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Obstetrics 2022 > Obstetrics - 1M > Flashcards

Obstetrics - 1M Flashcards

1
Q

Which of the following statements on the
pharmacokinetic properties of drugs used in
pregnancy is/are correct?
A. Fat-soluble drugs are distributed more
widely and tend to linger in the body
because they are slowly released from the
storage sites.
B. The absorption of an intramuscularly
administered drug is highly effective.
C. Since the placenta is a semi-permeable
membrane and a site of metabolism, all drugs
that pass through the placenta will be nontoxic to the fetus.
D. All of the above

A

A. Fat-soluble drugs are distributed more
widely and tend to linger in the body
because they are slowly released from the
storage sites

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2
Q

To be considered a teratogen, a candidate substance
or process should:
A. Result in a characteristic set of
malformation, including a selectivity for
certain target organs
B. Exert its effects at any stage of fetal
development
C. Show a dose-independent incidence
D. All of the above

A

A. Result in a characteristic set of
malformation, including a selectivity for
certain target organs

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3
Q

Fetal anoxia secondary to the use of
vasoconstrictors like prostaglandin and ergot is an
example of which teratogenic mechanism?
A. Direct drug actions on the process of
differentiation
B. Deficiency of a critical substance
C. Indirect effects on fetal tissue
D. Continued exposure to a teratogen may
produce cumulative effects or may affect
several organs going through varying stages
of development

A

C. Indirect effects on fetal tissue

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4
Q

The most crucial period of organogenesis and
therefore the time of greatest theoretical risk for
congenital malformations is
A. Pre-embryonic phase
B. Embryonic phase
C. Fetal phase

A

B. Embryonic phase

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5
Q

Thalidomide may affect the development of arms
and legs after only a brief exposure during
A. 3rd-8th weeks of gestation
B. 3rd-7th weeks of gestation
C. 4th-8th weeks of gestation
D. 4th-7th weeks of gestation

A

D. 4th-7th weeks of gestation

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6
Q

The principle of rational prescribing in pregnancy
will include the following:
A. Drugs that have teratogenic effects in animal
studies always present with risk of
malformation in humans when given in
clinical doses
B. Drugs that have been proven effective
should be continued and experimenting
new drugs should be avoided
C. Since pregnant women are orphan patients, it
is safe to assume that absence of data in
clinical studies means no teratogenic risk to
the fetus
D. All of the above

A

B. Drugs that have been proven effective
should be continued and experimenting
new drugs should be avoided

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7
Q

The following statements on physiologic and
relative pharmacokinetic changes of pregnancy is/are
true:
A. Because of the 50% increase in blood
volume and body water, drug dosage
should be increased in women taking
water-soluble drugs
B. Drug dosage should be increased in drugs
that are highly protein-bound since more free
drug is available for therapeutic effects on
mother and for placental transfer to the fetus
C. The dose of amoxicillin for a pregnant patient
with a UTI should be doubled because
amoxicillin is excreted unchanged in urine
D. All of the above

A

A. Because of the 50% increase in blood
volume and body water, drug dosage
should be increased in women taking
water-soluble drugs

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8
Q

Choose the best anticoagulant for a 32-year-old
primigravid on her 18th week AOG with lower limb
deep vein thrombosis
A. Heparin
B. Warfarin
C. Aspirin
D. Streptokinase

A

A. Heparin

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9
Q

A 25-year-old G1P0 on her 24th week AOG was
diagnosed to have UTI. Drug of choice for this patient
will include:
A. Tetracycline
B. Penicillin
C. Quinolones
D. All of the above

A

B. Penicillin

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10
Q

Which of the following is a correct combination of
a drug and its associated congenital anomaly?
A. Warfarin: DiSala Syndrome
B. Phenytoin: Cleft lip palate
C. Valproic acid: Ebstein anomaly
D. ACEI: Microcephaly

A

A. Warfarin: DiSala Syndrome

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11
Q

True statements about epilepsy in pregnancy
A. The incidence of congenital malformation
secondary to monotherapy or use of single
drugs in treatment of epilepsy is 0.5-1%
B. The dose of anti-epileptic drugs postpartum
is the same dose given during pregnancy
C. The first line of drug in the treatment of
epilepsy in pregnancy is valproic acid
D. All of the above

A

A. The incidence of congenital malformation
secondary to monotherapy or use of single
drugs in treatment of epilepsy is 0.5-1%

