O&G: PRACTICE 6

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.         Concerning the nutrition of pregnant women, which of the following is incorrect?
   a.       Their diet should provide 2500 Kcal/day which is about 300 Kcal/day more than the pre-pregnancy needs
   b.      Since protein is required for foetal growth, the protein requirement should be about 60gram per day
   c.       The recommended iron intake is about 30 milligram elemental iron per day
   d.      Well-balanced diet will usually provide adequate iron stores during pregnancy
   e.      The recommended calcium intake is 1200 milligram daily from diet or with addition of calcium supplements
   2.        Concerning postpartum haemorrhage, which of the following is incorrect?
   a.       It is defined as excess blood loss after delivery within the first six weeks of delivery
   b.      The most common cause is uterine atony
   c.       Massaging the uterus is a management option
   d.      Prostaglandin F2-alpha (haemabate) may be injected systemically or directly into the myometriun through the anterior abdominal wall to control the haemorrhage
   e.      The patient’s bladder should be full to provide pressure effect when controlling the haemorrhage
   3.       Concerning placenta praevia, which of the following is incorrect?
   a.       It should be suspected in all patients who present with vaginal bleeding after 24 weeks of gestation
   b.      Ultrasound is necessary to determine the position of the placenta
   c.       It requires immediate digital and pelvic examination before the diagnosis is excluded by other investigations
   d.      Transvaginal ultrasound is more accurate than transabdominal ultrasound in making the diagnosis
   e.      None of the above
   4.       Which of the following is incorrect about the aetiology of abruptio placentae?
   a.       Cocaine is a risk factor because it causes maternal hypertension and placenta vasoconstriction
   b.      Preterm premature rupture of membranes in pregnant women has been associated with it
   c.       Maternal trauma accounts for the largest number of cases
   d.      Uterine fibroids may contribute to abruptio when the placenta is implanted directly over a submucosal fribroid
   e.      Cigarette smoking is associated with decidual necrosis and an increased risk of abruptio especially in hypertensives
   5.       Which of the following is an inappropriate preconception care?
   a.       Giving folic acid to reduce the risk of neural tube defects
   b.      Determining the rubella status of women
   c.       Determining the varicella immune status if the patient does not recall having chickenpox in the past
   d.      Routine cystic fibrosis carrier screening in African Americans and Asians
   e.      Routine screening of African Americans for sickle cell disease
   6.       Concerning the pelvis of females, which of the following is incorrect?
   a.       Gynaecoid pelvis has a narrow pubic arch
   b.      There are four types of pelvis according to the Caldwell-Moloy classification
   c.       The posterior sagittal diameter of the inlet in the android type is much shorter than the anterior sagittal diameter thereby limiting the posterior space for the foetal head
   d.      Platypelloid type is the least frequent
   e.      About one-third of white women and one-sixth of non-white women have the android type
   7.       Which of the following statement is incorrect?
   a.       The best sources of protein for pregnant women are from animal sources such as meat, milk, eggs, poultry and cheese
   b.      Pregnant women should be encouraged to consume unpasteurized cheese and raw shell fish for healthy foetal growth
   c.       Most pregnant women need supplemental iron which is usually found in prenatal vitamins
   d.      Women with a history of giving birth to infants with neural tube defects need about 4milligram of folic acid per day during the antenatal period
   e.      None of the above
   8.       Secondary postpartum haemorrhage is usually the result of the following except:
   a.       Uterine rupture
   b.      Retained products of conception
   c.       Uterine infection
   d.      All of the above
   e.      None of the above  
   9.       Clinical palpation of placenta tissue through the cervical os in patients with placenta praevia can be attempted under the following conditions except
   a.       Delivery is contemplated at the time of examination
   b.      The examination is performed in the consulting room as part of routine clinic activities
   c.       The pregnancy is at or near term
   d.      Availability of facilities and staff for caesarean section
   e.      Availability of double set-up in case of need to deliver the foetus
   10.   Risk factors for abruptio placenta include the following except:
   a.       Factor V Leiden thrombophilia
   b.      Sudden decompression of the uterus by rupture of membranes in patients with polyhydramnios
   c.       Delivery of the first twin in multiple gestation leading to a shearing effect on the placenta as the uterus conracts
   d.      Previous history of abruption placenta
   e.      None of the above
   
   
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PAEDIATRICS CLINICALS: PRACTICE 5

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.       Symptomatology of vomiting include the following except:

a.       Bilious or non-bilious

b.      Effortless or projectile

c.       Associated abdominal distension

d.      Occurring postprandial and post-tussive

e.      Colicky or non-colicky

2.       Which of the following is incorrect about fluid and electrolytes in the body?

a.       Water accounts for about 75-80% of birth weight in a term neonate

b.      Foetuses and newborns have larger intracellular fluid than extracellular fluid

c.       Term neonates lose 10% of their birth weight in the first week of life while preterms lose about 15% of their birth weight within two weeks of life

d.      Total body water decreases with increasing body fat

e.      None of the above

3.       Children taking only maintenance fluid in the hospital are expected to lose about what percentage of their body weight daily?

a.       0.5-1%

b.      2-2.5%

c.       3-3.5%

d.      4.5-5%

e.      1.5-8.5%

4.       Usual causes of hypokalaemia include the following except:

a.       Chronic use of diuretics

b.      Constipation

c.       Laxative abuse

d.      Cushing syndrome

e.      Nasogastric tube drainage

5.       Which of the following statements is incorrect?

a.       Hypocalcaemia is defined as serum ionized calcium less than 4 milligram per decilitre

b.      While giving calcium gluconate by intravenous infusion slowly, there is need to monitor the heart rate as it causes cardiac arrest in diastole

c.       Hypocalcaemia may occur following exchange blood transfusion(EBT)

d.      Vitamin A and vitamin D intoxication may cause hypercalcaemia

e.      Hypercalcaemia is treated using normal saline plus or minus loop diuretics

6.       The parts of a sphygmomanometer include the following except:

a.       Bulb inflator

b.      Adjustment knob

c.       Mercury reservoir

d.      Cuff and bladder

e.      Mercury gauge

7.       Usual causes of Faget’s sign include the following except:

a.       Typhoid fever

b.      Brucellosis

c.       Yellow fever

d.      Cardiac conduction defects due to Lyme disease

e.      Acute malaria

8.       Indications for nasogastric tube include the following except:

a.       Gavage feeding

b.      Oral rehydration

c.       Gastric lavage in cases of corrosive poisoning

d.      To obtain sample during investigation of suspected tuberculosis

e.      None of the above

9.       Concerning suctioning machine, which of the following is incorrect?

a.       It is necessary to check the rubber tubing to ensure that it is leak proof

b.      Disposal of fluid in the suction bottle is necessary while in use to prevent backflow

c.       Retropharyngeal abscess and bulbar poliomyelitis are indications to use this device

d.      It should not be used for patients with status epilepticus to prevent worsening of seizures

e.      It may be needed for on-table suctioning during surgery

10.   Complications of using AMBU-bag (bag and mask) ventilation include the following except:

a.       Gastric distension from aerophagia

b.      Alveolar rupture

c.       Retinopathy of prematurity

d.      Circum oral and nasal trauma due to firm pressure of grip

e.      Introduction of infection

ANSWERS:

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