Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics 2022 > Obstetrics - COMPRE 2020 > Flashcards

Obstetrics - COMPRE 2020 Flashcards

1
Q

Which of the following patient will most likely have a C-section even if the pregnancy is term and cephalic in presentation?

A

38 year old G2P1 (1001) her first pregnancy was a C-section for failure of descent secondary to contracted inlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A 35 year old G1P0 came in for labor pain, her vital signs were normal upon PE fundic height was 32cm, estimated fetal weight 2.6 – 2.8Kg, FHT 14o/min RLQ, upon IE 1cm dilated, beginning effacement, intact membrane, st -3, 1 contraction per 30 minutes, what is the best management for this patient?

A

Send her home

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

There was a labor curve given. The following questions are based on that. A G1P0 38 weeks AOG, identify the abnormality.

A

Arrest of cervical dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

G1P0 38 weeks AOG, at what stage of labor does the

abnormality occurs?

A

Phase of maximum slope (The curve was in dilatation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

G3P2 (2002), 38 weeks AOG, at what phase of labour you recognize labor abnormality?

A

Deceleration phase (the curve shows 9cm dilatation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Identify the labor abnormality?

A

Failure of decent (St -2 for 3 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

G3P2 (2002) 38 weeks AOG, what is your diagnosis?

A

Prolonged latent phase (1cm for 17 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

G3P2 (2002) 38 weeks AOG, what is the best management?

A

Therapeutic rest (1cm for 17 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Multigravida patient is admitted on her 4th hour of labor, with regular contractions, cervix 2cm dilated, 50% effaced, st-2, LOP position, after 4 hours the cervix is 4cm dilated, fully effaced, st2, LOP, amniotomy was done. After 2 hours the cervix is 6cm
dilated, st 0, LOP, after 1 hour: 7cm dilated, st 0, 5 minutes to 3 hours, IE was done same finding, now with 2cm caput. Uterine contractions are strong, every 2-3 minutes, what is the best management?

A

C-section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A 24 year old primigravid patient consulted at the OB-ER. On the 10th hour of labor, she complains of watery vaginal discharge for an hour and irregular contractions. IE: 3-4cm dilated, ruptured bag, clear fluid gushing, head at station -1. 2 hour after
admission, the resident referred the patient to you with strong contractions every 1-2 minutes lasting to 40-60 seconds. Repeat IE was the same.

A

Sedate the patient and hook to tocometer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which of the following statement, the engagement of the fetal head is true?

A

The greatest diameter, the transverse diameter passes through the pelvic inlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In a vaginal delivery, the anterior shoulder is delivered, the OB palpates a nuchal cord, what is the best management?

A

Cord is slipped over the fetal head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the importance of fetal head flexion in the course of labor?

A

The occipitobregmatic diameter will present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common position in which the vertex enters the pelvis with the sagittal suture lying in the transverse pelvic diameter?

A

Left occiput transverse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A 31 year old G1P0, 34 weeks AOG, complaining of absence of fetal movement for 10 hours, vital signs are normal, fundic height 30cm, FHT 140??? RLQ. What is the best management?

A

Do a non- stress test immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A 33 year old G3P2, 40 weeks and 6 days, 1cm dilated, cephalic, no ballottement of the head, good fetal movement. What is the best management?

A

Do an amniotic fluid index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Correct sequence of new born care

A

Immediate drying, skin to skin contact, cord clamping and nonseparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which of the following is the correct method of drying?

A

Dry the baby’s face and head first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A 28 year old G1P0, at 38 weeks AOG, came in due to
hypogastria pain, patient had irregular prenatal check-up, upon PE: FH 27cm, with Leopold’s maneuverer revealed both transverse lei. Identify the position?

A

Right acromiodorsoanterior position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is presenting diameter of the picture given below?

A

Occipitomental diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

25 year old G2P1 (1001), at 39 weeks AOG, 1st pregnancy was normal delivery, prenatal check-up was unremarkable, PE: FH 32cm, Leopold’s maneuverer 2 FHT at left maternal side, LP 3 is unengaged. Not audible occiput was higher than sinciput. IE: cervix 3cm, 80% effaced, +BOW, st -2, what is the presenting diameter?