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12
Q

Which of the following associations between first
trimester antibiotic exposure and the given birth defect
is true?
A. Aminoglycoside may cause ototoxicity
B. Chloramphenicol may cause ashen-gray skin
coloration
C. Tetracycline may cause deciduous teeth
discoloration
D. Nitrofuratoin may cause cleft lip

A

Nitrofuratoin may cause cleft lip

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13
Q

Which of the following herbal remedies is
associated with increased risk of bleeding by
inhibiting COX?
A. Garlic
B. Ginger
C. Ginseng
D. Ginkgo biloba

A

D. Ginkgo biloba

(Disputed: Ginger is COX inhibitor according to
Williams)

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14
Q

Which of the following fetal concerns made the
FDA reclassify magnesium sulfate from category A to
category D?
A. Cleft lip & palate
B. Cardiac defects
C. Bone demineralization
D. Facial deformities

A

C. Bone demineralization

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15
Q

Which of the following is potential fetal
consequence of nitrofurantoin if given at or near term
A. Staining of deciduous teeth
B. Hemolytic anemia
C. Fetal arrhythmia
D. Neural tube defects

A

B. Hemolytic anemia

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16
Q 
Fern formation of dried cervical mucus is due to
the effect of which hormone?
A. Progesterone
B. Human placental lactogen
C. Estrogen
D. Prolactin
A

C. Estrogen

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17
Q

Softening of the uterine is most resulting in its
compressibility on bimanual examination is called?
A. Goodell’s sign
B. ?
C. Hegar’s sign
D. Chadwick’s sign

A

C. Hegar’s sign

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18
Q

A 24-year-old came in for vaginal spotting. Her
LMP was Oct. 4, which of the following clinical
findings will be most suggestive of pregnancy?
A. Previous menses every 28-30 days
B. Breast pain
C. Increase vaginal discharge
D. Bluish discoloration of the vagina

A

A. Previous menses every 28-30 days

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19
Q

A 28-year-old primigravid came in for her first
prenatal check-up. Her last LMP was Aug. 17, 2020.
She started vomiting 1 week ago. Her ultrasound
findings last Nov. 2 showed a live intrauterine
pregnancy compatible with 7 weeks intrauterine
gestation. What will be her AOG today?
A. 13 weeks
B. 9 weeks
C. 10 weeks
D. 8 weeks

A

B. 9 weeks

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20
Q

A 24-year-old consulted for vaginal spotting. Her
LMP was Oct. 12, 2020. Pregnancy test was positive.
Pelvic ultrasound showed a well-formed intrauterine
gestational sac, no fetus seen. Which of the following
is the most likely diagnosis?
A. Abortion
B. Failure of implantation
C. Ectopic pregnancy
D. 5 weeks gestation

A

D. 5 weeks gestation

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21
Q

A woman who has had 2 full term deliveries, 1
preterm delivery, 1 abortion, and 2 living children
would have this OB score:
A. G4P3 (2112)
B. G4P2 (2112)
C. G3P3 (2112)
D. G3P2 (2112

A

A. G4P3 (2112)

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22
Q 
Which of the following vaccines is recommended 
during pregnancy?
A. DPT
B. HPV
C. Hep B
D. MMR
A

A. DPT

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23
Q

A 38-year-old G6P5 had her prenatal check-up on
her 28th week of gestation showed a fundic height of
24 cm. What are the possibilities?
A. Normal pregnancy
B. Intrauterine growth restriction
C. Oligohydramnios
D. Genetic disorder

A

B. Intrauterine growth restriction

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24
Q

What information aside from gestational age is
considered especially important during prenatal visits?
A. Maternal heart rate
B. Accurate maternal BP
C. Activity
D. Occupation

A

B. Accurate maternal BP

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25
Q

Measurement of this predictive of gestational age
within 4-7 days accuracy by transvaginal ultrasound
A. Gestational sac
B. Biparietal diameter of the fetal head
C. Crown rump length
D. Femur length

A

C. Crown rump length

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26
Q

A 28-year-old G2P1 (1001) came in for prenatal
check up due to missed menstruation. Pregnancy test
was done with a positive result however, the patient
was unsure of her LMP since she has an irregular
cycle. On internal examination, the cervix is closed
and soft, the uterus is noted to be globular with an
average diameter of 8 cm all around. Based on the
examination, what is the possible age of gestation?
A. 8 weeks
B. 10 weeks
C. 12 weeks
D. 16 weeks

