Pathology of pregnancy Flashcards by Irene Italou

Recommended first-line antibiotic for the treatment of primary toxoplasmosis infection during pregnancy:
A) metronidazole
B) spiramycin
C) ampicillin
D) doxycycline

B) spiramycin

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Predominant organism in pyelonephritis during pregnancy:
A) Candida albicans
B) Escherichia coli
C) Streptococcus agalactiae
D) Ureaplasma urealyticum

B) Escherichia coli

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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

C) IV magnesium sulfate+ IV hydralazine ( Nepresol)

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Characteristic for hypertensive disorders during pregnancy, except:
A) proteinuria
B) liver enzymes elevation
C) pulmonary edema
D) serum creatinine decrease

D) serum creatinine decrease

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First-line therapy in seizure during pregnancy:
A) phenobarbital
B) carbamazepine
C) phenytoin
D) intravenous diazepam

D) intravenous diazepam

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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

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)

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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

C) >= 7,8 mmol/l

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Predisposing factors associated with abruptio placentae, except:
A) maternal hypertension
B) smoking
C) external trauma during pregnancy
D) anaemia
E) multiple birth

D) anaemia

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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

C) in 20% of cases can lead to choriocarcinoma

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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

C) Rh immune globulin should be given

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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

C) selective reduction of the affected twin is recommended

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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

E) all of the answers are correct

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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

A) 1st, 2nd and 3rd answers are correct

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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

B) 1st and 3rd answers are correct

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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

E) all of the answers are correct

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Complications associated with polyhydramnios:
1) prolapse of umbilical cord
2) uterine dysfunction
3) preterm birth
4) placental abruption
5) abnormal fetal presentations

A) 1st, 2nd, 4th and 5th answers are correct
B) 1st, 3rd and 4th answers are correct
C) 1st, 3rd and 5th answers are correct
D) all of the answers are correct

D) all of the answers are correct

Pair the correct characteristics with the disorders:
A) Explained by placental insufficiency
B) Often associated with multiple pregnancy
C) Usually occurs in the first 12 weeks
D) tubal rupture is possible

OBG - 8.21 - Intrauterine growth restriction
OBG - 8.22 - ectopic pregnancy
OBG - 8.23 - spontaneous abortion
OBG - 8.24 - breech presentation

21- A
22- D
23- C
24- B

Pair the disorders with the laboratory parameters :
A) Rhesus isoimmunization
B) Hypertensive disorders of pregnany
C) Recurrent abortion
D) Hydatidiform moles

OBG - 8.25 - Proteinuria (24hr-urine collection)
OBG - 8.26 - Maternal anti-D antibody titer
OBG - 8.27 - Beta-hCG
OBG - 8.28 - Evaluation of paternal and maternal chromosomes

25- B
26- A
27- D
28- C

Pair the pathogens with the adequate therapeutic possibilities.
A) spiramycin
B) acyclovir
C) azithromycin macrolid
D) third generation cephalosporins

OBG - 8.29 - Toxoplasma gondii
OBG - 8.30 - Chlamydia trachomatis
OBG - 8.31 - Herpes simplex (HSV-2, HSV-1)
OBG - 8.32 - Neisseria gonorrhoeae

29- A
30- C
31- B
32- D

Pair the pathogens with the adequate clinical condition:
A) fetal ophthalmia, opthalmoblenorrhoea
B) fetal chorioretinitis
C) neonatal pneumonia
D) chronic hepatitis

OBG - 8.33 - Hepatitis B virus
OBG - 8.34 - Toxoplasma gondii
OBG - 8.35 - Neisseria gonorrhoeae
OBG - 8.36 - Chlamydia trachomatis

33- D
34- B
35- A
36- C

Pair the diagnosis with the correct answer:
A) placenta praevia
B) abruptio placenta
C) both of them
D) none of them

OBG - 8.37 - bright red or brownish bleeding occurs, pain localised only to the uterus
OBG - 8.38 - hard, boardline uterus
OBG - 8.39 - it usually occurs in the second or third trimester of pregnancy
OBG - 8.40 - no need of hospitalization
OBG - 8.41 - blood coagulation disorders can occur
OBG - 8.42 - fetal heart frequency stays physiological
OBG - 8.43 - preeclampsia can preceed
OBG - 8.44 - In severe form can cause fetal death

