Samplex 2015 Flashcards
A 25 year old primigravid on her 37th week AOG consulted at the OB Admitting Section for complaint of vaginal bleeding noted after she experienced a gush of water amounting to about 2 glassfuls 2 hour PTC. On examination fetal heart tones could no longer be appreciated. What is the most probable diagnosis?
A. Abruptio placenta
B. Placenta previa
C. Vasa Previa
D. Placenta Accreta
C
A 25 year old primigravid on her 37th week AOG consulted at the OB Admitting Section for complaint of vaginal bleeding noted after she experienced a gush of water amounting to about 2 glassfuls 2 hour PTC. On examination fetal heart tones could no longer be appreciated.
The above condition is associated with what finding?
A. Separation of a normally implanted placenta
B. Placenta completely covering the cervical os
C. Velamentous insertion of the umbilical cord
D. Abnormal adherence of the placenta
C
Angie is a 24 yo medical student who had her LNMP on July 24, 2011. She has been diagnosed to have type I diabetes and has regular insulin shots.
Given the case above, which of the followings statements is true:
A. Angie should stop her insulin shots and start taking oral medications for diabetes.
B. Angie should start dieting and should not exercise to prevent abortion.
C. Untreated diabetes mellitus can give rise to both poor maternal and fetal outcomes.
D. All of the above
C
Insulin is categorized as an FDA Class ___ ?
A. A
B. B
C. C
D. D
B
Angie is a 24 yo medical student who had her LNMP on July 24, 2011. She has been diagnosed to have type I diabetes and has regular insulin shots..
To prevent neural tube defects, Angie should start taking folic acid ___________.
A. preconception
B. first sign of pregnancy
C. after first prenatal consult
D. anytime during pregnancy
A
Angie is a 24 yo medical student who had her LNMP on July 24, 2011. She has been diagnosed to have type I diabetes and has regular insulin shots..
The physiologic change in pregnancy that may have an impact in how Angie’s body will utilize the drugs she take over the course of her pregnancy is
A. decreased gut motility
B. increased tidal volume
C. increased renal blood flow
D. increase in maternal aqueous and fatty tissue spaces
A
Angie is a 24 yo medical student who had her LNMP on July 24, 2011. She has been diagnosed to have type I diabetes and has regular insulin shots..
During Angie’s prenatal check up, you noticed a curdlike discharge upon doing a vaginal speculum. Microscopic study revealed yeast infection.
Drug of choice in the treatment of this condition is:
A. oral oseltamivir
B. topical/vaginal suppository metronidazole
C. vaginal suppository clotrimazole
D. topical prednisolone
C
Angie is a 24 yo medical student who had her LNMP on July 24, 2011. She has been diagnosed to have type I diabetes and has regular insulin shots.
Sometimes, Angie would complain of headache and difficulty of sleeping especially on days just before exams. What would you advise her?
A. She can take diazepam at night time to help her sleep
B. She can try nonpharmacologic methods such as relaxation techniques and massage
C. She can use herbal medications to relieve her headache.
D. Paracetamol, mefenamic acid and ibuprofen are all equally efficacious and safe anytime during pregnancy.
D
A 28 year old G2 patient was brought to the OBAS for profuse vaginal bleeding after delivering to an 8 pound baby at home assisted by a midwife. On abdominal examination, the uterus was well contracted.
What is the most probable diagnosis?
A. Uterine atony
B. Retained placental fragments
C. Perineal lacerations
D. Uterine inversion
C
What is included in the active management of the third stage of labor?
A. administration of uterotonics after the delivery of the placenta
B. late cord clamping
C. controlled cord traction
D. insertion of rectal misoprostol
C
What will be an advantage in doing amniotomy in a patient whom you suspect in having Abruptio placenta?
A. It will ensure vaginal delivery
B. It can be diagnostic of abruptio placenta
C. It can decrease the incidence of Couvelaire uterus
D. It will restore function of the part of the placenta that is still implanted
B
The period of development of an offspring that may give rise to the “all or none” phenomenon is
A. pre-implantation period
B. embryonic period
C. fetal period
D. any of the above
A
What finding will be suggestive of Consumptive coagulopathy?
A. Fibrinogen level of 200 mg/dl
B. Platelet count of 100,000 microL
C. Note of hematuria on insertion of foley catheter
D. Bloody amniotic fluid on amniotomy
A
A 30 year old G2P1 patient on her 30th week AOG consulted the OBAS for complaint of vaginal bleeding noted upon waking up. She has had no prenatal checkups. Vital signs are within normal and bleeding has ceased but there was note of irregular uterine contractions.
What is the most probable diagnosis?
A. Placenta previa
B. Abruptio placenta
C. Placenta Accreta
D. Vasa previa
A
A 30 year old G2P1 patient on her 30th week AOG consulted the OBAS for complaint of vaginal bleeding noted upon waking up. She has had no prenatal checkups. Vital signs are within normal and bleeding has ceased but there was note of irregular uterine contractions. .
In the above patient, what will you request to verify your diagnosis most accurately?
A. Transvaginal ultrasound
B. Pelvic ultrasound
C. CT scan
D. MRI
A
A 30 year old G2P1 patient on her 30th week AOG consulted the OBAS for complaint of vaginal bleeding noted upon waking up. She has had no prenatal checkups. Vital signs are within normal and bleeding has ceased but there was note of irregular uterine contractions.