A

C. 12 weeks

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27
Q 
Changes of the uterine size, shape, and consistency 
are:
A. Presumptive signs of pregnancy
B. Presumptive symptoms of pregnancy
C. Probable evidences of pregnancy
D. Positive signs of pregnancy
A

C. Probable evidences of pregnancy

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28
Q

A 25-year-old primigravid came in for prenatal
check-up. She cannot recall her LMP. On IE, the
cervix is closed, uterine fundus is felt between the
umbilicus and the symphysis pubis, no palpable
adnexal mass. What is the possible AOG?
A. 10 weeks
B. 12 weeks
C. 16 weeks
D. 18 weeks

A

C. 16 weeks

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29
Q 
Estrogen stimulates which of the following?
A. Montgomery tubercle 
B. Vascular system of the breast
C. Alveolar component
D. Mammary duct system
A

D. Mammary duct system

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30
Q

A 29-year-old G1P0 was diagnosed having RHD
prior to pregnancy. She wants to know if her child will
inherit the disease. She wants a real time sonography.
At what AOG will fetal heart motion and movement
will be demonstrated by real time sonography?
A. 6 weeks
B. 8 weeks
C. 12 weeks
D. 16 weeks

A

B. 8 weeks

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31
Q

Which of the following endocrine disorders is
more associated with low birth weight infants upon
delivery?
A. Diabetes mellitus
B. Hyperthyroidism
C. Hypothyroidism

A

B. Hyperthyroidism

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32
Q 
15% of fetal death is caused by which of the 
following? 
A. Asphyxia
B. Congenital malformation
C. Infections
D. Maternal complications
A

B. Congenital malformation

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33
Q

Pre-conceptional folic acid supplementation can
reduce the risk of having a child with neural tube
defect by what percentage?
A. 72%
B. 26%
C. 90%
D. 11%

A

A. 72%

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34
Q

Which of the following endocrine disorders is
more associated with low birth weight infants upon
delivery?
A. Hyperthyroidism
B. Hyperparathyroidism
C. DM
D. Hypothyroidism

A

A. Hyperthyroidism

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35
Q 
15% of fetal death is caused by which of the 
following? 
A. Congenital Malformations
B. Maternal complications
C. Asphyxia
D. Infections
A

A. Congenital Malformations

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36
Q

Which of the following is the most accurate
definition of preconceptional care as defined by CDC?
A. set of interventions that aim to identify and
modify biomedical behavioral, and social
risks to a womans health or pregnancy
outcome through prevention and
management
B. Assure chilbearing age women that with
appropriate interventions they can enter
pregnancy in optimal health.
C. Implement strategies that mitigate potential
pregnancy risks before conception
D. Reduce risks of adverse pregnancy outcomes
through preconceptional interventions.

A

A. set of interventions that aim to identify and
modify biomedical behavioral, and social
risks to a womans health or pregnancy
outcome through prevention and
management

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37
Q 
When is the best opportunity to provide 
preconceptional counseling?
A. during a periodic health maintenance 
examination 
B. During the 6 week postpartum period.
C. During a hospitalization for an acute illness
D. At times an adverse pregnancy outcome is 
diagnosed.
A

A. during a periodic health maintenance

examination

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38
Q

A 27 year old patient presents to her neurologist to
discuss discontinuing her Levetiracetam prior to
attending pregnancy. Which of the following
characteristics make her candidate for
discontinuation?
A. she has tonic clonic seizures
B. She has been seizure free for 18 months
C. She has not required an EEG in 18 months
D. She is compliant with her medications

A

A. she has tonic clonic seizures

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39
Q

A 27 year old patient presents to her neurologist to
discuss discontinuing her Levetiracetam prior to
attending pregnancy. Which supplement should the
patient initiate prior to attempting pregnancy?
A. Folate 4mg
B. Folate 1mg
C. Niacin
D. Iron

A

A. Folate 4mg

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40
Q 
Worldwide, what are the most common single 
gene disorders?
A. Hemoglobinopathies
B. Cystic fibrosis
C. Tay Sachs Disease
D. Fragile X Syndrome
A

A. Hemoglobinopathies

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41
Q 
Which is the best way to identify a genetic 
abnormality in still born fetus?
A. Chromosomal microarray analysis
B. Karyotype
C. Maternal cell DNA testing
D. All of the above
A

