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Pregnancy > Maternal adaptation > Flashcards

Maternal adaptation Flashcards

1
Q

Softening of the uterine isthmus during 8 weeks AOG:

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

A

C

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2
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

D

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3
Q

Braxton Hick’s Contraction is not:

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

A

D

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4
Q

Softening of the cervix that occurs early in pregnancy

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

A

C

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5
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

B

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6
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

B

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7
Q

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

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

A

A

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8
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

D

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9
Q

Normal ovarian changes during pregnancy incude:

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

A

D

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10
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

C

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11
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

A

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12
Q

The following increases are noted in pregnancy EXCEPT:

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

A

B

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13
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

D

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14
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

B

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15
Q

Relaxin is secreted by the following organs EXCEPT:

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

A

C

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16
Q

Theca lutein cyst are benign ovarian lesions seen in which of the following:

a. Pregnancy
b. Hyperthyroidism
c. Gestational trophoblastic diseases
d. AOTA

A

D

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17
Q

The following are effects of hyperestrogenemia EXCEPT:

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

A

C

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18
Q

Which of the following minerals remain unchanged during pregnancy?

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

A

A

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19
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

A

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20
Q

The total iron requirement during pregnancy is:

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

A

B

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21
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

D

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22
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

D

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23
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

D

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24
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

C

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25
Q

The liver enzyme has oxytocinase and vasopressinase activity

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

A

B

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26
Q

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

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

A

D

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27
Q

High 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

A

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28
Q

The following statements is true about GH during pregnancy:

a. GH is secreted only by the maternal pituitary gland
b. GH peaks in the 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

D

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29
Q

Increased Prolactin secretion is brought about by:

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

A

B

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30
Q

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

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

A

C

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31
Q

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

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

A

A

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32
Q

The following facilitate the conversion of Vit D to 1,25 dihydroxyvitamin D3, except

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

A

B

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33
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

D

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34
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

D

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35
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

B

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36
Q

The following statements are true about maternal androgens during pregnancy EXCEPT:

a. Maternal androstenedione and testosterone production are increased
b. Maternal androstenedione is converted to estradiol
c. Increased SHBG decreases maternal testosterone
d. Little or no testosterone in maternal plasma enters the fetal circulation

A

C

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37
Q

Which of the following is decreased in pregnancy

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

A

C

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38
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

D

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39
Q

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

a. Stroke Volume
b. Cardiac Output
c. Blood Pressure
d. Ejection Friction

A

B

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40
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

D

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41
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 parts 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

A

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42
Q

Which of the following stays the same during pregnancy?

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

A

B

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43
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

B

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44
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

C

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45
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

A

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46
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

C

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47
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

B

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48
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

A

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49
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

B

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50
Q

A 25 year old primigravid comes to the OPD Clinic with the following dermatologic manifestation, a diffuse hyperpigmentation on the face. What is your diagnosis?

a. Striae Gravidarum
b. Linea Nigra
c. Melasma Gravidarum
d. Chloasma Gravidarum

A

C

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51
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

D

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52
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

A

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53
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

D

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54
Q

True statements about hyperpigmentation during pregnancy
A. Skin darkening develops in 10%
B. Pigmentation is more pronounced in women with white complexion
C.Dermal melanosis may persist up to 10 years in a third of affected women
D. Results from elevated MSH

A

D

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55
Q

True about hyperpigmentation EXCEPT
A. More pronounced in the areola, perineum, umbilicus and axilla
B. Begins to be evident usually in the 3rd trimester
C. Affects recent scars
D. Regresses postpartum

A

B

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56
Q

True statements about striae gravidarum EXCEPT
A. Family history is the strongest factor
B. These are silvery lines that represent the remains of previous striae in multigravids
C. Majority develop in the abdomen but may also be seen in the breast and thighs
D. Topical application of lotion during the first trimester will prevent this

A

D

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57
Q

True statements about nevi during pregnancy EXCEPT
A. A small minority develop enlarged melanocytes and increased melanin deposition
B. It is common for nevi to increase in diameter or become darker
C. No proof of malignant transformation
D. Further examination of nevi [which] enlarge

A

B

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58
Q

Mrs Martinez consulted with excessive hair loss. She delivered by CS two months ago. What will you advise her?
A. Will grow back in 2 months
B. There’s no treatment required
C. Further investigation

A

B

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59
Q

True statements about hirsutism during pregnancy EXCEPT
A. Mild hirsutism is common
B. Women with predisposed genetically to coarse hair growth are more severely affected
C. Typically persists within several months after delivery
D. Prompt investigation if with other evidence of masculinization

A

C

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60
Q

Starting at 12 weeks of age, changes in uterine size are predominantly due to

a. Pressure from products of conception
b. Stimulation of estrogen
c. Initial position of placenta
d. Increasing production of myocytes

A

A

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61
Q

Braxton-Hicks contractions are characterized by the following EXCEPT

a. Intensity is 5-25
b. Comes in at regular intervals at the 2nd trimester
c. Causes false labor
d. Generally painless

A

B

62
Q

Which cervical change is characterized by endocervical gland hyperplasia and hypersecretory appearance?

