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[HD 201] 3rd Exam > HD 201 E3 Samplex 2009 > Flashcards

HD 201 E3 Samplex 2009 Flashcards

1
Q

This physician administered chloroform to Queen Victoria in 1853 during the birth of her 8th child which created the foundation for the acceptance of the Church of the provision of analgesia for labor:

a. James Simpson
b. John Snow
c. Charles Meigs
d. Paul Zweifel

A

B

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2
Q

Virginia Apgar, the author of the APGAR score which evaluated the newborn and provided the objective criteria for the initiation of neonatal resuscitation was a/an:

a. Anesthesiologist
b. Pediatrician
c. Obstetrician
d. General Surgeon

A

A

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3
Q

Labor pain:

a. Should be endured by the mother
b. Decreases oxygen demand in the mother
c. Must be relieved as soon as the mother
d. Has no effect on the preterm fetus

A

C

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4
Q

The most significant ventilatory change in the parturient which may contribute to the increased anesthetic risk is:

a. Tidal volume
b. Inspiratory capacity
c. Functional residual capacity
d. Vital capacity

A

C

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5
Q

The syndrome of decreased venous return when the parturient lies flat on bed is called:

a. The Supine Hypotension Syndrome
b. The Sympathetic Block Syndrome
c. The Aortocaval Syndrome
d. The Vena Cava Syndrome

A

A

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6
Q

The difference between analgesia and anesthesia is:

a. Loss of consciousness
b. Motor blockade
c. Sensory blockade
d. No difference

A

A

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7
Q

The ideal analgesia for labor and vaginal delivery is one that

a. Provides loss of awareness of the mother
b. Provides dense motor block
c. Allows bearing down of the mother
d. Puts the mother to sleep

A

C

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8
Q

Non-pharmacologic methods for labor analgesia, EXCEPT:

a. Hypnosis
b. Acupuncture
c. Lamaze
d. Paracervical block

A

D

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9
Q

A non-opioid systemic medication used as labor analgesia adjuvant is:

e. Nalbuphine
f. Meperidine
g. Promethazine
h. Morphine

A

C

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10
Q

A component of “twilight” anesthesia famous during the 1950’s:

a. Atropine
b. Scopolamine
c. Neostigmine
d. Glycopyrrolate

A

B

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11
Q

Which of the following is not a part of the superior boundary of the true pelvis?

a. linea terminalis
b. ischial spines
c. promontory of the sacrum
d. pubic bones

A

B

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12
Q

The true pelvis is bounded below by which of the following structures?

a. linea terminalis
b. alae of the sacrum
c. pelvic outlet
d. upper margin of the pelvic bone

A

C

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13
Q

What is the normal angle of the subpubic arch under which the fetal head normally passes?

a. 40-50 degrees
b. 60-70 degrees
c. 90-100 degrees
d. 120-130 degrees

A

C

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14
Q

What does the obstetrical conjugate normally measure?

a. 9 centimeters
b. 10 centimeters
c. 11 centimeters
d. 12 centimeters

A

B

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15
Q

What is the shortest distance between the sacral promontory and the symphysis pubis?

a. diagonal conjugate
b. obstetrical conjugate
c. true conjugate
d. sagittal conjugate

A

B

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16
Q

How is the obstetrical conjugate computed?

a. add 1.5 cms to the diagonal conjugate
b. subtract 1.5 cms to the diagonal conjugate
c. average the diagonal and true conjugate
d. add 1.5 cms to the true conjugate

A

B

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17
Q

What is the average transverse diameter of the pelvic outlet?

a. 8 centimeters
b. 10 centimeters
c. 10.5 centimeters
d. 11 centimeters

A

D

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18
Q

What type of pelvis is associated with an inlet that is round, with straight pelvic sidewalls, spines that are not prominent, and a wide pelvic arch?

a. gynecoid
b. android
c. anthropoid
d. platypellopid

A

A

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19
Q

What is the rarest type of pelvis?

a. gynecoid
b. android
c. anthropoid
d. platypelloid

A

D

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20
Q

Engagement occurs when the biparietal diameter of the fetal head descends below the level of which of the following?