A. Chromosomal microarray analysis

42
Q

Which of the following obstetrical complications
is increased in adolescent pregnancies compared with
women aged 20-35?
A. Anemia
B. Aneuploidy
C. PPH
D. C delivery

A

A. Anemia

43
Q 
Which fetal tissues are most susceptible to damage 
by high phenylalanine levels?
A. Cardiac and neural
B. Renal and cardiac
C. Neural and hepatic
D. Renal and hepatic
A

A. Cardiac and neural

44
Q 
Birth defects are responsible for what percent of 
infant mortality?
A. 20%
B. 10%
C. 22%
D. 12%
A

A. 20%

45
Q

Which of the following are important aspects of
reproductive history that aid in preconceptional
counselling?
A. History of preterm delivery
B. Prenatal screening results from prior
pregnancy
C. Length of prior labor
D. Prior child’s birth weight

A

A. History of preterm delivery

46
Q 
Which is not a part of the goal of prenatal 
diagnosis?
A. prevent pregnancy termination
B. Optimal delivery
C. Provide fetal surveillance
D. After fetal treatment
A

A. prevent pregnancy termination

47
Q 
These women are excluded from prompt invasive 
diagnostic procedures?
A. women less than 20 years of age
B. History of triploidy
C. Parenteral aneuploidy
D. Women or their partner who have 
chromosomal translocation
A

A. women less than 20 years of age

48
Q 
Damage from amniotic band causing limb 
reduction abnormalities results from what etiology of 
the birth defect?
A. Disruption
B. Association
C. Deformation
D. Syndrome
A

A. Disruption

49
Q 
Fetal down's syndrome is characterized with which 
of the following markers?
A. 1st trimester low β HCG
B. Both β HCG and pregnancy associated 
plasma protein A are low
C. High PAPP-A
D. Increased nuchal translucency on 
ultrasound
A

D. Increased nuchal translucency on

ultrasound

50
Q 
Which is not a part of second trimester aneuploidy 
screening?
A. β HCG 
B. Maternal serum AFP
C. PAPP-A
D. Estriol
A

C. PAPP-A

51
Q

Which of the statement is true?
A. Cell-free DNA screening does not always
provide results
B. Diagnostic testing evaluate which patient is
at risk
C. Screening provides information which
diagnostic testing does not
D. Irreversible balance should be based on
screening test

A

A. Cell-free DNA screening does not always

provide results

52
Q

Cell-free DNA screening can be done with women
who are
A. 40 years old
B. 1st and 2nd trimester based test is negative
C. Previous pregnancy is low risk
D. Had no evidence of balance translocation in
both partners

A

A. 40 years old

53
Q 
Which of the following is common cause of fetal 
anemia 
A. Red cell production disorder 
B. Red cell enzymopathy 
C. Red cell alloimmunization
D. Red cell structural abnormality
A

C. Red cell alloimmunization

54
Q 
Pregnancy loss secondary to fetomaternal 
hemorrhage with red alloimmunization 
A. Ectopic pregnancy 
B. Chorionic villus sampling
C. Evacuation of molar pregnancy 
D. Placental abruption
A

A. Ectopic pregnancy

55
Q

Which of the following characterizes fetal
transfusion?
A. Performed 36-37 weeks prior to delivery
B. Umbilical artery is used via ultrasound
guided procedures
C. Peritoneal transfusion can be performed
D. Gestational age does not influence
management

A

C. Peritoneal transfusion can be performed

56
Q

Maintenance of phase 0 of parturition is apparently
dependent on which substances?
A. Estrogen and progesterone in concert with
each other
B. Prostaglandin
C. Beta HCG and relaxin
D. Corticotropin releasing hormone

A

D. Corticotropin releasing hormone

A. Estrogen and progesterone in concert with
each other ?

57
Q 
The criteria for the diagnosis of labor include 
which of the following?
A. Uterine contraction of at least one in ten 
minutes 
B. Documented progressive changes in 
cervical dilatation and effacement 
C. Cervical efficient to 20-30 %
D. Engagement
A

B. Documented progressive changes in

cervical dilatation and effacement

58
Q

A 30 year old g2p1 was admitted for labour pain
which started 6 hours prior to admission internal
examination revel the cervix to be 8 cm dilated, fully
effaced with head at 1 cm below the ischial spine at
what phase of labour is she in?
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4

