Obgyn - The pathology of pregnancy Flashcards
OBG - 8.1
Recommended first-line antibiotic for the treatment of primary toxoplasmosis infection during pregnancy:
A) metronidazole
B) spiramycin
C) ampicillin
D) doxycycline
ANSWER
B) spiramycin
EXPLANATION
Spiramycin is an effective treatment in toxoplasmosis It reduces the prevalence of the fetal infection but the effect to reduce the severity of fetal damage is controversial.
OBG - 8.2
Predominant organism in pyelonephritis during pregnancy:
A) Candida albicans
B) Escherichia coli
C) Streptococcus agalactiae
D) Ureaplasma urealyticum
ANSWER
B) Escherichia coli
EXPLANATION
Candida albicans usually cause vulvovaginitis, streptococcus agalactice is a major cause of severe neonatal infection, ureaplasma urealyticm cause cervicitis. E.coli is the most frequently isolated organism in urinary tract infections.
OBG - 8.3
Emergency therapy for hypertensive crisis in preeclampsia:
A) IV hydralazine ( Nepresol) + IV calcium
B) oral magnesium sulfate + oral beta-blocker
C) IV magnesium sulfate+ IV hydralazine ( Nepresol)
D) IV calcium + oral beta-blocker
ANSWER
C) IV magnesium sulfate+ IV hydralazine ( Nepresol)
EXPLANATION
Hydralazine is the most efficacious drug for the acute control of hypertensive crisis. Magnesium sulfate reinforces the effect of hydralazine and is the first-line treatment for prevention of eclamptic seizures.
OBG - 8.4
Characteristic for hypertensive disorders during pregnancy, except:
A) proteinuria
B) liver enzymes elevation
C) pulmonary edema
D) serum creatinine decrease
ANSWER
D) serum creatinine decrease
EXPLANATION
Proteinuria, liver enzymes elevation or in severe form pulmonary edema are important signs of hypertensive disorders during pregnancy. Other factors such as elevated serum creatinine level are evidence for severe form of the disease.
OBG - 8.6
First-line therapy in seizure during pregnancy:
A) phenobarbital
B) carbamazepine
C) phenytoin
D) intravenous diazepam
ANSWER
D) intravenous diazepam
EXPLANATION
First-line therapy for epileptic seizure irrespective pregnancy is the administration of diazepam. Administration of barbiturate can cause folic acid deficiency, carbamazepine or phenitoin can cause embriopathy.
OBG - 8.7
What is AFI (Amniotic fluid index)?
A) Quotient of the largest amniotic fluid pockets and the sagital diameter of the uterus
B) Quotient of the amniotic water volume and the fetal body weight
C) It represents the total of the linear measurements of the largest amniotic fluid pockets noted of each of the four quadrants of the gestational sac. (in centimeters)
D) Quotient of the amniotic fluid and the surface which was taken by the fetal body on the sagital ultrasound view
ANSWER
C) It represents the total of the linear measurements of the largest amniotic fluid pockets noted of each of the four quadrants of the gestational sac. (in centimeters)
EXPLANATION
AFI is used for the assessement to determine the amniotic fluid volume abnormalities (particular for polyhydramnion) (Phelan, J. P. et al.: Amniotic fluid volume assessment with the four-quadrant technic at 36—42 weeks’ gestation. J. reprod. Med. 32:540, 1987.)
OBG - 8.8
Glucose tolerance test in the screening for gestational diabetes is abnormal if the 2-hour plasma glucose level:
A) >= 11,1 mmol/l
B) >= 7.0 mmol/l
C) >= 7,8 mmol/l
D) >= 8,7 mmol/l
ANSWER
C) >= 7,8 mmol/l
EXPLANATION
If the 2- hour glucose tolerance test result exceeds the level of 7.8 mmol/l ,gestational diabetes is present. However the two another abnormally high level requires treatment.
