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1.Ms XX is a Para 0 and is 34/40 weeks pregnant. She has recently been diagnosed with obstetric cholestasis and commenced on ursodeoxycholic acid for the same. In view of increased obstetric surveillance, she is very concerned about fetal well being. Which of the following investigations would accurately predict the risk of fetal death?CorrectIncorrect
2.Ms XY presents to the labour suite with a second episode of reduced fetal movements. She is 17 years old, Para 0, 39/40 weeks pregnant. She is smoker and has poor access to care. CTG is reassuring/reactive, and an ultrasound scan reveals abnormally grown fetus, with normal liquor volume and normal umbilical artery doppler. Which of the following treatment options are best suited to her?CorrectIncorrect
3.All of the following statements regarding surveillance methods for small fro gestational age fetuses are true except:CorrectIncorrect
4.Which of the following statements about intrauterine fetal deaths is false?CorrectIncorrect
5.Ms XY is a primigravida who is 34 weeks pregnant. Her last two serial scans have shown an SGA fetus growing on the 9th centile. Her last scan shows positive EDF with a normal PI. She reports having good fetal movements. How should further fetal surveillance be undertaken?CorrectIncorrect
6.Of the following, the most consistent finding in uterine rupture is:CorrectIncorrect
7.A gravida 2 Para 1, booked for low-risk midwifery care presents at 38 weeks with diminished fetal movements for 48 hours. The fetal heart rate was undetectable and sadly, intrauterine fetal death was confirmed with an ultrasound scan. The mother would prefer to go home and return 24 hours later for induction after arranging childcare for her other child. Her blood group is B RhD negative. What would you advise?CorrectIncorrect
8.What is the risk of serious neonatal infection associated with prelabour rupture of membranes (PROM) at term?CorrectIncorrect
9.What vitamin should women be advised to be taken throughout pregnancy and also while breastfeeding?CorrectIncorrect
10.Which agent is considered first-line treatment for mild nausea and vomiting in pregnancy?CorrectIncorrect
11.Which is the strongest risk factor for hyperemesis gravidarum requiring hospitalization?CorrectIncorrect
12.For a woman who does not enter pregnancy with a known diagnosis, the diagnosis of chronic hypertension is supported when hypertension is present prior to what gestational age threshold?CorrectIncorrect
13.Which aspect of cardiac physiology does not change in pregnancy?CorrectIncorrect
14.Which of the following is never a normal finding in pregnancy?CorrectIncorrect
15.Which of the following does not contribute to the 40% increase in cardiac output seen during normal pregnancy?CorrectIncorrect
16.Which of the following statements regarding physiological changes in pregnancy is true?CorrectIncorrect
17.A 35-year-old G5P3 presents at 24 weeks’ gestation. She has a history of chronic hypertension, but she is noncompliant with medication. You would like to do a baseline 24-hour urine collection. The patient is of low health literacy, and you are concerned she will not complete the collection as an outpatient, but she refuses to be admitted for it. You decide to do a urinary protein-to-creatinine ratio on a spot urine sample so you can gather additional information about the patient’s renal status. What is the cutoff for abnormal?CorrectIncorrect
18.A 28-year-old woman at 32 weeks’ gestation in her first pregnancy presented with a rash and itching on the abdomen, trunk, legs and hands. On examination, there were vesicles and bullae. A diagnosis of pemphigoid gestationis was made by the dermatologists after skin biopsies. Which one of the following statements is true about pemphigoid gestationis?CorrectIncorrect
- A 30-year-old primigravida at 35 weeks’ gestation with monochorionic diamniotic pregnancy presents with intense itching and rash on the abdomen. On examination there were erythematous papules and plaques in the striae gravidarum with umbilical sparing. The most likely diagnosis is which one of the following?
20.A 26-year-old woman whose last menstrual period (LMP) was 2½ months ago develops bleeding, uterine cramps, and passes tissue per vagina. Two hours later, she is still bleeding heavily. What is the most likely diagnosis?CorrectIncorrect
- You are delivering a woman (gravida 3, para 2) with two previous successful vaginal births. The woman has been in labor for 12 hours with a 10-hour first stage. The second stage of labor has lasted approximately 1 hour 14 minutes. The baby is doing well without any evidence of distress and of an appropriate size (approximately 8 lb). The mother has had an epidural and is tired frompushing, and you decide to apply forceps. After pelvic examination, forceps are applied to the presenting part of a termpregnancy, but the lock does not properly articulate even with gentle maneuvering. What should you do?
- Vaginal examination is contraindicated in which situation during pregnancy?