What will be the most appropriate management for the above patient?
A. Immediate caesarean section
B. Give tocolytics and antenatal steroids
C. Do caesarean section after you have completed the antenatal steroids
D. Augment labor and do vaginal delivery
B
A G1 patient who has just delivered at the recovery room complained of severe pain in the vaginal area. Her vital signs are normal and there was no note of undue vaginal bleeding.
What will be your primary consideration?
A. Retained placental fragments
B. Uterine atony
C. Vulvar hematoma
D. Uterine rupture
C
Among these patients, who will be at highest risk of having Placenta accreta?
A. A G2 patient who underwent a Cesarean section for her first pregnancy last year
B. A G1 patient diagnosed to have placenta previa and preeclampsia
C. A G3 patient with 2 previous Cesarean section with an ultrasound of placenta previa
D. A G5 patient with Chronic hypertensive vascular disease
C
What will be a feature of dehiscence of uterine scar vs. a complete rupture?
A. intact fetal membrane
B. fetus is in the abdominal cavity
C. separation of the whole length of the uterine scar
D. finding of a contracted uterus alongside palpable fetal parts
A
Which among the following is the correct pairing?
A. Multivitamins - Category B
B. Misoprostol - Category D
C. Methotrexate - Category A
D. Amoxicillin - Category B
D
Which of the following is NOT TRUE?
A. thalidomide - craniofacial defects, nasal hypoplasia
B. lithium - cardiac defects
C. tetracycline - staining of deciduous teeth
D. captopril - fetal kidney damage
A
A genetic disease which causes the same dysmorphisms as warfarin ingestion is
A. Hurdle syndrome
B. osteogenesis imperfecta
C. Fabry’s Disease
D. Happle syndrome
D
A 20 year old primigravid consults on her 38th week age of gestation. Internal examination revealed the cervix to be dilated to 7-8 cms with ruptured bag of waters with the fetal head at station -1. You monitor her progress of labor and after 1 hour, the cervix became fully dilated with the fetal head still at station -1.
At this point, your impression is
A. failure of descent
B. arrest of descent
C. prolonged deceleration phase
D. protracted active phase
A
All statements are correct EXCEPT
A. When drug therapy is absolutely necessary, preference must be given to older drugs as opposed to newer systems
B. Monotherapy is preferred and in instances where drug combination is the treatment of choice, agents must be introduced one at a time
C. Systemic route of administration is preferred over topical or inhalation(?) as kinetics are more stable
D. none of the above
C
As a fetal effect during difficult labor/delivery, the following entity, characterized by scalp edema overlying the fetal occiput, may develop:
A. Cephalhematoma
B. Caput Succedaneum
C. Molding
D. Contusion
B
Delivery of a fetus in persistent occiput posterior includes the following EXCEPT:
A. Spontaneous vaginal delivery
B. Forceps delivery
C. McRobert’s maneuver
D. Manual rotation
C
Conditions that may require therapy in a pregnant woman include:
A. 13 weeks AOG with occasional nausea and vomiting
B. 32 weeks AOG with blood pressure of 160/100
C. 28 weeks AOG with grade 1 bipedal edema
D. 10 weeks AOG with urinalysis result of WBC 0-2
B
Pelvic inlet contraction is associated with the following EXCEPT: A. Early rupture of membranes B. Cord coil C. Transvere lie D. Protracted dilatation
B
The plane of least dimension is described by the following parameters EXCEPT:
A. Bispinous diameter
B. Posterior sagittal diameter
C. Sacrosciatic notch
D. Bituberous diameter
D
A 21 year old primigravid, 38 weeks AOG, was admittedo n Sept 1 at 7 am with a cervical dilatation of 2 cm, 50% effaced, intact bag of waters, head at station -2 with contractions every 5-6 minutes, 30 seconds. The following day at 7am, examination showed her cervix to be 2 cm fully effaced, head at station -2, with contractions every 6-8 minutes. The bag of water ruptured at 4 am.
What is your management?
A. Therapeutic rest
B. Augmentation of labor
C. Cesarean section
D. Expectant management
C
Associated with breech presentation
A. Placenta previa
B. Placenta accreta
C. Vasa previa
D. Succenturiate placenta
A
Vaginal breech delivery may be done in:
A. Patients with completed family size
B. Incomplete breech
C. Severe growth restriction
D. Imminent delivery
C
McRobert’s maneuver results in the following EXCEPT:
A. Increases pelvic dimensions
B. Straightens sacrum
C. Decrease in pelvic inclination
D. Rotates symphysis
A
Uterine dysfunction characterized by a distorted pressure gradient:
A. Hypotonic
B. Isotonic
C. Hypertonic
D. Tetanic
C
The midpelvis is likely to be contracted if the sum of the interischial spinous and the posterior sagittal diameter is equal to or less than:
A. 9.5 cm
B. 11.5 cm
C. 12.5 cm
D. 13.5 cm
D
What findings will be suggestive of uterine rupture?
A. Tetanic uterine contractions
B. Note of bloody mucus discharge at the onset of labor
C. Loss of presenting part on internal exam previously noted to be at station +1
D. Arrest in cervical dilatation at 5 cm dilatation
C
When the inlet is round, sidewalls are straight, spines are prominent, and the pelvic arch is wide, the pelvis is described as
A. Gynecoid
B. Android
C. Anthropoid
D. Platypelloid
C