A full term pregnant, obese, P5, presents to ER late in labor with a fully dilated cervix and involuntary bearing down. Head was delivered spontaneously but arrest of shoulder delivery occurred. Best management of this condition is:
Anonymous Quiz
0%
Immediate cesarean section
13%
Forcible traction on fetal head.
25%
Fundal pressure
63%
Introduce your hand vaginally to bring down the posterior arm.
0%
Cover the head with warm towel and wait for spontaneous expulsion.
The followings are known complications of episiotomy EXCEPT:
Anonymous Quiz
0%
Infection
11%
Dyspareunia
11%
Hematoma formation.
78%
Laceration of the cervix.
0%
Increased blood loss during labor.
A primigravida(PG) undergoes induction of labor with amniotomy followed by oxytocin at 41 weeks. Three hours later, she is getting 6 contractions/10 min, fetal heart rate (FHR) drops to 100/ min. First step in management is:
Anonymous Quiz
14%
Continue observation
29%
Change the position of the mother
0%
Give antibiotics.
0%
Give ergometrine IM
57%
Stop the oxytocin infusion
A 25-year-old, 2ndGPI, in labor. Cervix is 7cm dilated and 80% effaced with recent rupture of membranes. FHR: 120 140/minute but falls occasionally to 100/ minute unrelated to uterine contractions. How can you explain the FHR pattern?
Anonymous Quiz
13%
Normal pattern.
38%
Cord compression
25%
Head compression.
13%
Fetal infection.
13%
Fetal anemia
A P1+0 at 34 weeks develops marked pruritus on her palms and soles, with mildly elevated liver enzymes and elevated bile acids. Most probable diagnosis:
Anonymous Quiz
0%
Pancreatitis
0%
Urticaria
13%
Hyperthyroidism
25%
Acute fatty liver of pregnancy
63%
Cholestasis of pregnancy
A 2ndGP1 comes at 20 weeks' gestation for antenatal care (ANC). She is RH is negative and she did not receive anti-D in the previous pregnancy. How can you proceed?
Anonymous Quiz
8%
Pregnancy termination
58%
Measure antibody titer.
0%
Amniocentesis
25%
Give Anti D immunoglobulin.
8%
Perform intrauterine transfusion
Questions 24-25: A 35-year-old, G3P2, prev CS, presents at 32 wks with severe headache and
reduced fetal movements. Her BP is 150/90, US reveals asymmetric IUGR, AFI: 3.
24. Which of the following investigations is correlated to her condition?
reduced fetal movements. Her BP is 150/90, US reveals asymmetric IUGR, AFI: 3.
24. Which of the following investigations is correlated to her condition?
Anonymous Quiz
0%
Glycosylated hemoglobin,.
56%
Fetal Doppler.
22%
Fetal anomaly scan.
0%
Hepatitis B surface antigen
22%
All Of the above.
Possible complications for this case include all the following EXCEPT:
Anonymous Quiz
11%
Eclampsia
44%
Accidental hemorrhage
22%
Intrauterine fetal death.
11%
Delayed fetal lung maturation
11%
Premature labor.
Commonest cause of decreased hemoglobin concentration level during pregnancy?
Anonymous Quiz
53%
Iron deficiency.
6%
Folic acid deficiency.
6%
B12 deficiency.
35%
Physiologic hemodilution
0%
Hemolysis.
Which of the following is responsible for morning sickness during pregnancy?
Anonymous Quiz
0%
Estrogen
100%
HCG.
0%
Human placental lactogen.
0%
Cortisol.
0%
Progesterone.
Hyperemesis gravidarum is characterized by one of the following features:
Anonymous Quiz
46%
Self- limited condition that resolves spontaneously,
23%
More common in multigravida.
31%
More common in multiple pregnancies.
0%
Polyuria is a constant feature.
0%
Termination of pregnancy is usually indicated.
Concerning pyelonephritis during pregnancy:
Anonymous Quiz
0%
Fever and rigors are usually absent.
69%
Most of cases follow asymptomatic bacteriuria.
0%
Usually self-limited and resolves spontaneously.
0%
Penicillin should be avoided in first trimester.
31%
Urine analysis reveals pus cells: 1-5/ HPF
An asymptomatic 22-year- old PG presents for ANC. She had had a lower leg thrombosis
3yrs ago when on COCPs. What therapy would you recommend for her condition?
3yrs ago when on COCPs. What therapy would you recommend for her condition?
Anonymous Quiz
42%
Unfractionated heparin.
8%
No therapy antepartum unless she is confined to bed rest.
25%
Warfarin until 38weeks, and changing to heparin until labor
17%
Aspirin 81 mg daily.
8%
Close observation
Proteinuria in pregnancy may be due to all the following EXCEPT:
Anonymous Quiz
23%
Urine sample is not midstream and contaminated by secretions
15%
Urinary tract infection
0%
Preeclampsia.
8%
Renal impairment
54%
Excess protein dietary intake.
An 8 weeks PG, 23-year- old, presents with intractable vomiting for 3 days and marked
sense of fatigue. Her tongue is dry and urine analysis showed ketonuria. Best management:
sense of fatigue. Her tongue is dry and urine analysis showed ketonuria. Best management:
Anonymous Quiz
8%
Reassurance as it is a self-limited condition.
8%
Oral antiemetics
17%
Termination of pregnancy.
67%
Prevent oral feeding and give IV fluids in a hospital,
0%
Upper endoscopy is required.
AFV is a balance between production and resorption. Primary mechanism of resorption:
Anonymous Quiz
0%
Fetal breathing.
70%
Fetal swallowing
0%
Absorption across fetal skin.
20%
Absorption and filtration by fetal kidneys.
10%
Absorption through the placental circulation.
A PG with mitral stenosis, and fully dilated cervix for one hour, head station +1, direct
occipito anterior, is best delivered by:
occipito anterior, is best delivered by:
Anonymous Quiz
10%
Cesarean section.
30%
Forceps delivery.
10%
Vacuum extraction.
10%
Internal podalic version then breech extraction
40%
Expectant management.
Corticosteroids administered in PTL decrease rates of RDS if birth is delayed at least:
Anonymous Quiz
10%
12hours.
50%
24hours.
15%
36hours.
20%
48hours.
5%
72hours.
Questions 36-37: A 32-year-old G3P2 at 40wks +5 had PV of 1cm dilated cervix, cephalic
presentation, good fetal movement.
36. Next step in the management of this patient:
presentation, good fetal movement.
36. Next step in the management of this patient:
Anonymous Quiz
7%
Cesarean section
21%
Labor induction by Prostaglandins
14%
Labor induction by oxytocin
21%
Doppler for assessment of fetal well-being
36%
Schedule a visit after another week