A

Occipitomental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A 25 year old, 38 weeks G1P0 came in due to labor pain, with FH 32cm, with good fetal heart tone, IE: 4-5cm, fully effaced, +BOW St 0, after 3 hours IE: fully dilated, fully effaced, -BOW, St +1, however fetal ear was palpated. What is your impression?

A

Posterior asynclitism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A 35 year old, 38 weeks AOG, G1P0 in labor, FH 33cm, with good fetal heart tone, 4cm???, fully effaced, +BOW, St 0, cephalic. After 3 hours fully dilated, fully effaced, st +!, however you palpated the fetal ear. After 2 hours still fully dilated, fully effaced, st +3. You noted that the mother was exhausted, she cannot bare down adequately. What will be your next step?

A

Forceps delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A 28 year old G1P0, in a 2nd stage of labor for 1 hour, the head is at St +2, in LOT position, after satisfying all the requirements for using forceps, which among the following forceps will you use?

A

Keilland forceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

A 30 year old G1P0 in 2nd stage of labor for 2 hours, satisfying all the requirements for using the forceps delivery, you will apply this type of forceps?

A

Simpson’s forceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

A G1P0 in 2nd stage of labor for 2 hours, the head has now developed a caput, now shows sagittal suture in anteroposterior diameter, what conditions has now lead to the use of forceps delivery?

A

Low forceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

23 year old G1P0, 38 weeks AOG, UTZ single intrauterine pregnancy, cephalic, BPS 10/10, amniotic fluid 14cm, posterior grade 3 placenta, estimated fetal weight 4kg, 75 grams OGTT at 28 weeks AOG normal, physical examination: vital signs normal, FH 37cm, no uterine contractions, IE: cervix soft, closed, midposition and adequate pelvis. What is the management for this patient?

A

Not audible. sadt (di masarap kabonding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Most common cause of mid transverse arrest of fetal head during labor?

A

Contracted mid pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In a young primigravid, in labor at term, what cardinal

movement will be affected if there is convergence of pelvic side walls and narrowed interspinous diameter

A

Internal rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

32 year old G4P3(3003),37-38 weeks AOG, comes in labor, Fundic height = 30, good fetal heart tone, IE cervix fully dilated, st +3, left sacrum anterior. What is the most appropriate delivery method for the after coming head

A

Mauriceau maneuver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the best indicator of pelvic adequacy for vaginal breech delivery?

A

Steady cervical dilation and progressive descent with

contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

23 year old, primigravid delivered 30 minutes ago with profuse vaginal bleeding, BP 90/60, PR 94 bpm, IE cervix 5 cm dilated, uterus contracted at level of umbilicus, what is the management of this patient?

A

Check for cervical and vaginal laceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A 21 year old is birthed via forceps assisted vaginal delivery to a 2000 grams baby girl. In the process of the delivery, she sustains a second degree perineal laceration. During inspection prior to repair a non-enlarging solid swelling of clotted blood 1cm in
diameter is noted adjacent to the tear within the sub mucosa. After repairing the laceration, what is the next step in the management of this patient?

A

Manage expectantly with frequent evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

A 38 year old G5P5 delivered a 4100 grams baby after a 15 hour labor including a 2 and a half second stage. During the repair of midline episiotomy there is a marked increase in the amount of vaginal bleeding. Which of the following is an immediate cause of post-partum hemorrhage?

A

Uterine atony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

32 year old, G3P2 (2002), delivered spontaneously to a live term baby boy in a tertiary hospital. She gave a previous history of low segment caesarean section in 2014 for placenta previa. In this case the attending resident failed to check the placenta because he was in a hurry to transfer her to the ward. The delivery room was overcrowded. After 30 minutes the patient
passed out and the nurse on duty noted her bed sheets to be fully blood soaked. What is the gross mistake made?

