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1.40yrs old lady, G4P3 all svds, at 36 weeks of gestations with twin pregnancy, developed sudden brisk vaginal bleeding immediately following delivery of twins weighing 2kg and 9kg, episiotomy was not required, placenta was delivered without complications, she recived epidural top up 30 min before delivery. estimated blood loss is 700ml.
which is most likely cause of her genital tract bleeding?CorrectIncorrect
2. 38yrs old lady, prev 1 cs, presented in emergency deptt with c/o sudden heavy vaginal bleeding, immediately followed by delivery of a 3.8kg baby boy at 36weeks of gestation. there was acute onset of fetal bradycardia 10min prior to delivery of baby with cessation of uterine activity. urinary catheter shows hematuria. estimated blood loss 500ml, bp 90/70, pulse rate 120/min, what is cause of excessive vaginal bleeding?CorrectIncorrect
3. Regarding PPH, which of the following is correct?CorrectIncorrect
4. Active management of the third stage of labour reduces the risk of PPH. By what proportion is the risk of PPH reduced by prophylactic oxytocic agents?CorrectIncorrect
5. A 35-year-old grandmultipara has had a major postpartum haemorrhage (PPH) following a normal Mechanical and pharmacological measures have failed to control the bleeding. Examination has confirmed that there are no retained placental tissue in the uterine cavity and absence of trauma to genital tract. What is the most appropriate first-line surgical management?CorrectIncorrect
6. Your patient is now 14 days postpartum following an uncomplicated vaginal delivery. She notes heavy vaginal bleeding and passage of clots. Her temperature is 37.1°C; pulse, 88 bpm; and blood pressure, 112/72 mm Hg. Physical findings reveal approximately 60 mL of clot in the vaginal vault, a closed cervical os, and a 12-week-size boggy nontender uterus. Her hematocrit has declined 2 volume percent from that measured following delivery and is 30 volume the most appropriate management for this patient includes which of the following?CorrectIncorrect
7. Secondary postpartum hemorrhage is defined as bleeding from 24 hours to 12 weeks It may be caused by all EXCEPT which of the following?CorrectIncorrect
8. Your patient had a vaginal delivery yesterday complicated by a first-degree perineal laceration after a 12-hour labor. She is asymptomatic, afebrile, and has normal vital signs. Her uterus is firm and nontender. Her remaining physical examination is unremarkable. She has voided several times, and total urine output for the past 12 hours is 1400 mL. Her complete blood count from this morning reveals the following: hemoglobin, 9.8 g/dL; hematocrit, 31 volume percent; white blood cell count, 16,000/mm3; platelet count 118,000/mm3. Which of the following is the next best management step?CorrectIncorrect
9. Which organism has been implicated in late postpartum hemorrhage?CorrectIncorrect
10. An 18-year-old primigravida at 41 weeks’ gestation presented to Labor and Delivery for decreased fetal movement. She was found to have oligohydramnios, and an induction of labor was initiated. Twentyfour hours later, the patient was 4 cm dilated with no cervical change for 4 hours, despite adequate In addition, the patient had been diagnosed with chorioamnionitis, and intravenous antimicrobial therapy was begun. A cesarean delivery was performed for failure to progress. Postpartum, the patient continued to have fever for 5 days despite treatment with intravenous ampicillin, gentamicin, and clindamycin. Which of the following is a reasonable next step in the management of this patient?CorrectIncorrect
11.A 25 year old undergoes evacuation of retained products of conception for post part haemorrh age. What is the incidence of uterine perforation associated with this procedure?CorrectIncorrect
12.A 24 year old women is undergoing elective C‐section. She has no risk factors for PPH. What treatment, if any, should be used to reduce blood lossCorrectIncorrect
13. A 26 year old women delivers a male baby by normal vaginal delivery. She has no risk factors for PPH. W hat treatment, if any, should be used to reduce blood lossCorrectIncorrect
14. A 29 year old women returns to the obstetric unit 7 days after delivery by Caesarian She compl ains of mild lower abdominal pain and has had mild vaginal bleeding. Her observations are as follows:
Temperature 37.5 oC BP 120/80 Heart rate 88 Respiration rate 15 She has no known drug allergiesCorrectIncorrect
15. A 29 year old patient who is para 3 is in labour and has just delivered a baby boy. Which of the following is the most appropriate to give at this stage?CorrectIncorrect