A

Arias-Stella reaction

63
Q

What is Chadwick’s sign?

A

The violaceous appearance of the vagina during pregnancy

64
Q

. A 26 year old primigravid underwent CS. She was was diagnosed to have 8 cm theca-lutein cysts. What should be the best management?
A. Total hysterectomy with bilateral salphingo-oophorectomy
B. Bilateral oophorocystectomy
C. Reassure her that it will regress postpartum
D. Give chemotherapy

A

C

65
Q 
Solid ovarian tumor which is an exaggeration of the luteinisation of the normal ovary
A. Luteoma
B. Theca-lutein
C. Derruoid
D. Endometrioma
A

A

66
Q 
Maternal hypervolemia is most marked at which stage?
A. 1st trimester
B. 2nd trimester
C. 3rd trimester
D. Labor
A

B

67
Q

Mrs. Cruz has Hb 11mg/dl at 32 weeks AOG. What would you advise her?
A. This is due to hypervolemia of pregnancy and she should not be bothered by it
B. She should undergo blood transfusion right away as this could have deleterious effects on her baby
C. Her haemoglobin is within normal limits for a pregnant woman in the third trimester so she should be reassured
D. This is due to iron deficiency so she should increase her FeSO4 intake

A

D

68
Q

Characteristics of hypervolemia except:
A. Results from an increase in both plasma and erythrocyte
B. More erythrocytes than plasma is added
C. Erythrocyte ↑ by 450 mL
D. Bone marrow hyperplasia

A

B

69
Q 
Which of the following have high levels during pregnancy?
A. Interleukin 1-β
B. T-helper 1
C. T-cytotoxic 1
D. Tumor necrosis factor β
A

A

70
Q 
Which of the following is depressed during pregnancy?
A. IgA
B. IgB
C. interferon γ
D. T-helper 2
A

C

71
Q 
A pregnant woman had lab test as prescribed by her doctor. Her WBC = 16,000/ml. Other findings are normal. What should be done?
A. Consult an infectious disease doctor
B. Consult a haematologist
C. Look for other indication of disease
D. Reassure her
A

D

72
Q 
Peaks of cardiac output during pregnancy, EXCEPT
A. 12 weeks
B. 28 weeks 
C. during labor 
D. immediately postpartum
A

A

73
Q 
Which of the following results in ↑ cardiac output at rest during pregnancy?
A. increased mean arterial pressure
B. decreased stroke volume
C. decreased vascular resistance
D. decreased basal metabolic rate
A

C

74
Q 
Which of the following is decreased in pregnancy?
A. heart rate
B. cardiac output
C. osmotic pressure
D. stroke volume
A

C

75
Q

Which of the following changes is true? [during pregnancy]
A. the diaphragm rises up to 2 cm
B. the subcostal angle widens
C. the thoracic circumference increases to 4 cm
D. the thoracic cage expands by 6 cm

A

B

76
Q 
The increase in minute ventilation is caused by the following EXCEPT:
A. respiratory alkalosis
B. enhanced respiratory drive
C. stimulatory effects of estrogen
D. something reserve volume
A

C

77
Q

Hydroureter and hydronephrosis is caused by:
A. estrogen effect
B. increased amounts of relaxin
C. compression of ureter by enlarging uterus
D. vena cava compression by gravid uterus

A

C

78
Q 
Which of the following is excreted in large amounts during pregnancy?
A. protein
B. vitamin A
C. vitamin C
D. vitamin K
A

B,D

79
Q

Characteristics of renal hydrodynamics during pregnancy
A. serum creatinine and urea nitrogen values increases
B. renal plasma flow increases
C. protein, amino acid, and glucose excretion decreases
D. serum osmolarity increases 10 mOsm/L

A

A

80
Q

Which of the following is TRUE?
A. pyrosis is a result of acid reflux into upper esophagus
B. gastric emptying is prolonged during pregnancy
C. haemorrhoids are uncommon
D. the appendix is displaced upward and laterally