a. ischial tuberosities
b. midpelvis
c. pelvic floor
d. pelvic inlet

A

D

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21
Q

The true and false pelvis are delineated by:

a. linea nigra
b. linea terminalis
c. linea alba
d. linea reticularis

A

B

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22
Q

The anterior boundary of the true pelvis consists of the following, EXCEPT:

a. pubic bones
b. ascending and superior rami of the ischial bones
c. descending and superior rami of the ischial bones
d. obturator foramina

A

C

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23
Q

The sacral promontory corresponds to the sacral vertebra number:

a. S1
b. S2
c. S3
d. S5

A

A

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24
Q

The sacroiliac joints represent the junction between the sacrum and:

a. the pubis
b. the ilium
c. the ileus
d. the ischium

A

B

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25
Q

The arcuate ligament of the pubis refers to the:

a. anterior pubic ligament
b. posterior pubic ligament
c. superior pubic ligament
d. inferior pubic ligament

A

D

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26
Q

What is the clinical significance of relaxation of joints during parturition?

a. It produces less pain during labor
b. It relaxes the muscles
c. It allows for a larger pelvic outlet
d. It allows for a roomier midpelvis

A

C

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27
Q

Of the 4 imaginary planes of the pelvis, which has the least obstetric significance?

a. plane of greatest pelvic dimension
b. superior straight
c. inferior straight
d. plane of least pelvic dimension

A

A

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28
Q

Among the anteroposterior diameters of the pelvis, this is the only clinically measurable diameter?

a. true conjugate
b. obstetric conjugate
c. oblique conjugate
d. diagonal conjugate

A

D

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29
Q

This refers to the narrowest diameter of the pelvic inlet:

a. true conjugate
b. obstetric conjugate
c. oblique conjugate
d. diagonal conjugate

A

B

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30
Q

This refers to the greatest diameter between the linea terminalis on either side:

a. diagonal conjugate
b. right oblique conjugate
c. left oblique conjugate
d. transverse diameter

A

D

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31
Q

The type of IUD which reduces menstrual flow and maybe beneficial to women with menorrhagia:

a. Levonorgestrel IUD
b. Lippes Loop
c. Copper T 380A
d. Stainless steel IUD

A

A

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32
Q

Combined oral contraceptives may produce the following adverse effects, EXCEPT:

a. decreased glucose tolerance
b. cholestosis
c. increased risk of cervical cancer with prolonged use
d. increased risk of pituitary adenoma

A

D

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33
Q

One of the following bleeding patterns is less likely with oral pills containing 20-25μg of estrogen:

a. menorrhagia
b. amenorrhea
c. scanty menses
d. breakthrough bleeding

A

A

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34
Q

The family planning method that primarily prevents pregnancy by producing thick and scanty cervical mucus is:

a. combined oral contraceptives
b. progestin only contraceptives
c. transdermal contraceptive patch
d. vaginal ring

A

B

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35
Q

The sustained rise in temperature observed when charting basal body temperatures in the BBT method is due to the hormone:

a. estrogen
b. progesterone
c. LH
d. FSH

A

B

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36
Q

IUD remaining in the uterus during pregnancy may cause the following complications, EXCEPT:

a. preterm labor
b. late septic abortion
c. congenital fetal abnormalities
d. early spontaneous abortion

A

C

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37
Q

Based on recent studies, IUD works in preventing pregnancy primarily by:

a. impairing viability of sperms
b. acting as physical barriers to sperms
c. interfering with successful implantation of fertilized ovum
d. inhibiting ovulation

A

A

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38
Q

Which of the following contraceptive methods may aggravate dysmenorrhea?

a. DMPA
b. Implants
c. IUD
d. Combined oral contraceptives

A

C

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39
Q

In which portion of the fallopian tube does fertilization normally occur?

a. interstitial portion
b. isthmus
c. ampulla
d. fimbriae

A

C

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40
Q

The technique of tubal sterilization where a loop of tube is ligated and the knuckle of the tube is cut above the ligature is called:

a. Parkland procedure
b. Irving procedure
c. Pomeroy procedure
d. Madlener procedure

A

C

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41
Q

Women taking combined oral contraceptives are protected from:

a. cervical cancer
b. gall bladder disease
c. endometrial cancer
d. liver tumor

A

C

42
Q

The hormonal method of contraception which prevents pregnancy primarily by suppression of ovulation is:

a. progestin only injectables
b. subdermal implants
c. progestin only pills
d. combined oral pills