37- B
38- B
39- A
40- D
41- B
42- A
43- B
44- C

Detection of acute rubella infection in first trimester requires pregnancy termination, because if acute rubella infection does occur in first trimester, the risk of severe congenital malformations following infection is 80%.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A) both the statement and the explanation are true and a causal relationship exists between them;

Cause of bleeding during pregnancy is always due to abnormal placental implantation because the placenta also synthetises intrauterin steroids.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

D) the statement is false, but the explanation itself is true

Chromosomal abnormalities are true indication of amniocentesis in cases when the risk of the abnormalities is more than 1 % because the fetal loss rate is about 1% per procedure.
A) both the statement and the explanation are true and a causal relationship exists between them;
B) both the statement and the explanation are true but there is no causal relationship between them;
C) the statement is true, but the explanation is false;
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A) both the statement and the explanation are true and a causal relationship exists between them;

Hypoglicaemia occurs often in macrosomia caused by maternal diabetes that is the reason why normoglycaemia needs to maintain with oral antidiabetic drugs escpecially during organogenesis. A) both the statement and the explanation are true and a causal relationship exists between them; B) both the statement and the explanation are true but there is no causal relationship between them; C) the statement is true, but the explanation is false; D) the statement is false, but the explanation itself is true E) both the statement and the explanation are false

C) the statement is true, but the explanation is false;

What is the most probable diagnosis? A 31-year-old primipara in 8th week of pregnancy has more frequently vomiting and inability to retain food, and requires hospitalization. A) ectopic pregnancy B) threatened miscarriage C) hydatidiform mola D) choriocarcinoma E) hyperemesis gravidarum

E) hyperemesis gravidarum

Which examination should be given first? A 31-year-old primipara in 8th week of pregnancy has more frequently vomiting and inability to retain food, and requires hospitalization. A) chest X-Ray B) pelvic ultrasound C) blood test for electrolyte and acetone D) ECG E) CT

C) blood test for electrolyte and acetone

What is the first-line treatment? A 31-year-old primipara in 8th week of pregnancy has more frequently vomiting and inability to retain food, and requires hospitalization. A) administration of antibiotic B) administration of iv. fluid C) administration diuretics D) sedation E) only observation

B) administration of iv. fluid

What is the most likely diagnosis? A 32-year-old multiple pregnant in 37th weeks of pregnancy is delivered by paramedics to the hospital with vaginal bleeding and severe abdominal pain. Stabbing pain high in the uterine fundus. Blood pressure: 80/60 Hgmm, Pulse: 100/min. Obstetrical examination: cervix dilatated, rupture of membrane, amniotic fluid is bloody. Fetal bradycardia. Anamnesis: Ultrasound during the 28th week detected fundal location of the placenta. A) placenta previa B) placenta accreta C) placental abruption D) velamentous umbilical cord

C) placental abruption

Which is the good management? A 32-year-old multiple pregnant in 37th weeks of pregnancy is delivered by paramedics to the hospital with vaginal bleeding and severe abdominal pain. Stabbing pain high in the uterine fundus. Blood pressure: 80/60 Hgmm, Pulse: 100/min. Obstetrical examination: cervix dilatated, rupture of membrane, amniotic fluid is bloody. Fetal bradycardia. Anamnesis: Ultrasound during the 28th week detected fundal location of the placenta. A) C/S after managing the shock B) administration of oxytocin with careful observation C) acute tocolysis and careful observation D) immediately C/S, iv. fluid, transfusion

D) immediately C/S, iv. fluid, transfusion

Which examination should be given first? Primiparous patient in 32th weeks of pregnancy notices heavy bleeding from vagina without any uterine contraction. A) blood test for complete blood count and measure of clotting potential B) bimanual examination C) transabdominal ultrasound D) abdominal MRI E) temperature measurement

C) transabdominal ultrasound

The most important complication is: Primiparous patient in 32th weeks of pregnancy notices heavy bleeding from vagina without any uterine contraction. A) premature rupture of membranes B) preeclampsia C) haemorrhagic shock D) prolapse of umbilical cord

C) haemorrhagic shock

Which is the good management? Multiparous pregnant in 37th weeks of pregnancy goes to see her GP with symptoms of dizziness, epigastric and right upper quadrant pain for two days. Blood pressure: 145/90 Hgmm, pulse 82/min. Urine dipstick test: elevated levels of protein A) antacids and diet B) spasmolytic and digestive drugs, diet C) admit to Dept of Internal Medicine D) admit to Dept of ObGyn E) admit to Dept of infectious diseases

D) admit to Dept of ObGyn