A

C. Phase 3

59
Q

30 year old g2p1 was admitted for labour pain
which started 6 hours prior to admission internal
examination revel the cervix to be fully dilated, fully
effaced, after another 1 hour of good labor with head
at +2 at what phase of labour is she in?
A. 1st stage latent phase
B. 1st stage active phase
C. 2nd stage of labour
D. 3rd stage of labou

A

C. 2nd stage of labour

60
Q

A 28 year old primy gravid on her 38 th week of
gestation consulted for hypogastric cramps
Occurring every 10 - 25 mins the cervix was 1 cm
dilated, intact bag of water fetal head at station -2 what
phase of labour is patient in ?
A. Latent phase
B. Acceleration phase
C. Phase of maximum slope
D. Deceleration phase

A

A. Latent phase

61
Q 
Which of the following phases of labour is most 
affected by analgesia/anasthesia ?
A. Latent phase 
B. Phase of maximum slope
C. Acceleration phase
D. Deceleration phase
A

A. Latent phase

62
Q

Ehlers-Danlos syndrome and marfan syndrome
causes which of the following problems during
pregnancy?
A. Dystocia
B. Preterm labour
C. Fetal death in utero
D. Placenta previa

A

B. Preterm labour

63
Q 
Friedman's Curve is essentially a function of which 
of the following over time?
A. Cervical effacement
B. Uterine contraction
C. Cervical dilatation
D. Decent
A

C. Cervical dilatation

64
Q

A 24 y/o G1P0 was admitted at 38 weeks for
hypogastric cramps since 4 hours prior to admission
on PE the cervix is soft 3 cm dilated 70% effaced ,intact bag of water head unengaged which of the
above finding is cause for concern ?
A. 3 cm dilated
B. Intact bag of water
C. Cervix 70% effaced
D. Head unengaged

A

D. Head unengaged

65
Q 
Collagen breakdown increase in hyaluronic acid 
explains which change in cervix?
A. Lightning
B. Ripning
C. Dilatation
D. Position of cervix
A

B. Ripning

66
Q

What causes placental separation during the 3rd
stage of labor?
A. Hematoma Formation between the placenta
and the remaining decidua
B. Decrease in the area of placental
implantation site
C. Traction of the cord with the delivery of the
baby
D. All of the above

A

B. Decrease in the area of placental

implantation site

67
Q

Maintenance of the phase 0 of parturition is
apparently dependent on which substances?
A. Estrogen and progesterone in concert with
each other
B. Corticotropin-releasing hormone
C. HCG and Relaxin
D. Prostaglandins

A

B. Corticotropin-releasing hormone

68
Q

During phases 1 and 2 of parturition uterine
quiescence true inhibition of smooth muscle response
to oxytocin. Which of the following is the primary
regulator of oxytocin receptor expression?
A. Calcium
B. Progesterone
C. Prostaglandin Dehydrogenase
D. Corticotropin-releasing hormone

A

B. Progesterone

69
Q 
Which phase of parturition corresponds to the 
clinical stages of labor
A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4
A

C. Phase 3

70
Q 
Which of the following agents is t rise to initiate 
phase 3 of parturition: 
A. Progesterone
B. Prostaglandin
C. Corticotropin-releasing hormone
D. Relaxin
A

B. Prostaglandin

71
Q

What is the first sign of early pregnancy on
ultrasound that can be seen as early as 5 weeks
A. Yolk Sac
B. Gestational Sac
C. CRL
D. Fetal Pole

A

B. Gestational Sac

72
Q

In the absence of TVS for early pregnancy
determination the gestational sac is reliably seen using a trans ab sonography
A. 5 weeks
B. 9 weeks
C. 8 weeks
D. 6 weeks

A

D. 6 weeks

73
Q 
What is a sonographic measurement of the 
gestational sac called
A. Mean Sac Diameter
B. CRL
C. Fetal pole
D. Yolk sac
A

A. Mean Sac Diameter

74
Q 
What is the first anatomical structure identified 
within the gestational sac
A. Fetal pole
B. GS
C. Yolk Sac
D. CRL
A

C. Yolk Sac

75
Q

What is the most accurate of gestational age in
early pregnancy because there is little variability at
that time.
A. CRL
B. Fetal pole
C. Yolk sac
D. MSD

