This represents the risk associated with each pregnancy such as OB risk

a. Maternal mortality ratio
b. Infant mortality rate
c. Maternal death
d. NOTA

A

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51
Q

This refers to the death of a woman while pregnant aggravated by pregnancy but not from accidental or incidental causes

a. Maternal death
b. Maternal mortality rate
c. Infant death

A

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52
Q

Maternal death is considered when a woman dies within how many days of termination of pregnancy

a. 45
b. 42
c. 49
d. 46

A

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53
Q

The MDG target for maternal mortality ratio

a. 55 per 100,000 live births by 2016
b. 55 per 100,000 live births by 2015
c. 55 per 100,000 live births by 2014
d. 55 per 100,000 live births by 2017

A

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54
Q

The causes of maternal mortality in the Philippines include:

a. Complication of childbirth due to sepsis
b. Facility based deliveries
c. Presence of skilled birth attendant
d. AOTA

A

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55
Q

Mechanism that explain the occurrence of pyrosis, except

a. Lower esophageal sphincter tone
b. Higher intragastric pressure
c. Lower intraesophageal pressure
d. Lower wave speed & higher amplitude of esophageal peristalsis

A

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56
Q

Liver changes during pregnancy include:

a. Decreased hepatic flow and diameter of portal vein
b. Total albumin is decreased
c. Serum albumin concentration is decreased
d. AST, ALT, bilirubin levels are increased

A

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57
Q

The liver enzyme has oxytocinase and vasopressinase activity

a. Serum aspartate transaminase
b. Leucine aminopeptidase
c. Alanine Transminase
d. Gamma Glutamyl transferase

A

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58
Q

Which hormone impairs gallbladder contraction during pregnancy by inhibiting Cystokinin-mediated smooth muscle stimulation:

a. Aldosterone
b. Testosterone
c. Estrogen
d. Progesterone

A

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59
Q

Which levels of this hormone during pregnancy inhibit intraductal transport of bile and this cause intrahepatic cholestasis

a. Estrogen
b. Progesterone
c. Aldosterone
d. Testosterone

A

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60
Q

The following statements is true about GH during pregnancy:

a. GH is secreted only by the maternal pituitary glang
b. GH peaks in th amniotic fluid at 17 weeks AOG
c. The placenta is the principle source of GH secretion beginning 8 weeks AOG
d. Maternal Levels of GH slowly increase and plateau at 28 weeks AOG

A

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61
Q

Increased Prolactin secretion is brought about by:

a. TSH
b. Serotonin
c. Dopamine
d. Progesterone

A

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62
Q

Increased Prolactin is brought by:

a. TSH
b. Serotonin
c. Dopamine
d. Progesterone

A

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63
Q

There are a number of alterations in thyroid physiology and function during pregnancy, which includes:

a. Increased TRH
b. Decreased total serum throxine
c. Increased TBG
d. Decreased Total T3

A

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64
Q

____ is structurally similar to TSH and heance has intrinsic thyrotropic activity

a. hCG
b. TRH
c. Total T3
d. Total Thyroxine

A

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65
Q

The following facilitate the conversion of VIt D to 1,25 dihydroxyvit D3, except

a. Increased Parathyroid hormone
b. Increased Calcitonin
c. Decreased Calcium
d. Decreased phosphate

A

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66
Q

True of Thyroid physiology during pregnancy

a. The complex alterations of thyroid regulation alters maternal thyroid status as measured by metabolic studies
b. The basal metabolic rate remains unchanged throughout gestation
c. If fetal body surface is considered along with that of the mother, then the basal metabolic rates are similar to those in nonpregnant women
d. Normal suppression of TSH may lead to a misdiagnosis of subclinical hypothyroidism

A

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67
Q

Increased levels of parathyroid hormone during pregnancy result from:

a. Increased calcium concentration in pregnant women
b. Decreased plasma volume
c. Decreased glomerular filtration rate
d. Materno-fetal transfer of calcium

A

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68
Q

Which of the following is decreased in pregnancy

a. CO
b. Stroke Volume
c. Systemic Vascular resistance
d. Heart Rate

A

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69
Q

In which AOG would you except the greatest risk of decompensation in a gravidocardiac?

a. 5-10 weeks
b. 24-28 weeks
c. During labor
d. Immediately postpartum

A

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70
Q

Which of the following is the product of systemic vascular resistance and Heart rate?

a. Stroke Volume
b. CO
c. Blood Pressure
d. Ejection Friction

A

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71
Q

How would you advise a pregnant woman who complains of feeling faint after lying flat on bed?