23.An 18-year-old patient finally delivered a 4,000-g infant vaginally. Her prenatal course was complicated by anemia, poor weight gain, and maternal obesity. Her labor was protracted, including a 3-hour second stage, a mid-forceps delivery with a sulcus laceration, and a third-degree episiotomy. Which of the following is the greatest predisposing cause of puerperal infection in this patient?CorrectIncorrect
- You are examining a 34-year-old woman (gravida 3, para 2) at 38- 5 /7 weeks’ gestation. She is in labor (5 cm). There is no fetal part in the pelvis. Ultrasound report notes a transverse lie with the fetal back toward the maternal legs. Which of the following is the procedure of choice?
- After delivery, paralysis is noted on one side of the face in a newborn. This is most often associated with which of the following?
26.A 33-year-old Type 1 diabetic patient (gravida 1, para 0) is scheduled for induction of labor at 37 weeks’ gestation. Which of the following should her insulin dosage should be?CorrectIncorrect
27.On her first prenatal visit, a 17-year-old single woman (gravida 1, para 0), 32 weeks by good dates, is found to have vital signs as follows: BP, 135/85; P, 84; T, 98.6°F; and R, 20. She also has ankle and hand edema and a uterine fundus measuring 42 cmwith breech concordant twins on ultrasound. She has normal pelvic measurements and the cervix is closed and soft, with the presenting part at station −1. Her UA revealed no WBCs or bacteria with 2+ protein. Her hematocrit is 38, and her WBC count is 9800. The next step in care of this patient should include which of the following?CorrectIncorrect
- A relative contraindication for induction of labor includes which of the following?
- During delivery of a first twin, a very tight nuchal cord is reduced fromthe baby’s neck by clamping and dividing it. After this, the second twin (as yet unborn) develops severe fetal distress. Of the following, what is the most likely mechanismfor the distress in the second twin?
- A patient is measuring size larger than dates at her initial obstetric visit at 24 weeks’ EGA. She is worried about twins since they “run” in the family. The best method to safely and reliably diagnose twins is by which of the following?
- A 32-year-old woman has a twin pregnancy at 8 weeks’ gestation. During her initial prenatal care visit, you review risks for multifetal pregnancies. Which of the following statements reflects the most frequent risks in twin pregnancies?
- A fetus presents in breech position and is delivered without assistance as far as the umbilicus. The remainder of the body is manually assisted by the obstetrician. What is this called?
- A 28-year-old G3P2002 patient presents at 38 weeks’ gestation. A fetus was felt to be in breech position as judged by information gained through Leopold’s maneuvers. The fetus was well down in the pelvis, and the uterus was irritable. Pelvimetry was within normal limits, and the estimated fetal weight was 7½ lb and ultrasound confirms a frank breech with a well-flexed head and AFI of 14 cm. Assuming the provider has adequate experience in each of the following, what would not be offered to the patient as an approach to delivery management?
- In which of the following cases might internal podalic version be indicated?
- A woman without prenatal care in labor at 38 weeks has a breech presentation. As the breech is expelled, a spina bifida is noted. The head does not deliver. With this history, what is the most likely problem?
- Which of the following indications most likely predict a classic cesarean section as opposed to a traditional transverse lower uterine segment cesarean section?
- Which of the following is the most common complication of full anticoagulation with low-molecular weight heparin?
- Antimicrobial therapy is routinely applied to the eyes of newborns to prevent blindness caused by which of the following?
39.a 24 weeks g2p1 at 36 weeks with c.o tonic clonic fits, she is having blood pressure of 180/120, baby is alive what is best management?CorrectIncorrect
40.a PG has presented with c/o heavy painful bleeding at 35 weeks, baby is alive, poor bishop, what is best mode of delivery?CorrectIncorrect
- A28yrs old G4P3 has presented with c/o heavy painful bleeding at 36 week s, baby is dead, poor bishop, what is best mode of delivery?
42.A G2 P1 at 32 weeks of gestation. she is K/C of chronic HTN from last 2 years. Her previous child was delivered by EM LSCS for placental abruption at 34 weeks, birth weight was 1.5 kg. her SFH is 28cm. recent scan shows parameters of 28weeks with reduced end diastolic flow. What is best management?CorrectIncorrect
43.Placenta previa best diagnosed by ?CorrectIncorrect
44.Which of the following is a risk factor for vasa previa?CorrectIncorrect
45.Which of the following is a risk factor placental abruption?CorrectIncorrect
46.What is the risk of major cardiovascular event in future if a patient had pre-eclampsia in current pregnancy?CorrectIncorrect
47.First sign of MGSO4 toxicity?CorrectIncorrect
48.Which of the following is major risk factor for pre-eclampsia?CorrectIncorrect
49.There are many relative contraindications to the use of vacuumextraction for delivery if all else is appropriate. What would be an acceptable scenario for application of a vacuumextractor?CorrectIncorrect
50.Patient with chronic hypertension having SGA fetus. Cause?CorrectIncorrect