A

Placenta was not inspected for completeness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

A 35 year old, G4P3, who delivered at 39 weeks via normal vaginal delivery, the placenta was implanted fundally, delivery of the placenta was complicated by an inverted uterus with subsequent haemorrhage leading to 1500 ml of blood loss. How will you manage the above patient?

A

Call for help, secure blood products, adequate anaesthesia, and manual reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

A 29 year old, G2P1, 30 weeks AOG, comes to see you with new onset gastric reflux not responsive to antacids. The patient reported that she did not experience this during her previous pregnancy at the age of 20. What physiologic changes of
pregnancy explained this symptom?

A

Decreased gastroesophagel sphincter tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

A 28 year old, G2P1 (1001), of 5 weeks AOG came in for prenatal check-up. You requested for transvaginal ultrasound, findings showed, intrauterine gestation of 5 weeks and 4 days by gestational sac diameter, there was an ovarian cyst measuring 7cm of the widest diameter at the left side. The description of ring of fire was also noted. What is the possible adnexal cyst?

A

Corpus luteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

This change in the cervix makes identification of atypical glandular cells in Pap smear difficult.

A

Hyperplasia and hyper secretory appearance of endocervical glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which of the following soluble receptor

attenuates vascular endothelial and placental growth factor in vivo?

A

SFLT-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The fetus gains the most amount of weight during which period of AOG?

A

10-20 weeks

42
Q

Which of the following statements is true regarding the glucose and insulin levels in pregnant and non-pregnant women?

A

Glucose levels increases after meals in pregnancy

43
Q

A 28 year old, G1P0, 42 weeks AOG presents to the clinic with complaints that she is always tired all the time and her feet swell if she stands for too long. Her cervix is posterior, closed, uneffaced and very firm. As discussion begins regarding the possibility of induction, the patient asks what her chances of having her baby vaginally are.

A

Induction with artificial ripening agent is an option

44
Q

. A 25 year old, G1P0 at 39 weeks came in due to watery vaginal
discharge, FH 30 cm, with Good fetal heart tone, cervical exam
includes pooling amniotic fluid, IE 1cm, 50% effaced, cephalic, st
-1, she has mild to moderate uterine contractions lasting 30
seconds interval of 10 minutes, venoclysis was done, oxytocin
drip with 10 units oxytocin incorporated in 1 liter of D5LRS was
started. How many drops of oxytocin will achieve regular
contractions

A

16-24 drops

45
Q

What is the fetal position when the fetal head after engagement
goes into posterior asynclitism at the pelvic brim?

A

Left occiput transverse

46
Q

A 27 year old, G1P0, was seen at the clinic for prenatal care for
her amenorrhoea for 8 weeks and PT is positive. TVS done
compatible with AOG. She complains of frequent urination and
unexplained weight loss which started 6 months prior to the
pregnancy. You requested urinalysis which revealed glycosuria.
FBS 130mg/dl. What is the diagnosis

A

G1P0, pregnancy uterine, 8 weeks AOG, Overt diabetes mellitus

47
Q

For patients with average risk for GDM. When should testing be
done?

A

Perform 75g OGTT at 24-28 weeks, then repeat at 32 weeks

AOG

48
Q

A 38 year old, G2P1, consulted at 10 weeks AOG, her 1st baby was 4.1 kg at birth and was delivered via CS. Her BMI in-between pregnancies was 32. Her mother died of diabetic complications.
Her blood chemistry 6 weeks post-partum was within normal
limits. Which of the following should be done.

A

Diabetes screening as soon as feasible

49
Q

Fetal growth monitoring is essential in the management of
diabetes in pregnancy because diabetic pregnant patients are
prone to develop fetal macrosomia with poor glycemic control.
Which of the following is true?

A

Fetal macrosomia is associated with difficult delivery and birth trauma

50
Q

Polyhydramnios is one of the fetal complications of diabetes in pregnancy. Which of the following is true?