A

D

81
Q 
Which of the following is increased during pregnancy?
A. alkaline phosphatase
B. alanine transaminase
C. albumin
D. bilirubin
A

A

82
Q 
Mrs. Gavino complains of gum bleeding while brushing her teeth. This is most likely due to:
A. epulis of pregnancy
B. pyrosis
C. haemorrhoids
D. tooth decay caused by pregnancy
A

A

83
Q

The increased predisposition of cholesterol stones in the gallbladder of multiparous women can be explained by the following EXCEPT:
A. Increased cholecystokinin-mediated smooth muscle contraction
B. Increased contractility of the gallbladder
C. Increased residual volume of gallbladder contents
D. Increased cholesterol saturation

A

B

84
Q 
Peptide hormone primarily secreted by adipose tissue with a key role in the deposition of fat and energy expenditure
A. leptin
B. ghrelin
C. estrogen
D. progesterone
A

C

85
Q 
True of electrolyte metabolism
A. 1000 mEq of sodium is excreted
B. total serum calcium is increased
C. magnesium concentration is decreased
D. potassium is unchanged
A

C

86
Q

This affords protection against the natriuretic effects of progesterone and ANP:
A. ↑ deoxycortisterone
B. ↑ serum cortisol
C. ↓serum and urine concentration of DHEA-S
D. ↑ aldosterone

A

D

87
Q 
Hormone for extracellular Ca2+ increase and phosphate decrease
A. cortisol
B. parathyroid hormone
C. prolactin
D. thyroxine
A

B

88
Q 
Slow gastric emptying during labor can cause
A. acid reflux
B. constipation
C. hemorrhage
D. flatulence
A

A

89
Q

Hegar’s sign is appreciated at?

A. 0-6 AOG
B. 6-8 AOG
C. 12-16 AOG
D. 16 AOG

A

B

90
Q 
Beading of cervical mucus is caused by
A.	Amniotic fluid leakage
B.	Estrogen
C.	Progesterone
D.	HCG
A

C

91
Q

Softening and cyanosis of the cervix is due to
A. Increased vascularityy and edema of the cervix
B. Involution of cervical glands
C. Progressive increase in frequency and intensity of uterine contractions
D. Increase in pressure exerted by products of conception

A

A

92
Q

Overstimulation of FSH
A. Hyperreactio luteoma
B. Edometrioma
C. Polycystic ovary

A

A

93
Q

Pitting edema of the angle and legs is caused by
A. Partial occlusion of the vena cava
B. Decrease venous pressure at the level below uterus
C. Increase in interstitial colloid osmotic pressure
D. Fat accumulation as maternal reserves

A

A

94
Q 
Normal pregnancy is characterized by
A.	Mild fasting hyperglycemia
B.	Postprandial hypoglycemia
C.	Hyperinsulinimea
D.	AOTA
A

D

95
Q 
Which of the ff increase glucose?
A.	Peripheral insulin resistance
B.	Increased glucagon
C.	Decreased placental lactogen
D.	Decreased fatty acid
A

A

96
Q 
Accelerated starvation is characterized by
A.	Decrease free fatty acid
B.	Increase plasma triglyceride
C.	Lower plasma cholesterol levels
D.	Shift from lipid to glucose
A

B

97
Q

True of fat metabolism
A. Fat deposition occurs peripherally
B. Fat deposition is made available for placental transfer during 2nd trimester
C. Fat storage primarily occurs midpregnancy
D. There is an increase in lipoprotein lipase

A

C

98
Q 
What is the amount of blood loss in CS?
A.	500mL
B.	1000mL
C.	1500mL
D.	2000mL
A

B

99
Q 
Increase in pregnancy?
A.	Total pulmonary resistance
B.	Residual volume
C.	Lung compliance
D.	Air conductance
A

D

100
Q

AOG 24, inc labor breathing, what do you do?
A. Complete bed rest
B. Perform 2D-echo
C. Perform xray
D. Reassure that it is normal/physiologic

A

D

101
Q

Effect of maternal hyperventilation during pregnancy
A. Reduced maternal PCO2
B. Impedes CO2 transfer from fetus to mother
C. Prevents O2 release to fetus
D. Increase HCO3 levels

A

A

102
Q 
Which of the ff ieads to decrease in maternal arteriovenous oxygen difference
A.	Increase cardiac output
B.	Decrease tidal volume
C.	Increase pulmonary resistance
D.	Decrease hemoglobin mass
A

A

103
Q 
Which may be a normal finding in pregnancy?
A.	Pyuria
B.	Hematuria
C.	Glucosuria
D.	Proteinuria
A

C

104
Q

True about renal adaptation in pregnancy except
A. Increased renal excretion leads to more concentrated urine
B. RPF>GFR but decreases in late pregnancy
C. Creatinine clearance is greater than the normal state