A

D

43
Q

Among the natural family planning methods, the least effective method is:

a. cervical mucus
b. calendar rhythm
c. basal body temperature
d. symptothermal

A

B

44
Q

The preferred site in the fallopian tube for tubal ligation and application of occlusive device is:

a. isthmus
b. fimbriae
c. ampulla
d. interstitial portion

A

A

45
Q

The longest delay in return of fertility after discontinuation of the contraceptive method is:

a. DMPA
b. Combined oral contraceptives
c. IUD
d. Progestin only pills

A

A

46
Q

The cardinal movements of labor in occiput presentation and in chronological order:

a. Engagement, descent, flexion, external rotation, extension, internal rotation, expulsion
b. Engagement, flexion, descent, internal rotation, extension, external rotation, expulsion
c. Engagement, descent, internal rotation, flexion, external rotation, extension, expulsion
d. Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion

A

D

47
Q

Which is not characteristic of true labor:

a. contractions are regular
b. discomfort is mainly in the lower abdomen
c. intervals between contractions shorten
d. cervix progressively dilates

A

B

48
Q

The station of the presenting part refers to:

a. degree of opening of the external os
b. level of descent of the presenting part into the maternal pelvis
c. the position of the presenting part in relation to the pelvis
d. fetal lie

A

B

49
Q

Cervical dilatation, is assessed by indicating the following, EXCEPT:

a. consistency
b. degree of effacement
c. position with respect to presenting part
d. color and character of discharge

A

D

50
Q

Choose the correct statement regarding second stage of labor.

a. Its onset is signified by full cervical dilatation and ends with delivery of the infant.
b. Mean duration is 30 minutes for multiparas, 70 minutes for nulliparas.
c. Fetal heart rate monitoring is not as frequent as compared to the first stage of labor.
d. Ritgen maneuver is performed to deliver the fetal shoulder.

A

A

51
Q

A 3rd degree perineal laceration involves the following soft tissue structures, EXCEPT:

a. vaginal mucosa
b. rectal mucosa
c. perineal skin and fascia
d. anal sphincter

A

B

52
Q

Choose the correct statement regarding anterior asynclitism.

a. The sagittal suture approaches the symphysis pubis.
b. More of the anterior parietal bone is present.
c. It always leads to cephalopelvic disproportion.
d. It is synonymous to Litzmann’s obliquity.

A

B

53
Q

Once active labor is diagnosed, the following should be assessed:

a. the fetal heart rate
b. fetal presentation
c. size of the fetus
d. ALL OF THE ABOVE

A

D

54
Q

The portion of the fetus that brings about effacement and is felt during vaginal examination is:

a. station
b. presenting part
c. position
d. lie

A

B

55
Q

If the neck is flexed and the occipital fontanel is felt during an internal examination, what is the presentation:

a. breech
b. cephalic
c. brow
d. shoulder

A

B

56
Q

The reference point used in determining the station of the presenting part is:

a. sacral promontory
b. ischial spine
c. perineal body
d. sacrospinous ligament

A

B

57
Q

The following laboratory examinations are essential before delivery, EXCEPT:

a. urinalysis
b. complete blood count
c. chest X-ray
d. blood typing

A

C

58
Q

The earliest sign of placental separation is:

a. The uterus becomes globular.
b. Sudden gush of blood
c. The uterus rises in the abdomen.
d. The umbilical cord lengthens.

A

A

59
Q

In nulliparas, the fetal head descends at an average rate of:

a. 1.2 cm/hr
b. 1.5 cm/hr
c. 2 cm/hr
d. 2.5 cm/hr

A

A

60
Q

During the first stage of labor, fetal lie and presentation is determined by:

a. Taking the fundic height
b. Performning abdominal palpation (Leopold’s maneuver)
c. Listening to the fetal heart tones
d. Doing the speculum examination

A

B

61
Q

What is the hormone responsible for milk ejection?

a. prolactin
b. oxytocin
c. growth hormone
d. thyroid hormone

A

B

62
Q

What is the initiator of lactogenesis in the postpartum period?

a. The fall of plasma progesterone
b. The rise of estrogen
c. The release of prolactin inhibiting factor
d. The decrease in estrogen

A

A

63
Q

What happens to the prolactin levels in the breastfeeding mother during night time?

a. it decreases
b. it increases
c. stays the same
d. becomes negligible

A

B

64
Q

What is the importance of colostrum?

a. It eliminates the Lactobacillus bifidus in the gut.
b. Colostrums is low in proteins.
c. It facilitates the passage of meconium.
d. It has higher fat as compared to mature milk.