A

A. CRL

76
Q 
Picture UTZ
What is the useful feature of an early pregnancy 
ultrasound to confirm an early intrauterine pregnancy 
when the embryo is not yet visualized
A. Double bleb sign
B. Gestational sac
C. Double decidual sign
D. Intradecidual sign
A

C. Double decidual sign

77
Q

Which of the following do you need to measure at
11-13 weeks and now considered as part of the
antenatal screening EXCEPT?
A. Nasal Bone
B. Cardiac Rate
C. Nuchal Translucency
D. Double velocimetry flow

A

B. Cardiac Rate

78
Q 
On the TVS the placenta can be seen as early as 
how many weeks
A. 8 weeks
B. 10 weeks
C. 9 weeks
D. 11 weeks
A

A. 8 weeks

79
Q

The correct plane for the measurement of the head
circumference and biparietal diameter must include
the following EXCEPT
A. Cavum Septum Pellucidum
B. Thalamus
C. Choroid Plexus
D. Cisterna Magna

A

D. Cisterna Magna

80
Q 
What does abdominal circumference reflect
A. Fetal growth
B. Fetal size
C. Fetal girth
D. Fetal abdomen
A

B. Fetal size

81
Q 
The following conditions are associated with 
polyhydramnios except for
A. Maternal DM
B. GI and CNS anomalies 
C. Fetal skeletal dysplasia
D. IUGR
A

D. IUGR

82
Q 
The following are considered part of the fetal 
survey except for
A. Fetal spine
B. Fetal kidney 
C. Fetal pancreas
D. Fetal gender
A

C. Fetal pancreas

83
Q

A 41 year old G3P2 2002 known hypertensive with
no prior ultrasound with complaint of on and off
hypogastric pain. Blood pressure of 160/110 mmHg,
fundic height of 35 cm, fetal heart tone 143 bpm, IE
cervix close. What is your choice of ultrasound?
A. Transabdominal sonography
B. Congenital anomaly scan
C. Biophysical profile
D. All of the above

A

C. Biophysical profile

84
Q

A 41 year old G3P2 2002 known hypertensive with
no prior ultrasound with complaint of on and off
hypogastric pain. Ultrasound showed that ff: biparietal
diameter: 34 weeks, head circumference: 34 weeks,
abdominal circumference 33 weeks, femur length of
34 weeks, amniotic fluid 6 cm 4 quadrants, placental
grade 3 anterior, distal femoral epiphysial .48 cm.
What will you advice the patient except?
A. Admit
B. Doppler velocimetry
C. Steroid injection
D. IV hydration

A

C. Steroid injection

85
Q

Ultrasound findings: anechoic center surrounded
by 2 concentric echogenic rings surrounding the
gestational sac, what is your most likely
consideration?
A. Intrauterine pregnancy
B. Ectopic pregnancy
C. Miscarriage
D. Anembryonic pregnancy

A

A. Intrauterine pregnancy

86
Q

A 34 year old G2P1 1001 pregnancy at 34 weeks
came in for the non-stress test. Baseline fetal heart
tone: 130-140, moderate variability, with
accelerations, no decelerations.
A. Reactive tracing
B. Non-reactive tracing

A

A. Reactive tracing

87
Q

A 24 year old G1P0 pregnant for 36 weeks with
gestational diabetes, diet controlled, came in for NST.
Baseline fetal heart tone: 130-140, minimal
variability, no acceleration
A. Reactive tracing
B. Non-reactive tracing

A

B. Non-reactive tracing

88
Q

Interpret contraction stress test: with accelerations,
no decelerations despite a regular uterine contractions
A. Positive CST
B. Negative CST

A

B. Negative CST

89
Q

Interpret the CST: normal fetal heart rate, no
acceleration, no deceleration, minimal variability,
mild contractions

A

Unsatisfactory

90
Q

True about positive CST
A. This is a normal test result
B. Uniform repetitive late fetal heart rate
decelerations following 50% or more of
contraction even if the contraction
frequency is fewer than 3 in 10 minutes
C. Variable (inaudible) could be the result of
utero placental insufficiency
D. Contractions are not necessary in performing
the test

A

B. Uniform repetitive late fetal heart rate
decelerations following 50% or more of
contraction even if the contraction
frequency is fewer than 3 in 10 minutes