A

A

105
Q 
Decrease in T helper 1 cells results to the following except
A.	Preeclampsia
B.	Decrease in TNF B
C.	Continuation of pregnancy
D.	Remission from autoimmune disease
A

A

106
Q 
Which of the ff is depressed during pregnancy?
A.	Interleukin 13
B.	Interleukin 6
C.	Interleukin 4
D.	Interleukin 2
A

D

107
Q 
All are elevated in cervical mucus during pregnancy except
A.	Interleukin B
B.	Interleukin 13
C.	Immunoglobulin A
D.	Immunoglobulin G
A

B

108
Q 
This antigen is expressed only in humans
A.	HLA-C
B.	HLA-E
C.	HLA-G
D.	AOTA
A

C

109
Q 
Increase risk of gallbladder stones
A.	Decreased residual volume
B.	Increased contractability
C.	Increased cholesterol and bile saturation
D.	Increased cck-mediated contraction
A

C

110
Q 
Which of the ff increase during pregnancy?
A.	Alanine transferase
B.	Bilirubin
C.	Alkaline phosphatase
D.	Serum albumin
A

C

111
Q

Conversion of 25-hydroxy D3 to 1,25dihydroxy Vitamin D3 is oppressed by
A. Calcitonin
B. Low calcium
C. PTH

A

A

112
Q

What causes dextrorotation of the gravid uterus?

a. colorectal area
b. rectosigmoid
c. appendix
d. Underlying vessels

A

B

113
Q

Which of the following does not influence uterine hypertrophy?

a. Position placental implantation
b. increase in estrogen
c. mechanical distention of the fetus
d. increased vasculature

A

D

114
Q

Pregnancy is associated with a decrease in which of the following?

a. IL 2
b. IL 4
c. IL 6
d. IL 13

A

A

115
Q

Fat deposition occurs primarily during

a. early pregnancy
b. midpregnancy
c. 3rd trimester
d. puerpuerium

A

B

116
Q

Magnesium levels in pregnancy can be described as:

a. decrease in total serum and ionized forms
b. decrease total and increased ionized forms
c. normal total and decreased ionized forms
d. increased total and ionized

A

A

117
Q

Total serum calcium is decreased in pregnancy due to:

a. decreased intestinal absorption
b. increased excretion
c. decrease in amount of bound calcium
d. increased metabolism of calcium

A

D

118
Q

During pregnancy, there is prolonged hyperglycemia in the postprandial state. This is due primarily to:

a. dec insulin secretion
b. inc glycogen production
c. peripheral resistance to insulin 
d. secretion of defective insulin molecules

A

C

119
Q

What is the weight of the uterus upon full term?

a. 1000 g
b. 1100 g
c. 1200 g
d. 1300 g

A

B

120
Q

Changes in the cervix during pregnancy EXCEPT:

a. hypertrophy of connective tissues
b. increased vascularity
c. hyperplasia of cervical glands
d. softening and cyanosis

A

A

121
Q

The minimum amount of water that an average woman retains during pregnancy (in L)

a. 5.5
b. 6
c. 6.5
d. 7

A

C

122
Q

Prolongation of the anagen phaseof hair growth is caused by

a. Estrogen
b. Progesterone
c. Androgen
d. aldosterone

A

A

123
Q

Characteristic feature of normal pregnancy

a. Scoliosis
b. lumbar lordosis
c. kyphosis
d. cervical lordosis

A

B

124
Q

Which of the following statements is true?

a. pelvic joint relaxation due to relaxin
b. joint laxity during early pregnancy
c. wider permament pelvis for multigravid
d. back pain treatment through bed rest and paracetamol

A

D

125
Q

The most common neurologic complaint in pregnancy

a. headache
b. seizure
c. loss of consciousness
d. numbness

A

A

126
Q

This condition is caused by growth of capillaries

a. granuloma gravidarum
b. spider angioma
c. epulis of pregnancy
d. palmar erythema

A

C

127
Q

Treatment for leg edema:

a. diuretics
b. elastic stockings
c. decreased fluid intake
d. prolonged bed rest

A

B

128
Q

The following changes in the CVS are considered to be normal or physiologic during pregnancy except

a. minimal pericardial effusion
b. inc heart rate by 10 to 15 beats per minute
c. displacement of the apex beat to the right and upwards
d. inc in cardiac silhouette on x-ray

