O&G: PRACTICE 5

SINGLE BEST OPTION SERIES

         INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.        Risk factors for placenta praevia does not include:
   a.       Previous history of placenta praevia
   b.      Advanced maternal age
   c.       Smoking cigarette
   d.      Singleton pregnancy
   e.      Previous dilatation and curettage
   2.       Concerning morbidly adherent placenta, which of the following is incorrect?
   a.       Placenta accreta should always be considered in the presence of placenta praevia
   b.      The presence of placenta increta  may necessitate caesarean hysterectomy
   c.       In placenta percreta, placental invasion stops at the myometrium
   d.      In placenta accreta, the placenta is attached directly to the myometrium
   e.      There is absence of decidua basalis
   3.       A 26-year old woman, gravida 2, para 1, at 36 weeks of gestation with a history of prior caesarean section, presents with abdominal pain and vaginal bleeding. She admits to using cocaine. Her vital signs are significant for temperature 99.9 Fahrenheit, heart rate of 120 per minute, blood pressure of mmHg. Foetal heart rate baseline is in the 160_s with minimal variability and repetitive late decelerations. Her blood work is significant for haemoglobin of 7.5 g/dl, platelets of 110 000 and fibrinogen level of 250 mg/dl. The most likely diagnosis is:
   a.       Trauma
   b.      Cervical polyp
   c.       Placenta praevia
   d.      Placental abruption
   e.      Uterine rupture
   4.       Which of the following is incorrect about clinical pelvimetry?
   a.       The diagonal conjugate is measured from the sacral promontory to the anterior inferior part of the pubic symphysis
   b.      Obstetric conjugate is the length from the sacral promontory to the posterior pubic symphysis
   c.       Obstetric conjugate is determined by adding 1.5 centimetre to the diagonal conjugate
   d.      The obstetric conjugate is the shortest anterior posterior diameter through which the foetal head must pass
   e.      None of the above
   5.       Prenatally, foetal presentation is determined using the.......................manoeuvre
   a.       Leopold
   b.      Mc Robert
   c.       Lovset’s
   d.      Zan Vanelli
   e.      Mauriceau-Smellie Veit
   6.       Which of the following is incorrect about vasa praevia?
   a.       It involves rupture of vessels on the maternal side of the placenta
   b.      It is much rarer than abruptio or placenta praevia
   c.       Multiple pregnancy is a predisposing factor
   d.      Vessels across the cervix rupture during spontaneous or artificial rupture of membranes
   e.      To prevent acute foetal exsanguinations, rapid caesarean section should is done.
   7.       Majority of vaginal bleeding from placenta praevia occur in the following circumstance:
   a.       During rest
   b.      After trauma/pelvic examinatiom
   c.       During and after coitus
   d.      During labour when the lower uterine segment begins to efface and dilate
   e.      None of the above
   8.       Concerning abruptio placentae, which of the following is incorrect?
   a.       It is the premature separation of a normally implanted placenta after 20 weeks of gestation
   b.      It is usually initiated by bleeding into the decidua basalis
   c.       Concealed abruption is less compromising to maternal haemodynamic status than the revealed type
   d.      It is a direct cause of some stillbirths
   e.      It is associated with increasing cocaine use in a number of cases
   9.        The following are risk factors for placental abruption except:
   a.       Hypertension
   b.      History of previous placental abruption
   c.       Increased maternal age
   d.      History of previous caesarean section
   e.      Multiparity
   10.   The most common pelvic type in females, is:
   a.       Android
   b.      Gynaecoid
   c.       Anthropoid
   d.      Platypelloid
   e.      None of the above 
   
   
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