O & G: practice 4

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.        Concerning the causes of third trimester bleeding, which of the following is incorrect?
   a.       Bloody show is a normal part of labour and the blood is mixed with mucus
   b.      In vasa praevia, there may be rupture of placental vessel with a velamentous cord insertion
   c.       The diagnosis of vasa praevia can be made by Apt test
   d.      If foetal parts are palpable abdominally, uterine culture is then an unlikely cause of haemorrhage
   e.      Vaginal laceration may cause obstetric haemorrhage
   2.       On clinical pelvimetry, a pelvis with a diagnonal conjugate greater than .....................centimetres is considered to be adequate for delivery of a normal-sized foetus
   a.       7.5
   b.      8.5
   c.       9.5
   d.      10.5
   e.      11.5
   3.       Each antenatal visit throughout the period of gestation should routinely include the assessment of the following except:
   a.       Maternal weight
   b.      Maternal height
   c.       Urine dip for glucose and protein
   d.      Blood pressure
   e.      Uterine size foetal heart tones
   4.       Which of the following is incorrect about placenta praevia?
   a.       The patient is usually in less distress compared to abruption placentae
   b.      Patients usually presents with tender, tense abdomen
   c.       It may cause abnormal lie and presentation of foetus
   d.      The cardiotocography findings are usually normal
   e.      It does not usually have particular association with pre-eclampsia
   5.       Concerning placenta praevia, which of the following is incorrect?
   a.       Over 90% of praevias detected by second trimester ultrasound will usually resolve as the lower uterine segment develops as pregnancy progressing
   b.      A repeat ultrasound should be performed at 28 weeks of gestation to confirm the diagnosis
   c.       Being of Asian and African ethnic background are implicated risk factors for it
   d.      The most characteristic sign is painful vaginal bleeding in the third trimester of pregnancy
   e.      The incidence increases with increasing number of caesarean section
   6.       Severe haemorrhage may occur after delivery in parturient with placental praevia usually because:
   a.       There is velamentous insertion of vessels
   b.      Placental migration in the lower uterine segment which has decreased muscle content leads to ineffective contraction
   c.       Prelabour administration of pethidine will not allow the uterus to contract properly
   d.      Maternal starvation during labour
   e.      None of the above
   7.       Non-obstetric causes of third trimester vaginal bleeding does not include:
   a.       Bacterial vaginosis
   b.      Cervical polyps
   c.       Cervical cancer
   d.      Necrobiosis of fibroids
   e.      Gonorrhoea
   8.       A bluish-red hue of the cervix of pregnant women during the first trimester defines:
   a.       Prehn sign
   b.      Chadwick’s sign
   c.       Hegar’s sign
   d.      Mc Donald’s sign
   e.      Von Fernwald’s sign
   9.       Which of the following is an inappropriate prenatal care?
   a.       Giving precautions of preterm labour after 20 weeks of gestation
   b.      Using foetal kick chart after 28 weeks of gestation which is a normal of 10 foetal movements in 2 hours
   c.       Telling patients about the warning signs of pre-eclampsia after 35 weeks of gestation
   d.      Giving RhoGAM to rhesus negative women between 24 and 28 weeks of pregnancy
   e.      Conducting genetic screening at 41 weeks of gestation
   10.   Which of the following is incorrect about abruptio placentae?
   a.       Coagulation defect may occur early
   b.      It is the premature separation of an abnormally sited placenta from the uterine wall
   c.       In more than two-thirds of cases, the blood tracks down to the cervix and is revealed as vaginal bleeding
   d.      Maternal shock or foetal distress may occur without obvious bleeding
   e.      If the foetus is alive and near term, the delivery is best by caesarean section
   
   
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