91
Q

True about reactive NST
A. Based on the hypothesis, the heart rate of
the fetus that is non-acidemic as a result of
fetal hypoxia or neurological depression
will temporarily accelerate in response to
fetal movement
B. Describe fetal heart rate decelerations in
response to fetal movement as a sign of fetal
health
C. Involves the use of doppler detected fetal
heart rate deceleration coincident with fetal
movement perceived by the mother
D. Difficult to perform

A

A. Based on the hypothesis, the heart rate of
the fetus that is non-acidemic as a result of
fetal hypoxia or neurological depression
will temporarily accelerate in response to
fetal movement

92
Q 
Factors affecting respiratory movements include 
A. Hyperglycemia
B. Post-term labor 
C. Sound stimuli 
D. Amniotic fluid volume
A

C. Sound stimuli

93
Q

True for antepartum surveillance
A. Initiated at 40 weeks
B. Indications include maternal condition
like cyanotic heart disease, diabetes,
chronic renal disease
C. Women at risk for still-birth need not
undergo fetal surveillance
D. (Inaudible) pregnancies difficult to explain
and is an added expense to the patient

A

B. Indications include maternal condition
like cyanotic heart disease, diabetes,
chronic renal disease

94
Q

Components of the biophysical profile tests get a
score of 2 if:
A. Pocket amniotic fluid volume measures
atleast 3 cm in 2 planes
B. More than two decelerations of more than 15
beats for 15 seconds within 20-40
C. More than 1 episode of extremity
extension and subsequent return to flexion
D. More than 5 discrete body or limb
movements
E. More than 1 episode of rhythmic breathing
lasting more than 20 seconds within 20
minutes

A

C. More than 1 episode of extremity

extension and subsequent return to flexion

95
Q

A 23 year old G1P0 pregnancy uterine 36 weeks
and 4 days age of gestation, GDM on diet. Patient
came in to your clinic with a BPS of 6/10, how will
you manage this patient?
A. Amniotic fluid volume is abnormal repeat
BPS
B. Amniotic fluid volume is normal and
cervix is favorable, deliver
C. If amniotic fluid volume is abnormal, wait for
the patient to go into labor
D. No need to do anything because this is just a
sign of possible fetal asphyxia

A

B. Amniotic fluid volume is normal and

cervix is favorable, deliver

96
Q

A 36 year old G2P0 0010 at 37 weeks of gestation,
GDM on insulin. Patient came in to your clinic with a
BPS score of 10/10. How will you manage this
patient?
A. Deliver this patient because BPS score
indicate an asphyxiated fetus
B. Repeat test within 24 hours
C. Repeat test weekly
D. No fetal indication for intervention repeat
test twice weekly.

A

D. No fetal indication for intervention repeat

test twice weekly.

97
Q

True about doppler velocimetry
A. Blood flow velocity measured by doppler
ultrasound reflects (inaudible)
B. Growth restricted fetuses several fetal
vascular circuits including umbilical
artery, the MCA, ductus venosus, have
been evaluated as diagnostic tool for fetal
well-being
C. Maternal uterine doppler is used to predict
placental hyperperfusin
D. Can be done as early as 12 weeks

A

B. Growth restricted fetuses several fetal
vascular circuits including umbilical
artery, the MCA, ductus venosus, have
been evaluated as diagnostic tool for fetal
well-being

98
Q

Which of the following artery wave form is normal

A

answer A- there should be an

immediate return

99
Q

True about middle cerebral artery doppler
A. Doppler velocimetry of MCA to detect fetal
compromise is recommended
B. Fetus is hypoxic attempts veins sparring by
increased cerebro-vascular impedance
C. MCA doppler is proven valuable in
detecting fetal anemia
D. MCA is normally a low resistant vessel

A

C. MCA doppler is proven valuable in

detecting fetal anemia

100
Q

True of ductus venosus
A. Doppler ultrasound to asses fetal venous
circulation not routinely necessary
B. Doppler of the fetal aorta is the best important
predictor of peri-natal outcome for growth
restricted fetuses at 26-33 weeks
C. Negative or reverse flow in the ductus
venosus is an early finding for hypoxic
fetuses
D. Gestational age at delivery is a major
determinant of peri-natal outcome
independent of ductus venosus flow

A

D. Gestational age at delivery is a major
determinant of peri-natal outcome
independent of ductus venosus flow

Obstetrics 2022 (7 decks)

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