A

Polyhydramnios is caused by fetal hyperglycemia which leads to polyuria

51
Q

Glycemic targets in overt or gestational diabetes

2 hours post-prandial blood glucose of less than or equal to —-

A

120mg/dl

52
Q

When should the patient with diabetes treated with insulin be delivered

A

38 weeks

53
Q

ACOG, recommends to repeat the 75g 2 hour OGTT for the diagnosis of overt DM post-partum

A

6 weeks

54
Q

From within outward which of the following are tissues of the
pelvic floor

A

Peritoneum, sub peritoneal connective tissue, internal pelvic
fascia, levator ani muscles and coccygeus, external pelvic fascia,
superficial muscles and fascia, subcutaneous and the skin

55
Q

In median episiotomy which of the following will be in the

restoration of the perineal body for long support?

A

Closure of fascia and incised muscles

56
Q

21 year old 31-32 weeks with the chief complaint of watery
vaginal discharge VS: BP 110/70, T 38.2 C pulse rate of 102,
abdominal exam- no uterine contraction, FHT 132/min ,
speculum exam with pooling of amniotic fluid, IE cervix 2cm 80%
effaced cephalic, station 0.What is the best management for
her?

A

Induction of labor ( because patient shows signs of

chorioamnionitis)

57
Q

21 year old 31-32 weeks with the chief complaint of watery
vaginal discharge, abdominal exam- no uterine contraction,
good FHT, speculum exam with pooling of amniotic fluid, IE
cervix soft and closed. Which of the following is not part of the
management?

A

Nifedipine

58
Q

Which of the following is true regarding family planning?

A

IUD is best suited for older porous women

59
Q

Gian 22 y/o, G2P2 (2002) commercial sex worker came in for
desirous for contraception. What is the best method you would
advise?

A

Condom

60
Q

Lea 26 y/o G1P1 (1001) came in for consult for contraception.
PMH unremarkable. She is on 3rd day of her menstruation.
Positive for acne. BMI is normal. IE unremarkable. What is the
best method suited for her?

A

Combined oral contraceptive

61
Q

What is the mechanism of action of combined oral contraceptive
pills?

A

Estrogenic agent suppress the FSH; Progestational agent suppress the LH

62
Q

Which of the following breast diseases are the cause of

spontaneous non milky nipple discharge?

A

Fibrocystic change and intraductal papilloma

63
Q

BRCA 1 and BRCA 2 are the genes found in the breast and the

ovarian tissue. Which of the following are their main role?

A

Encode for DNA repair

64
Q

56 y/o sought consult for second opinion for her previous
consecutive annual breast mammography showing BIRADS
category 1 and 2. It should be explained to her that this category
is?

A

Non malignant

65
Q

52 y/o nulligravid with stage 2 breast cancer having a preoperative multi-disciplinary counselling asks about her survival
after surgery and post op chemo radiation. Which of the
following statement is true about survival after breast cancer
surgery?

A

Survival depends on presence and no of axillary node

metastasis

66
Q

24 y/o nulligravid complains of painful small lumps in both of her
breasts. She is on day 25 of her regular menstrual cycle. Family
history (-) breast Cancer On palpation found nodularities on
upper inner quadrant of both breast. What is the next step in
the evaluation?

A

Repeat breast exam after menstruation

67
Q

What is the suggested management of asymptomatic

leiomyoma?

A

Observation and annual pelvic exam

68
Q

Select the best statement that characterizes the leiomyoma?

A

Sufficiently large uterus due to myoma can cause urinary

frequency

69
Q

Which medical management address the symptoms of

dysmenorrhea, menorrhagia, pelvic pressure and infertility?

A

GnRH agonist

70
Q

According to FIGO Iatrogenic cause of abnormal uterine

bleeding is?

A

Warfarin

71
Q

Endometriosis may have this characteristic?

A

Spread by adherent lymphatic

72
Q

Primary method to diagnose endometriosis is to?

A

Laparoscopy

73
Q

Which of the following symptoms is least seen in patient with
endometriosis?

A

Non cyclic Pelvic pain

74
Q

A perimenopausal women with mild cyclic pain with

endometriosis can be managed with?

A

Expectant management

75
Q

GnRH agonist are used in the treatment of endometriosis.
Which of the following statement is true regarding its effect on
endometriosis?

