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FCPS Part 2 Written 3 MONTHS Antenatal Care & Medical Disorders Day1

FCPS Part 2 Written 3 MONTHS Antenatal Care & Medical Disorders Day1

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Question 1 of 20

1. Question
1. A patient develops hypertension in the third trimester, at delivery her blood pressure is 148/94 mm Hg. Urine protein by dipstick is trace, PIH profile normal , her hypertension has resolved by the time of her hospital discharge. What is her correct diagnosis?
- a. Preeclampsia
- b. Chronic hypertension
- c . Gestational hypertension
- d. Superimposed preeclampsia
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Question 2 of 20

2. Question
1. Which of the following may explain the development of preeclampsia ?
- a.Increased volume of chorionic villi .
- b. Extensive remodeling of the spiral arterioles .
- c. Increased invasion of extravillous trophoblastic tissue
- d.None o f the above
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Question 3 of 20

3. Question
1. What is the underlying etiology for proteinuria that is seen with preeclampsia?
- a. Increased capillary permeability
- b. Increased renal artery resistance
- c. Increased glomerular ilIItration rate
- d. Increased systemic vascular resistance
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Question 4 of 20

4. Question
1. All EXCEPT which of the following increase a woman’s predisposition to develop preeclampsia syndrome?
- a. Obesity
- b. Smoking
- c. Nulliparity
- d. Multiple gestation
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Question 5 of 20

5. Question
1. What is a possible explanation for the increased incidence of preeclampsia seen in patients whose pregnancies are complicated by the aneuploidy?
- a. Increased antiangiogenic factor levels
- b. Increased frequency of placental mosaicism
- c. Higher frequency of spiral arteriole atherosis
- d. Increased levels of oxidative products in the placenta
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Question 6 of 20

6. Question
1. Which of the following leads to increased uric acid levels in patients with preeclampsia?
- a. Increased tubular reabsorption
- b. Increased placental production
- c. Decreased glomerular filtration rate
- d. All of the above
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Question 7 of 20

7. Question
1. You see a patient with a blood pressure of 160/110 mm Hg and UA 3+ , and right upper quadrant discomfort at 36 weeks’ gestation. Following induction of labor, she delivers vaginally. She has uterine atony, and her estimated blood loss is 1500 mL. Her serum creatinine was normal predelivery and now its 2 mg/dL. What is the most likely explanation for this finding?
- a . Postpartum hemorrhage
- b. Severe preeclampsia alone
- c . Subcapsular liver hematoma
- e.Dehydration secondary to prolonged induction
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Question 8 of 20

8. Question
1. A primigravida with pre eclampsia delivered 4 hours ago. Her delivery was uneventful, and her estimated blood loss was 500 mL. but her urine output for the past 4 hours is only 100 mL. Her BP is 148/88, pulse is 84, she has 12 respirations per minute, and no evidence of ongoing bleeding is noted. Which of the following treatment options is most appropriate for this patient?
- a. Continue observation
- b. Give 10 mg intravenous furosemide
- c . Transfuse 2 units of packed red blood cells
- d. Give 500 mL bolus of intravenous normal saline
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Question 9 of 20

9. Question
1. An eclamptic patient who has received a 4-g loading dose of magnesium sulfate has another seizure. Which of the following medications can be given as adjuvant anticonvulsant therapy?
- a . Midazolam
- b . Thiopental
- c . Additional magnesium sulfate
- d. All of the above
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Question 10 of 20

10. Question
1. What is the target magnesium level when used for eclampsia prophylaxis?
- a. 2.0–3.5 mg/dL
- b. 4.8–8.4 mg/dL
- c. 8.4–10.4 mg/dL
- d. None of the above
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Question 11 of 20

11. Question
1. What clinical sign or test can be used to detect hypermagnesemia prior to development of respiratory depression?
- a . Heart rate
- b . Patellar reflex
- c. Presence of clonus
- d. Visual field testing
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Question 12 of 20

12. Question
1. A 36-year-old primigravida has a 2-year history of chronic hypertension that is well controlled with medication. She monitors her blood pressure at home, and at her 16-week appointment, she is thrilled to report a drop in her blood pressure. What is the best response to this information?
- a. She should discontinue her medication at this time.
- b. Chronic hypertension typically improves early in pregnancy.
- c. This finding predicts a favorable prognosis for her pregnancy.
- d. None of the above
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Question 13 of 20

13. Question
1. Which of the following medications is preferred for intrapartum prevention of eclampsia?
- a. Phenytoin
- b. Midazolam
- c. Phenobarbital
- d. Magnesium sulfate
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Question 14 of 20

14. Question
1. A 31-year-old woman presents to the antenatal clinic when she is 22 weeks pregnant. She has had normal antenatal care until her last visit two weeks previously with no medical history or medications. At this visit, her BP is 145/98 mmHg with signiﬁcant proteinuria. What is your management?
- A. Admit and treat.
- B. Admit and measure BP every four hours.
- C. Arrange for home blood measurements daily.
- D. Arrange for home BP measurements every other day.
- E. Arrange for antenatal clinic visit reviews every week.
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Question 15 of 20

15. Question
1. You are admitting a 33-year-old woman with a BP of 170/115 mmHg. Her urine dipstick showed 1+ proteinuria. What is the quickest and most convenient method to quantify her proteinuria?
- A. Automated reagent-strip urine testing daily.
- B. Automated reagent-strip urine testing twice weekly.
- C. A spot urinary protein: creatinine ratio.
- D. Urine dipstick twice daily.
- E. Urine dipstick once daily
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Question 16 of 20

16. Question
1. which of the following features are not a hallmark of acute fatty liver of pregnancy?
- A. Disseminated intravascular coagulation
- B. Elevated liver enzymes
- C. Hypoglycaemia
- D. Hyperuricaemia
- E. Proteinuria
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Question 17 of 20

17. Question
1. What proportion of cases of HELLP syndrome will result in an acute kidney Injury
- A. 0.3–1.5%
- B. 3–15%
- C. 23–35%
- D. 43–55%
- E. 63–75%
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Question 18 of 20

18. Question
1. With regards to acute fatty liver of pregnancy (AFLP):
- A. It is a fatal disease if not timely treated
- B. It may progress to fulminant hepatic failure rapidly
- C. Serum urea levels are increased
- D. Blood glucose levels are very high
- E. It may present with disseminated intravascular coagulation
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Question 19 of 20

19. Question
1. Complications of HELLP syndrome are:
- A. chronic renal failure
- B. Hepatic rupture
- C. Massive hepatic necrosis
- D. Subcapsular liver haematoma
- E. Placental abruption
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Question 20 of 20

20. Question
1. With regards to haemolysis, elevated liver entymes and low platelets (HELLP) syndrome:
- A. The incidence of HELLP is 4-12% of those with pre-eclampsia/eclampsia
- B. The rate of recurrent HELLP syndrome in subsequent pregnancies is 4%
- C. HELLP syndrome is associated with 2–4% maternal mortality
- D. Women who had HELLP syndrome in a previous pregnancy have a 55% risk of developing pre-eclampsia in subsequent pregnancies
- E. Burr cells and polychromasia on peripheral smear are indicative of haemolysis
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