OBG - 8.9
Predisposing factors associated with abruptio placentae, except:
A) maternal hypertension
B) smoking
C) external trauma during pregnancy
D) anaemia
E) multiple birth
ANSWER
D) anaemia
EXPLANATION
All of them are predisponic factors for abruptio placentae except anaemia. The common possible cause in the listed cases is the damages /lesions of vessels.
OBG - 8.10
Which is false about hydatidiform mole?
A) proliferation of throphoblast cells
B) genetic composition is triploid
C) in 20% of cases can lead to choriocarcinoma
D) plasma hCG level is elevated
ANSWER
C) in 20% of cases can lead to choriocarcinoma
EXPLANATION
The incidence of the gestational throphoblast diseases is about 20%, but choriocarcinoma represents a smaller amount of that . The incidence of hydatiform mole transformation to choriocarcinoma is about 2 %.
OBG - 8.12
After resolving extrauterine pregnancy an Rh-negative pregnant requires:
A) evaluation of the administration of Rh immune globulin is individual
B) administration of Rh immune globulin is not necessary
C) Rh immune globulin should be given
D) maternal Rh-antibody titer should be considered in the next pregnancy
ANSWER
C) Rh immune globulin should be given
EXPLANATION
To avoid the Rh-isoimmunisation , Rh immune globuline should be given within 72 hours to an Rh-negative woman with an ectopic pregnancy.
OBG - 8.13
Which one is the correct method in multiple pregnancy if one twin’s detected fetal anomaly is incompatible with life?
A) to continue the pregnancy
B) interruption of the multiple pregnancy is required
C) selective reduction of the affected twin is recommended
D) CTG surveillance is required regularly
ANSWER
C) selective reduction of the affected twin is recommended
EXPLANATION
In cases of twin pregnancy where one of the fetuses is affected by severe congenital anomaly or and the other fetus is healthy, selective abortion has been accepted as the method of choice to save the healthy sibling and to improve its life expectations.
OBG - 8.15
Etiology of ectopic pregnancy:
1) anomaly of the Fallopian tubes development
2) previous inflammation in the lumen of the tubes
3) Chlamydia trachomatis infection
4) scars, adhesions in the tube’s wall
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
ANSWER
E) all of the answers are correct
EXPLANATION
All of abnormalities that has an effect on a fallopian tube’s normal function can be a cause of ectopic pregnancy. Such as congenital tubes anomalies, inflammations, scars in the wall of fallopian tubes.
OBG - 8.16
What drug/drugs is/are a good management in the treatment of hypertensive disorders in pregnancy?
1) alpha-methyldopa
2) calcium antagonist
3) beta -blockers
4) thiazid diuretics
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
ANSWER
A) 1st, 2nd and 3rd answers are correct
EXPLANATION
Diuretic can not be used in pregnancy expecially in preeclampsia, because of the reduction of plasma volume and the potential for decreasing placental perfusion
OBG - 8.17
Which can cause polyhydramnion?
1) fetal haemolytic anaemia
2) premature rupture of the membranes
3) diabetes mellitus
4) praeeclampsia
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
ANSWER
B) 1st and 3rd answers are correct
EXPLANATION
Praeeclampsia due to placental insufficiency can cause oligohydramnion. Premature rupture of membranes cause oligohydramnion. Severe maternal diabetes or fetal haemolytic anaemia can cause polyhydramnion
OBG - 8.18
Which are the symptoms of threatened eclampsia?
1) visual disturbances, constant or severe headache
2) severe hypertension
3) hyperreflexivity
4) vomiting, epigastric pain
A) 1st, 2nd and 3rd answers are correct
B) 1st and 3rd answers are correct
C) 2nd and 4th answers are correct
D) only 4th answer is correct
E) all of the answers are correct
ANSWER
E) all of the answers are correct
EXPLANATION
Criteria for eclampsia are severe hypertension, epigastric or right upper quadrant pain, cerebral or visual disturbances, vomiting and hyperreflexion can occur