A

C

129
Q

An increase in cardiac output is accounted for by an increase in:

a. Peripheral vascular resistance
b. Heart rate
c. Maternal weight

A

B

130
Q

Highest peaks in cardiac output EXCEPT:

a. 28-32 weeks
b. 36-40 weeks
c. Late 2nd stage of labor
d. Immediately postpartum

A

B

131
Q

Diminished blood flow from the lower extremities causes the following EXCEPT:

a. Varicose veins
b. Dependent edema
c. Deep vein thrombosis
d. Hemorrhoids

A

D

132
Q

The RA system, mediated both the maternal uteroplacental unit and maternal kidney, act to control blood pressure via their pressor effects. In woman, destined to become hypertensive, what change occurs?

a. They maintain this refractoriness to the pressor effects
b. They lose this refractoriness to the pressor effects
c. Their refractoriness is heightened/increased
d. NOTA

A

B

133
Q

Which of the following respiratory changes occur in pregnancy?

a. Increase in inspiratory reserve volume
b. Increase in functional residual capacity
c. Increase in tidal volume
d. Increase in lung capacity

A

C

134
Q

Which of the following pulmonary functions is not affected by pregnancy?

a. Lung compliance
b. Tidal volume
c. Functional residual capacity
d. Expiratory reserve volume

A

A

135
Q

Responsible for increase in GFR and renal blood flow

a. Estrogen
b. Progesterone
c. Relaxin
d. PTH

A

C

136
Q

A normal finding during pregnancy is:

a. Proteinuria
b. Hematuria
c. Glucosuria
d. Pyuria

A

C

137
Q

The main endocrine organ during pregnancy:

a. Ovary
b. Pituitary gland
c. Thyroid gland
d. Placenta

A

D

138
Q

Which of the following is not essential in maintaining pregnancy?

a. Adrenal gland
b. Thyroid gland
c. Pituitary gland
d. Parathyroid gland

A

C

139
Q

Principal function of maternal serum prolactin

a. Ensure successful pregnancy outcome
b. Regulate fetal growth
c. Regulate calcium absorption
d. Ensure lactation

A

D

140
Q

Which of the following is TRUE regarding thyroid physiology:

a. Thyroxine-binding globulin decreases during the first trimester
b. Moderate thyroid enlargement is due to glandular hyperplasia and increased vascularity
c. There is increased availability of iodide
d. Thyroxine (T4) is greatly decreased

A

D

141
Q

The following have increased levels during pregnancy EXCEPT:

a. Dehyrdoepianrosterone sulfate (DHEAS)
b. Aldosterone
c. Cortisol
d. Testosterone

A

A

142
Q

Which of the following pregnancy hormones have an immunosuppressive affect?

a. hPL
b. LHRH
c. hCG
d. TRH

A

C

143
Q

The antigenically foreign fetus is protected from rejection by the maternal immune system by:

a. Mast cells
b. Trophoblastic tissues
c. Plasma cells
d. Intravenous immunoglobulins

A

B

144
Q

The highest levels of leukocyte count during normal pregnancy occurs during

a. 1st trimester
b. 2nd trimester
c. 3rd trimester
d. Labor

A

D

145
Q

The suppression of T-helper-1 and T-cytotoxic 1 cells decreases the following EXCEPT:

a. Interleukin- 2
b. Interleukin- 4
c. Interferon-g
d. Tumor necrosis factor-β

A

B

146
Q

Pyrosis is caused by

a. Decrease in lower esophageal sphincter tone
b. Increase in intraesophageal pressure
c. Decrease in intragastric pressure
d. Higher wave and amplitude of esophageal peristalsis

A

A

147
Q

The increased predisposition of cholesterol stones in the gallbladder of multiparous women can be explained by the following EXCEPT:

a. Increased cholecytokinin- mediated smooth muscle contraction
b. Increased contractility of the gallbladder
c. Increased residual volume of gallbladder contents
d. Increased cholesterol saturation

A

B

148
Q 
Normal in pregnant patients
A. Mild fasting hyperglycemia
B. Postprandial hypoglycemia
C. Hypoinsulinemia
D. Greater suppression of glucagon
A

D

149
Q 
Memory related memory decline is experienced during
A. First trimester
B. Second trimester
C. Third trimester
D. Labor
A

C

150
Q 
The increase in joint laxity is due to an increase in which levels of which hormone during pregnancy?
A. Progesterone
B. Estrogen
C. Relaxin
D. None of the above
A

D

151
Q 
Sustains increased plasma volume in late pregnancy
A. Prolactin
B. Parathyroid hormone
C. Placental growth hormone
D. Cortisol
A

D

Pregnancy (4 decks)

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