A

C

65
Q

What is the best way to increase a mother’s milk supply?

a. Take lactogogues like malunggay leaves
b. Skip feeding so breast will be engorged
c. Drink milk
d. Nurse more often

A

D

66
Q

A 19 y/o G1P1(1001) nurse complained of a whit dot in her right nipple. It was noted when she missed a couple of feedings because she was on duty. What is the best explanation for this condition?

a. Her breasts are engorged
b. She has acute mastitis
c. She has sore nipples
d. She has blocked lactiferous ducts

A

D

67
Q

The patient in #66 was seen by the OB Admitting Section Resident and her impression was that the patient has breast engorgement. What is the best management for this?

a. Nurse more often
b. Use breast pump most of the time
c. Apply a breast shield
d. Take antibiotics

A

A

68
Q

What is the long term effect in a lactating mother if she just pumps her breasts and not breastfeed her infant directly onto her breasts?

a. No effect on her milk supply, anyway she is still breasfeeding
b. Her milk supply willl diminish because of incomplete emptying
c. Her milk supply will increase because she is pumping
d. NONE OF THE ABOVE

A

B

69
Q

What is the meaning of the term “nipple confusion”?

a. The baby is not sure which mother’s nipple has the most milk – the right or the left
b. The baby prefers to suck at the mother’s breast rather than the bottle nipple
c. The baby prefers to suck at the bottle nipple rather than the mother’s nipple
d. The baby is confused – is she likes the taste of the milk formula or the mother’s milk

A

C

70
Q

A 27 y/o G1P1(1001) patient consulted for fever and chills. A week of PTC, she had a sore at the right nipple area which gradually healed. This was followed by erythema and pain at the right upper quadrant of the breast. At this time, she was also feeling weak with occasional fever. Review of the family history showed that her mother had a Modified Radical Mastectomy (MRM) for breast cancer 3 years ago. What is the most likely diagnosis?

a. blocked lactiferous ducts
b. breast abscess
c. breast cancer
d. acute mastitis

A

D

71
Q

Privacy is a component of what principle in bioethics?

a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

A

A

72
Q

What bioethical principle is established/practiced when one elicits informed consent?

a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

A

A

73
Q

In situations where bioethical principles may conflict, what principle will always prevail?

a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

A

A

74
Q

The robinhood practice of taking from the rich to help the poor violates what principle?

a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

A

A

75
Q

Providing monetary renumeration to facilitate/obtain informed consent violates the principle of:

a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

A

A

76
Q

Prescribing oral contraceptive pills (OCP) to a 15 y/o who just delivered her first baby, upon the insistence of her mother, and hardly giving her a chance to ask questions pr express her preferences, is in violation of her:

a. Due justice
b. Autonomy
c. Beneficence
d. Non-maleficence

A

B

77
Q

If human life is assumed to start at fertilization, which of the following could represent a violation of the right of the unborn?

a. condom
b. diaphragm
c. spermicide
d. IUD

A

D

78
Q

Insisting on BTL (bilateral tubal ligation) for a 25 y/o G5P5 with GDM (gestational diabetes mellitus) and hypertension is most likely based on the ethical principle of:

a. Beneficence
b. Justice
c. Non-maleficence
d. Autonomy

A

A

79
Q

Giving scholarships only to the 1st two children of a family to encourage birth control may be viewed as violating:

a. Justice
b. Autonomy
c. Beneficence
d. Non-maleficence

A

A

80
Q

Allowing a woman with an unwanted pregnancy to have an abortion is an argument based on respect to her:

a. Autonomy
b. Beneficence
c. Non-maleficence
d. Justice

A

A

81
Q

The stages of labor consist of:

a. cervical effacement and dilatation
b. placental separation and expulsion
c. delivery of the fetus
d. ALL OF THE ABOVE

A

D

82
Q

ET, a 22-year old G1P0 consulted at the OB Admitting Section with a chief complaint of blood-tinged mucoid discharge per vagina. This event suggests:

a. Labor will be finished in the next few hours
b. A life-threatening situation that needs laboratory examinations
c. Expulsion of the mucus plug
d. NONE OF THE ABOVE

A

C

83
Q

During the next few hours, she complained of increasing pain during contractions. Labor pains are due to:

a. Stretching of the cervix during dilatation
b. A pathological retraction ring
c. Lack of oxygen within the uterine muscles
d. ALL OF THE ABOVE

A

D

84
Q

At the 14th hour of labor, Resident A noted a Bandl ring which is:

a. Always seen in primigravidas
b. A pathological retraction ring
c. An extreme thickening of the lower uterine segment
d. An indicator of good uterine contractions

A

B

85
Q

The following is true of the active phase of cervical dilatation, EXCEPT:

a. Not sensitive to sedation
b. The cardinal movements of labor take place
c. Cervical dilatation is most rapid
d. As full cervical dilatation nears, there is a lag in dilatation

A

B

86
Q

Which functional division of labor is not affected by sedation and conduction anesthesia?

a. preparatory phase
b. dilatational phase
c. pelvic phase
d. latent phase

A

B

87
Q

Increased rate of fetal head descent occurs during:

a. engagement of fetal head
b. phase of maximum slope
c. presentation of fetal head at the pelvic floor
d. at the level of the fetal head at station 0

A

B

88
Q

The pelvic floor consists of the following muscles, EXCEPT:

a. levator ani
b. pubococcygeus
c. iliococcygeus
d. piriformis

A

D

89
Q

During the delivery of the placenta, Resident B noted that blood escaped the placental site in an inverted sac and fetal surface appeared in vulvar area. This placental extrusion mechanism is known as:

a. Schultze mechanism
b. Duncan mechanism
c. Ritgen mechanism
d. Retroplacental mechanism

A

B

90
Q

The following is/are true of oxytocin, EXCEPT:

a. Oxytocin prevents postpartum hemorrhage
b. Osytocin production occurs in the posterior pituitary
c. Oxytocin levels increase in the first stage of labor
d. Oxytocin acts on the myoepithelium of the mammary ducts

A

C

91
Q

As gestation advances, the baseline fetal heart rate normally decreases due to:

a. maturation of the parasympathetic system
b. increase in fetal size
c. changes in progesterone level
d. increase in fetal movement

A

A

92
Q

What is the normal average range of fetal heart rate at term?

a. 100 to 120 beats per minute (bpm)
b. 110 to 140 bpm
c. 120 to 160 bpm
d. 130 to 160 bpm

A

C

93
Q

Characteristics of the baseline fetal heart rate, EXCEPT:

a. Refers to the modal characteristics that prevail apart from accelerations and decelerations
b. It is the approximate mean rate rounded to increments of 20 bpm during a 40 minute tracing segment
c. It is under the control of the sympathetic and parasympathetic centers
d. Arterial chemoreceptors also control the fetal heart rate

A

B

94
Q

Which is NOT associated with fetal bradycardia?

a. fetal head compression
b. maternal fever
c. congenital heart block
d. fetal distress

A

B

95
Q

True statement regarding the nonstress test
:
a. It describes fetal heart rate acceleration in response to fetal movement.
b. It is primarily a test of uteroplacental perfusion.
c. It is less commonly used to assess fetal well-being.
d. It involves the use of ultrasound in detecting fetal heart rate changes.

A

A

96
Q

The five variables assessed in a biophysical profile include the following, EXCEPT:

a. fetal heart rate acceleration
b. fetal breathing
c. amniotic fluid volume
d. placental thickness
e. fetal tone

A

D

97
Q

In the biophysical profile, each normal variable is assigned a score of __ each and abnormal variables a score of __.

a. 0,1
b. 1,2
c. 2,0
d. 1,0

A

C

98
Q

The highest possible score for a normal fetus in a biophysical profile is:

a. 5
b. 8
c. 10
d. 12

A

C

99
Q

A modified biophysical profile includes:

a. nonstress test and fetal breathing
b. nonstress test and amniotic fluid volume
c. fetal tone and movement
d. fetal movement and amniotic fluid index

A

B

100
Q

A nonstress test shows 3 fetal heart rate accelerations (baseline of 130-accelerated to 150 bpm) associated with fetal movement, all occurring within 20 minutes. Is this normal?

a. Yes
b. No
c. Maybe
d. I dont know

A

A

[HD 201] 3rd Exam (6 decks)

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