A

Estrogen can be added as an adjunct therapy

76
Q

The hypo estrogenic state….. necessary in the treatment of
endometriosis can be created medically with contraceptive
inducing?

A

Pseudo pregnancy state

77
Q

In cases of primary amenorrhea in pubertal patient having
discordance between genotype and phenotype with
psychological female gender identity management includes?

A

Hormonal replacement therapy and pre expected (?)

menopause

78
Q

Which of the following causes of secondary amenorrhea will

come up with a positive result in a progesterone challenge test?

A

Polycystic ovarian syndrome

79
Q

Which of the following patients with genetic disorders

presenting with amenorrhea, which one would have a uterus?

A

Swyer syndrome the pure gonadal deficiency

80
Q

Which of the functional cyst will appear in ovarian hyper

stimulation using assisted ovarian technology?

A

The theca lutein cyst

81
Q

Which of the statement best describes a mature cystic

teratoma?

A

May contain a dermal process

82
Q

What is the best indicator of ovarian reserve?

A

Anti-mullerian hormone

83
Q

Best diagnostic tool to determine tubal patency?

A

Hysterosalphingogram

84
Q

Part of workup of infertile women presenting with

oligomenorrhea?

A

Prolactin

85
Q

Correct statement of perimenopause?

A

Menstrual irregularities defines and establishes peri menopausal transition

86
Q

. 29 year old G2P2 present with a 2cm lesion at the cervix which
appears only at a small portion of a adjacent vaginal. What Is the
next step to be taken?

A

Punch biopsy of the lesion

87
Q

For cervical cancer what is the most significant prognostic
factor?
Stage of the disease

A

Stage of the disease

88
Q

The histological changes associated with intraepithelial

neoplasia in the vulva or cervix is basically?

A

Loss of normal maturation of the squamous epithelium

89
Q

A 60 y/o complains of vulvar irritation on the pelvic exam she
has 2x2 cm thick whitish elevated lesion at the labia majora
what is the diagnostic procedure of choice in this patient?

A

Excision biopsy

90
Q

Regarding vulvar intraepithelial neoplasia, which of the following
statement is correct?

A

The risk of progression to cancer is higher in older women

91
Q

50 y/o women is found to have asymmetric 1x1 cm….edges
which according to the patient used to be black but is now
reddish black. What is the best management approach?

A

Do excision biopsy

92
Q

What is the best treatment function of the paeget disease of the
vulva?

A

Wide Local excision

93
Q

A 40 y/o G3P3 consulted at OPD with an atypical cellular
hyperplasia in the pap smear .The next step in the management
of her case is?

A

Colposcopy

94
Q

A 45 y/o G5 presents with abnormal uterine bleeding. Speculum
exam reveals smooth closed cervix with malodorous discharge
and corpus enlarged. What is the next course of action in the
management of this patient?

A

Biopsy

95
Q

48 y/o healthy post-menopausal woman has a pap smear which
reveal s atypical glandular cells. She doesn’t have history of
abnormal Pap smear. Which of the following is the next best
step?
Colposcopy, endocervical curettage and endometrial sampling48 y/o healthy post-menopausal woman has a pap smear which
reveal s atypical glandular cells. She doesn’t have history of
abnormal Pap smear. Which of the following is the next best
step?

A

Colposcopy, endocervical curettage and endometrial sampling

96
Q

What is the most important prognostic factor of the vulvar

cancer?

A

Lymph node involvement

97
Q

Primary vaginal cancer is rare. Most cancer vagina are extension
from which organ?

A

Cervix

98
Q

Adenocarcinoma is more likely to have the squamous cell to

spread to which organ or tissue?

A

Lungs

99
Q

A 62 y/o post-menopausal woman complains of on and off
profuse vaginal bleeding. Pertinent PE shows normal external
genitalia, smooth vaginal walls, smooth small cervix and
enlarged uterus. What is the diagnostic procedure of choice in
this patient?

A

Endometrial biopsy

100
Q

When is staging accomplished in endometrial CA?

A

When the results of histopath are in

Obstetrics 2022 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions