WorksheetsPGI NOVEMBER 2020
Total questions: 55
Worksheet time: 25mins
During labour, station +1 indicates that the presenting part is?
High in the false pelvis
On the perineum
Slightly below the ischial spine
Slightly above the ischial spine
What is this classic pathologic finding?
Schiller-Duval bodies
Call-exner bodies
Hobnail cell
Sertoli-leydig cell
What is this pathologic finding associated with
Yolk sac tumor
Dysgerminoma
Immature teratoma
Clear cell tumor
What layer of the anterior abdominal wall continues onto the perineum and provide the fatty substance to the mons pubis and labia majora?
Scarpa fascia
Camper fascia
Colles fascia
Caldwell fascia
When the shoulder of the fetus is to the mother’s left and the back is anteriorly positioned, this is termed:
right acromiodorsoanterior transverse lie
right acromiodorsoposterior transverse lie
left acromiodorsoanterior transverse lie
left acromiodorsoposterior transverse lie
Delayed cord clamping for preterm deliveries have the following advantages EXCEPT:
Decreased need for blood transfusion
Higher red cell volume
Lower rate of necrotizing enterocolitis
Higher incidence of intraventricular hemorrhage
Leopold maneuver with breech presentation may present with:
Third maneuver – hard mass deeply engaged
Third maneuver – movable mass above the symphysis pubis
First maneuver – large, nodular mass occupying the fundal area
First maneuver – hard, round, ballottable mass occupying the fundal area
Maneuver advocated to limit spontaneous vaginal lacerations by using gloved fingers beneath draped towel and exerting forward pressure on the fetal chin through the perineum front of the coccyx is:
Modified Prague maneuver
Modified Ritgen maneuver
Mauriceau maneuver
Rubin maneuver
In a Maylard incision for cesarean delivery, this vessel may be lacerated lateral to the rectus belly during transection.
Superior epigastric artery
Inferior epigastric artery
Superficial circumflex iliac artery
Deep circumflex iliac artery
The decision to delivery time following uterine rupture is associated with normal neonatal neurological outcome according to Utah investigators if done within:
40 minutes
30 minutes
18 minutes
25 minutes
What is this classic pathologic finding?
Schiller-Duval bodies
Call-exner bodies
Hobnail cell
Sertoli-leydig cell
Which of the following is TRUE in the use of epidural analgesia in laboring patients with prior cesarean section?
It might mark the pain of uterine rupture.
Analgesic doses are higher in those undergoing trial of labor.
It may safely be used during a trial of labor.
It is associated with either forceps or vacuum assisted delivery
A 25-year old, G1P0, 38 weeks AOG had hypogastric pains since the night prior to consultation associated with frequent bearing down sensation. On pelvic examination, cervix admits tip with brownish mucoid vaginal discharges. Patient is in the:
Latent phase of the preparatory division of labor.
Acceleration phase of the preparatory division.
Dilatational division of the first stage of labor.
Deceleration phase of the first stage of labor
Options for the management of the case above are the following EXCEPT:
Monitor fetal heart beat pattern with fetal admission test followed by intermittent assessment of fetal
heart rate with labor progression.
Analgesia and sedation with Meperidine 50mg and Promethazine 25mg IM
Active management with oxytocin induction with fetal heart rate monitoring.
Preinduction cervical ripening with prostaglandin E2 gel.
Which of the following pelvic muscle is NOT transected during a mediolateral episiotomy?
Bulbocavernosus muscles
Superficial transverse perineal muscles
Ischiocavernosus muscles
Anal sphincter muscles
What are the 5 components of the APGAR score?
Heart rate, respiratory effort, muscle tone, reflex irritability, color
Heart rate, respiratory effort, muscle tone, reflex irritability, eye opening
Heart rate, respiratory effort, muscle tone, cry, color
Heart rate, blood pressure, muscle tone, reflex irritability, color
An 18-year-old woman came to Emergency Room for profuse vaginal bleeding with loss of consciousness. Vital signs were stable. LMP was unrecalled. What is the first step in the management of this patient?
Internal Exam
Stat TVS
Pregnancy Test
Transfuse PRBC
During the second stage of labor, which of the following is TRUE regarding patient positioning?
Legs are separated or widely placed and not higher than the other.
The popliteal region should rest comfortably in the proximal portion and the
heel in the distal portion.
The legs are strapped into the stirrups and unstrapped should quick flexion of the thighs toward the abdomen be done.
Upright position is currently being recommended to augment pushing efforts with less incidence of perineal trauma.
The ciliated cells of the tubal mucosa are most abundant at the:
Ampulla
Isthmus
Interstitial area
Infundibulum
A 28-year old, G3P1011, 38-39weeks AOG, came in for irregular uterine contractions. Pelvic examination showed a 2cm dilated cervix, 70% effaced, soft, and mid position with fetal occiput at S-2. Bishop score is:
4
6
5
7
A term patient came in with irregular uterine contractions. Pelvic examination showed a 2cm dilated cervix, 70% effaced, soft, and mid position with fetal occiput at S-2.Preferred management of the case is:
Early amniotomy
Membrane stripping
Active management with oxytocin infusion
Oxytocin infusion with elective amniotomy at 5cm or greater
In post term pregnancies, which of the following is TRUE of most cases of non-reassuring fetal heart rate pattern?
Caused by uteroplacental insufficiency
Correlated with viscous meconium
Associated with cord occlusion
Associated with prolonged labor
These muscles constrict the vaginal lumen and aid release of secretions from the Bartholin’s glands.
Ischiocavernosus muscle
Bulbocavernosus muscle
Pubococcygeus muscle
Superficial transverse perineal muscle
Intrapartum fetal heart beat pattern consistent with cord occlusion in postterm pregnancies with oligohydramnios.
Variable deceleration
Prolonged deceleration
Saltatory baseline fetal heart rate
Minimal variability
In which functional division of labor will the deceleration phase of cervical dilatation start?
Abdominal
Dilatational
Preparatory
Pelvic
Recommended elemental iron supplement to be given daily to pregnant women is:
A. C.
B. D.
7 mg
27 mg
17 mg
35 mg
. Recommended daily intake of folic acid to prevent neural tube defect, in succeeding pregnancies of a woman who has had a prior pregnancy complicated by a neural tube defect:
4 mg
4 mcg
400 mcg
400mg
The recommended increase in caloric intake during pregnancy:
300 kcal
500 kcal
400kcal
600 kcal
The following vaccines can be given during pregnancy EXCEPT:
Hepatitis B
Influenza
Pneumococcal
MMR
RUE regarding primary tetanus immunization EXCEPT:
The vaccination series consists of 2 Td and 1 Tdap injections
Td is given at 0, 1, 6-12 months.
Td is administered intramuscularly into the deltoid muscle.
Tdap is given subcutaneously as a substitute to one Td dose and should be given only postpartum
External cephalic version (ECV) has a 60% success rate, at what age of gestation will you consider ECV?
36wks
37wks
38wks
39wks
The following are factors favoring cesarean delivery vs planned vaginal delivery EXCEPT
Stargazing fetus
Large fetus
Inlet AP diameter of 10cm
Healthy and viable fetus 8cm dilated
The initial step in performing Zavanelli maneuver in cases of shoulder dystocia is:
Administer uterine relaxant.
Flex the head and push it back into the vagina.
Return the head to the occiput anterior or occiput posterior position.
Perform cesarean section.
The restrictive use of episiotomy as concluded by ACOG in 2013 is associated with which of the following?
Less anterior perineal trauma
Less posterior perineal trauma
More healing complications
Increased incidence of rectal tears
One of the following is a suitable candidate for trial of labor.
A 28-year old, G2P1001, previous low transverse cesarean section 3 years ago for breech presentation.
A 35-year old, G4P2012, 30-31weeks AOG, with vaginal delivery on her first baby and low transverse cesarean section on her second baby for NRFHB pattern a year ago.
A 26-year old, G2P1001, 38-39weeks AOG, previously sectioned for cephalopelvic disproportion. EFW=3,500grams.
A 38-year old, G3P1011, 12-13weeks AOG, previous low transverse cesarean section for CPD. Current BMI – 35.
When the fetus lies with the long axis transversely, what is foremost within the birth canal
Fetal head
Fetal shoulder
Fetal small parts
Fetal buttocks
The following is/are TRUE of the pelvic inlet:
The obstetrical conjugate is the shortest distance between the sacral promontory and the symphysis pubis.
This is measured at the level of the ischial spines.
The true conjugate is estimated by subtracting 1.5cm from the diagonal conjugate.
Engagement occurs when the biparietal diameter of the fetal head descends below the level of the pelvic floor.
The following is/are TRUE of fetal head changes during labor:
Overlapping of the parietal bones usually occur even before labor ensues.
Molding results in a lengthened suboccipitobregmatic diameter and a shortened mentovertical diameter.
Caput succedaneum develops over the most dependent portion of the head after a rigid vaginal outlet resistance.
Even in prolonged labors differentiation of the various sutures and fontanels could still be done.
The structures provide significant support to the perineal area superficially.
Pubococcygeus muscle and internal anal sphincter muscle.
Bulbocavernosus muscle, superficial transverse perineal muscle and external anal sphincter muscle.
Levator ani muscles and external anal sphincter muscle.
Ischiocavernosus muscle, iliococcygeus muscle and internal anal sphincter muscle.
Which of the following is TRUE of the round ligament.
Sampson artery runs within this ligament.
It divides the pelvic cavity into anterior and posterior comparments.
This unites firmly to the uterus and upper vagina.
This structure extends laterally and downward into the inguinal canal and terminate in the lower portion of the labia majora.
The Bishop Score is used to assess the favorability of the cervix for labor induction. What score conveys a high likelihood for a successful induction?
7
10
9
5
In delivering a breech baby who fails to rotate his/her back anteriorly, the best way to deliver the aftercoming head is by
Modified Ritgen maneuver
Mauriceau maneuver
Modified Prague maneuver
Delivery using the Tucker-McLane forceps
Which clinical manifestation best suggests postpartum metritis?
Abdominal pain
Foul-smelling lochia
Fever
Leukocytosis
How should a woman who has had 4 pregnancies delivered at term, one of which was a twin pregnancy, be designated?
G5P4
G4P5
G4P4
G5P5
Which of the following is correct about the first stage of labor?
It has a latent and an active phase
Begins when the cervix is completely dilated
Begins with braxton hicks contractions
Commonly associated with early and variable decelerations
A 30-year-old G1P0 patient presents to the labor room with every 3 to 5 minutes contractions. She is not sure if she is leaking fluid from her vagina. Rupture of membranes would be supported by which of the following?
Nitrazine paper remaining orange when exposed to the fluid from the vagina
Normal AFI on ultrasound
A negative tampon test
Pooling of fluid in the vagina on speculum examination
On internal examination you attempt to determine the presentation of the fetus. Which of the following presentations and positions would be most favorable to achieve a vaginal delivery
Transverse
Vertex with occiput anterior
Vertex with occiput posterior
Vertex with occiput transverse
A patient is now in the second stage of labor. She is pushing effectively but during contractions you notice decelerations on fetal heart tracings. Which of the following is most concerning?
Isolated early decelerations
Repetitive variable decelerations that resolve quickly
Repetitive early decelerations
Repetitive late decelerations and loss of variability between contractions
What kind of cephalic presentation is described when the fetal neck is only partially flexed and the anterior fontanel is foremost on internal examination?
Brow
Sinciput
Face
Vertex
Which of the following is the correct sequence of the cardinal movements of labor?
Descent, engagement, flexion, internal rotation, extension, external rotation, expulsion
Engagement, descent, flexion, external rotation, extension, internal rotation, expulsion
Flexion, descent, internal and external rotation, extension, expulsion
Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion
The labia minora lack all EXCEPT which of the following?
Eccrine glands
Hair follicles
Apocrine glands
Sebaceous glands
rom proximal (uterus) to distal ( fimbrae), the correct progression of fallopian tube anatomy is which of the following?
Isthmus, infundibulum, ampulla
Isthmus, ampulla, infundibulum
Infundibulum, ampulla, isthmus
Ampulla, infundibulum, isthmus
49. The pelvis is formed by which of the following bone(s)?
Sacrum
Coccyx
Innominate
All of the above
Which of the following is true regarding relaxation of the pelvic joints at term in pregnancy?
Is permanent and not accentuated in subsequent pregnancies
Allows or an increase in the transverse diameter o the midpelvis
Results in marked mobility o the pelvis at term because o a downward gliding movement o the sacroiliac (SI) joint
Displacement o the SI joint increases outlet diameters by 1.5 to 2.0 cm in dorsal lithotomy position
BONUS What is the possible name of dr abbys’s child
Choco
espresso
Vanille(a)
Ferrero
