OBSTETRICS AND GYNAECOLOGY: PRACTICE 2

                                SINGLE BEST OPTION SERIES
         
                   INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.        Which of the following is incorrect about foetal engagement during labour?
   a.       Engagement is said to have occurred when the widest part of the presenting part of the foetus, has passed through the maternal pelvic inlet.
   b.      Engagement usually has occurred in majority of nulliparous women prior to labour.
   c.       If less than two-fifths of the foetal head is palpable abdominally, the head is not yet engaged.
   d.      The foetal head normally enters the maternal pelvis in the transverse position.
   e.      None of the above.
   2.       The series of changes in position and attitude that the foetus undergoes during its passage through the birth canal, is best referred to as:
   a.       Stages of labour
   b.      Induction of labour
   c.       Mechanism of labour
   d.      Active phase labour
   e.      Onset of labour
   3.       The process by which the cervix shortens in length as it becomes included in the lower segment of the uterus, is referred to as:
   a.       Engagement
   b.      Crowning
   c.       Latent phase of labour
   d.      Effacement
   e.      Stimulation of labour
   4.       ‘’Face to pubes’’ delivery suggest that a foetus was in............................. position during gestation:
   a.       Occipito-posterior
   b.      Occipito-anterior
   c.       Occipito-frontal
   d.      Occipito-mental
   e.      All of the above
   5.       An abnormal foetal heart rate pattern on external foetal monitoring using cardiotocogaphy include:
   a.       Baseline heart rate of 110-160 beats per minute
   b.      Any deceleration
   c.       Baseline heart rate variability of 10-25 beats per minute
   d.      Two accelerations in 20 minutes
   e.      None of the above.
   6.       The greatest longitudinal diameter that a foetus may present with during labour, is usually:
   a.       Mentovertical
   b.      Submento-bregmatic
   c.       Suboccipitobregmatic
   d.      Occipitofrontal
   e.      Occipitomental
   7.       Which of the following is incorrect about cervical softening/ripening during labour?
   a.       There is increase in water content of the cervix
   b.      There is replacement of dermatan sulphate by the more hydrophilic hyaluronic acid
   c.       There is increase in proteolytic activity and collagen turnover in the cervix
   d.      Fergusson reflex is the initiator of cervical ripening.
   e.      It precedes cervical effacement and dilatation
   8.       The following are usually recorded on a partograph except:
   a.       Frequency and strength of uterine contractions
   b.      Decent of the foetal head in fifths palpable
   c.       Rate of cervical dilatation
   d.      Apgar score
   e.      Observations of maternal wellbeing such as blood pressure, pulse rate, and temperature.
   9.       Which of the following is inappropriate in the management of a parturient in latent phase labour that is progressing normally?
   a.       Total restriction of eating and drinking.
   b.      Performing vaginal examination four-hourly
   c.       Encouragement and reassurance
   d.      Administration of simple analgesics
   e.      If the membranes are still intact, it is not necessary to rupture them.
   10.   The following are key features of management principles of the first stage of labour in a parturient except:
   a.       Emotional support
   b.      Monitoring of foetal wellbeing
   c.       Pain relief
   d.      Restriction of fluid intake
   e.      Monitoring of maternal wellbeing.
   
   
   ANSWERS:
   1. c
   2. c
   3. d
   4. a
   5. b
   6. a
   7. d
   8. d
   9. a
   10. d
   
   
                                           REMEMBER
   ” Some people sin by not working diligently for six days whereas, others – because of greed, unbelief or powerlessness- sin by working also on a day of rest and worship. Either way of breaking this   command results in poverty.”   By  Vishal Mangalwadi.