Quiz 1: Antenatal Care Flashcards

1
Q

An extra-uterine pregnancy is suggested by:

  • A uterus that is larger than expected for the duration of pregnancy
  • Morning sickness and breast tenderness
  • Lower abdominal pain and vaginal bleeding
  • The absence of fetal movements
A

Lower abdominal pain and vaginal bleeding

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2
Q

A woman should book for antenatal care:

  • Before she falls pregnant
  • When she has missed her second menstrual period
  • When she first feels fetal movements
  • When she is 28 weeks pregnant
A

When she has missed her second menstrual period

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3
Q

When a patient has had a Caesarean section:

  • The type of uterine incision is of no importance
  • Only those patients who had a vertical lower segment incision may be allowed to have a vaginal labour
  • Only those patients who had a transverse lower segment incision may be allowed to have a vaginal labour
  • Only those patients who had a transverse lower segment incision for a non-recurring indication may be allowed to have a vaginal labour
A

Only those patients who had a transverse lower segment incision for a non-recurring indication may be allowed to have a vaginal labour

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4
Q

The last normal menstrual period may be used to calculate the duration of pregnancy:

  • If that was the last menstrual period while the patient was on her last packet of oral contraceptive pills
  • If the patient has a regular cycle and she was not on contraceptives.
  • If the last menstrual period had started earlier and had been shorter than the patient would have expected.
  • Patients’ information about their last menstrual period is always wrong.
A

If the patient has a regular cycle and she was not on contraceptives.

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5
Q

A cervical smear for cytology must be done during the first antenatal visit as part of the gynaecological examination:

  • In all women
  • Only if the cervix appears abnormal.
  • From all women 30 years or more who have not had a previous smear which had been reported as normal

-Only if there is a symptomatic vaginal discharge (e.g. itchiness or burning)
back

A

From all women 30 years or more who have not had a previous smear which had been reported as normal

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6
Q

The abdominal examination is a useful assessment of the duration of pregnancy:

  • From 8 to 12 weeks
  • From 10 to 16 weeks
  • From 13 to 17 weeks

-From 18 to 24 weeks
back

A

From 13 to 17 weeks

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7
Q

If a patient is 10 weeks pregnant:

  • The fundus will be palpable 2 cm above the pelvic symphysis
  • The fundus is not palpable abdominally and it is, therefore, not possible to determine whether the dates correlate with the size of the uterus
  • It would be better to ask her to return in 6 weeks’ time for booking
  • The uterine size may be determined vaginally with fair accuracy
A

The uterine size may be determined vaginally with fair accuracy

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8
Q

The best method of assessing the duration of pregnancy by physical examination at 18 or more weeks is:

  • The symphysis-fundus measurement
  • Bimanual palpation of the uterus on vaginal examination
  • Palpation of the abdomen
  • To establish the lie of the fetus and assess the size of the fetal head
A

The symphysis-fundus measurement

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9
Q

If the uterine fundus is just below the umbilicus (20 weeks) and the patient is 18 weeks pregnant by dates:

  • The dates must be considered correct and used to determine the duration of pregnancy
  • The fundal height must be considered correct and used to determine the duration of pregnancy
  • An ultrasound examination must be requested and the result used to determine the duration of pregnancy
  • The average duration of 19 weeks must be accepted as the correct duration of pregnancy
A

The dates must be considered correct and used to determine the duration of pregnancy

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10
Q

A uterus that is smaller than expected may be due to:

  • A breech presentation
  • An intra-uterine death
  • Polyhydramnios
  • None of the above
A

An intra-uterine death

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11
Q

Antenatal ultrasound examination is an accurate method of determining the duration of pregnancy up to:

  • 28 weeks
  • 24 weeks
  • 20 weeks
  • 16 weeks
A

24 weeks

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12
Q

During the antenatal period ultrasonography must be done between 18 and 22 weeks:
-On very obese patients where determination the duration of pregnancy is difficult

  • On patients needing elective delivery, e.g. those with two previous Caesarean sections
  • On patients with a history of severe pre-eclampsia before
  • 34 weeks gestation
  • In all of the above patients
A

In all of the above patients

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13
Q

A positive RPR (VDRL) indicates the presence of syphilis if:

  • The titre is 1:4 or more
  • The titre is 1:8 or more
  • The titre is 1:16 or more
  • Any titre is present
A

The titre is 1:16 or more

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14
Q

Which of the following results indicate active syphilis?

  • A positive syphilis rapid test
  • A positive syphilis rapid test plus a negative RPR
  • A positive syphilis rapid test plus a positive RPR
  • A CIN III lesion on cervical cytology smear
A

A positive syphilis rapid test plus a positive RPR

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15
Q

Syphilis in pregnancy should be treated with:

  • Nitrofurantoin (Macrodantin)
  • Benzathine penicillin (Bicillin LA or Penilente LA)
  • Tetracycline
  • Ampicillin
A

Benzathine penicillin (Bicillin LA or Penilente LA)

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16
Q

How often should a woman at low risk, who lives near a clinic, visit the antenatal clinic between 28 and 34 weeks?

  • Weekly
  • Every 2 weeks
  • Once a month
  • No visit is required between these dates
A

No visit is required between these dates

17
Q

The visit at 34 weeks is important because:

  • The fetus now becomes viable and the patient must monitor the fetal movements.
  • A vaginal examination must be done on patients who are at risk of preterm labour to determine whether there are cervical changes.
  • The lie and presentation of the fetus are now important and have to be carefully determined.

-A repeat ultrasound examination must now be done on patients who had ultrasonography at 18 and 22 weeks.
back

A

The lie and presentation of the fetus are now important and have to be carefully determined.

18
Q

Oesophageal candidiasis suggest which clinical stage of HIV infection?

  • Stage 1
  • Stage 2
  • Stage 3
  • Stage 4
A

Stage 4

19
Q

Antiretroviral treatment during pregnancy should be provided with:

  • AZT alone
  • Nevirapine alone
  • A fixed drug combination dose (TLD) pill
  • AZT plus FDC
A

A fixed drug combination dose (TLD) pill

20
Q

TLD is contra-indicated if the woman has:

  • Stage 4 disease
  • Chronic renal disease
  • Oral candidiasis (thrush)
  • Repeated upper respiratory tract infections
A

Chronic renal disease