a. Move slowly to wait for her BP to stabilize
b. Use a higher pillow
c. Elevate her legs when sleeping
d. Sleep or relax on her left side

A

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72
Q

A patient is taking Metoprolol for mild hypertension prior to pregnancy. Which of the following is true in her case?

a. She may not need anti-hypertensives in the most past of her pregnancy
b. She would have to be maintained in the same dose of her anti-hypertensives
c. She would have to increase the dose of her anti-hypertensive medications
d. Her hypertension would behave erratically during pregnancy

A

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73
Q

Knowing the physiology of circulation in pregnancy, what maneuver would improve outcome during cardiac resuscitation

a. More and stronger Cardiac compressions
b. More breaths
c. Early defibrillation
d. Lateral displacement of the uterus

A

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74
Q

Which of the following stays the same during pregnancy?

a. Vital Capacity
b. Total lung Capacity
c. Tidal Volume
d. Inspiratory Capacity

A

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75
Q

The following is the result of the elevated diaphragm in pregnancy

a. Increased functional residual capacity
b. Decreased residual volume
c. Increased respiratory rate
d. Decreased alveolar ventilation

A

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76
Q

Mild Dilatation of the renal pelvis in pregnancy is due to

a. Elevation of estrogen
b. Elevation of the diaphragm
c. Elevation of progesterone
d. Elevation of the cardiac output

A

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77
Q

The bipedal edema and varicose veins in pregnancy may result from

a. The compression of the iliac veins by the fetal head
b. Increase in the risk of venous thromboembolism
c. Supine hypotension syndrome
d. Patency of the venous valves

A

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78
Q

Which cardiac examination finding in pregnancy is most INCOMPATIBLE with normal:

a. Split S1
b. Systolic murmur
c. Diastolic Murmur
d. Mildly thicker left ventricle

A

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79
Q

Higher progesterone in pregnancy results in the following change in the urinary system

a. Higher creatinine clearance
b. More residual urine
c. Higher glomerular filtration rate
d. Lower risk for ascending urinary infection

A

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80
Q

Which of the following diseases may be masked by the physiologic changes in pregnancy?

a. Kidney disease
b. Cardiac disease
c. Pulmonary Disease
d. Deep Vein Thrombosis

A

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81
Q

The CVS changes of a pregnant women is like

a. Sleeping
b. Dreaming
c. Exercising
d. Eating

A

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82
Q

The hyperpigmentation associated with pregnancy is presumed to be due to increased levels of which hormone

a. TSH
b. MSH
c. GnRH
d. SRH

A

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83
Q

Patient presents with melasma gravidarum. What is your differential diagnosis?

a. Association with liver disease
b. Association with progesterone replacement therapy
c. Association with thyroid abnormalities
d. Association with connective tissue disease

A

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84
Q

Patient presents with melasma gravidarum. From the following options, which will NOT be part of your present management on the case?

a. Laser Therapy
b. Reassurance
c. Avoidance of Sun exposure
d. Mild Bleaching Creams

A

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85
Q

Development of new nevi during pregnancy is thought to be an effect of

a. Increased estrogen deposition
b. Increased progesterone deposition
c. Increased MSH deposition
d. Increased melanin deposition

A

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86
Q

Vascular spiders during pregnancy are most likely the consequence of:

a. Hyperprolactinemia
b. Hyperestrogenemia
c. Hypercoagulability
d. Hyperandrogenism

A

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87
Q

Your 31 y/o patient who is into her 34th weeks of pregnancy complains of diffuse mottling of her palms. This condition is through to be due to several contributory factors. Which of the following is NOT contributory to this condition?

a. Hormone Replacement Therapy
b. Hypokinetic circulation
c. Increased estrogen levels
d. Genetic predisposition

A

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88
Q

What is the major contributory factor to the development of hemorrhoids during pregnancy?

a. Hyperestrogenic state
b. Increased blood volume during pregnancy
c. Prolonged standing
d. Increased weight of the gravid uterus

A

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89
Q

As you are doing a pelvic exam on your pregnant patient who is currently 37 weeks AOG, you notice the following serpentile violaceous lesions on her vulva. What would you advise the patient?

a. There is a high likelihood of rupture
b. There is a high likelihood of an episiotomy
c. There is a high likelihood of immediate regression at term

A

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90
Q

Causes of elevated aldosterone secretion during pregnancy include:

a. Decreased Renin
b. Decreased Sodium intake
c. Decreased Angiotensin II
d. Increased Fetal Gland Secretion

A

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