WorksheetsSafe Motherhood Seminar Pre test
Total questions: 21
Worksheet time: 12mins
A 27-year-old, G3P2 at 39 weeks of gestation presents to PAC in active labor. Her pregnancy has been uncomplicated and her prior two deliveries were vaginal. Her cervix is 6 cm, 90% effaced, mid-position and soft. The fetus is not engaged and is thought to be vertex. Initial fetal monitoring shows a heart rate in the 140s with good accelerations and is reassuring. Contractions are 4 minutes apart and the patient is comfortable. Twenty minutes later, the patient experiences a large gush of clear fluid, and severe variable decelerations appear on the fetal heart rate monitor.
What is the most likely diagnosis at this time?
uterine rupture
placental abruption
placenta previa
cord prolapse
vasa previa
A 38 years old, G2P1 at 38 weeks 5 days of gestation in labour. Her pregnancy has been complicated by T2DM for which she takes Metformin 1g BD. She has gained 12kg during pregnancy despite both medication and nutritional consultation. Her BMI at booking was 34kg/m2. Descent of the fetal head is slower than anticipated with ‘positive turtle sign’ during contractions. The head is delivered after 2 hours of pushing. The anterior shoulder is difficult to deliver without increased traction.
What is the most important action to take at this time?
ask the nurse to apply suprapubic pressure
call for additional help
flex the maternal hips and bring the knees up to the chest
perform an episiotomy
remove the baby’s posterior arm
You are called by the nurse to see a 23-year-old woman who delivered a 4.3 kg baby boy approximately 6 hours ago. The nurse noted that the patient is continuing to bleed more than expected. The patient is awake and talking, but feels dizzy. Her blood pressure is 90/40 mm Hg and her pulse is 110 bpm. You see that her perineal pad is soaked with blood. Which of the following is your most appropriate initial intervention?
Give Oxytocin and Carboprost
Perform bimanual uterine massage
Place a large-bore IV and give a 1 L bolus of 0.9% saline
Take blood for Hb and crossmatching
The following is/are antenatal risk factor(s) for venous thromboembolism
Pre-existing T2DM without nephropathy
Day 14 post elective Caesarian section
G4P0+A3 at 28 weeks with IVF pregnancy
Hyperemesis gravidarum
Post-natal 20 days with current Covid-19 infection
Common signs & symptoms of pulmonary embolism as follow:
Sudden onset of shortness of breath
Chest pain that worsened on expiration
Tachycardia
Unexplained hypothermia
Investigation that is recommended if the patient presents with symptoms suggestive of pulmonary embolism:
Arterial blood gas
Chest radiograph
D-dimer
ECG
Full blood count
Hepcidin level will be high in iron deficiency anemia (IDA) and low in anemia of chronic disease
True
False
Intramuscular iron is prefered route in iron therapy if not responding to oral iron
False
True
Iron requirement during pregnancy is 5x higher than non-pregnant state
True
Flase
Serum Ferritin is the test to evaluate iron stores and value <30ug/dl indicate low iron status
True
False
Parenteral iron is contraindicated in the first trimester
True
False
Below statements are true regarding GDM/diabetes in pregnancy management, except
supplement of 5 mg folic acid perday should be given to women with diabetes who plan to become pregnant
blood glucose targets for diabetes in pregnancy fasting 《 5.1 mmol/L
those with GDM, OGTT should be performed 6/52 after delivery to detect diabetes and prediabetes
all pregnant women with uncomplicated pregnancies should be encourage to excersise
serial growth scan is performed every 4 weeks from 28-36 weeks of gestation
Hypertensive Disorder in Pregnancy
Early recognition can prevent the maternal / fetal morbidity & mortality
Most of the eclampsia were seen during antenatal
Preventable condition
Majority of HDP death were associated with pre-eclampsia
Gestational diabetes in pregnancy
Is defined if 2 hours glucose is > 11mmol/L
Is associated with an increased risk of congenital malformation
Impaired glucose tolerance is not associated with increased of intrauterine death
Impaired glucose tolerance is associated with 50% chance of women developing diabetes mellitus in the long term
During labour, blood glucose concentration should be maintained < 7.0 mmol/l
In the management of Hypertensive Disorders in Pregnancy (HDP)
In the absence of risk factors, all mild HDP should start with anti- hypertensive agent to prevent its progression
It is recommended that in an uncomplicated severe HPT, aim is to achieve for a rapid lowering of blood pressure
In the absence of hypertension with proteinuria, eclampsia is unlikely to occur
Risk of future eclampsia among pregnant mother who had eclamptic fit is <2%
Valium is more superior than Magnesium Sulphate in the management of eclampsia
A healthy 35 year old primid has an OGTT at 16 weeks and her results is 5.2 & 10.7mmol/L. What is her diagnosis?
Gestational Diabetes
Diabetes Mellitus
Impaired OGTT
What is the value of HbA1c in pregnancy?
To differentiate DM from GDM
To identify patients who need a detail scan
The guide patient management patient especially with regards to glycemic control.
48mmol/L is the preferred pre-pregnancy levels for patients with DM
A healthy 29 year old primid was diagnosed to have GDM requiring 1gm of metformin XR. What is her future risk of developing Diabetes?
5 % risk in 5 years
15% risk in 5 years
30% risk in 5 years
50% risk in 5 years
A 37 year old multip with a BMI of 35kg/m2 has a past history of preeclampsia requiring a caesarean section at 32 weeks. What is her recommended dose of aspirin if she is now 12 weeks pregnant?
75mg OD
81mg
100mg OD
150mg OD
A 32 year old primigravida has a family history of preeclampsia. She also has a BMI of 36kg/m2. Which of these interventions would you recommend with regards to preeclampsia prevention?
Low salt diet
Calcium 1gm BD
Vitamin D3 400IU
Folic acid 5mg OD
Bed rest
A 35 year old primid with chronic hypertension presents to the clinic with headache and she has a BP of 170/110mmHg. What will be her preferred first line treatment in a primary care setting?
IV magnesium sulfate 4gm bolus and 1gm/ hour infusion
IV labetalol 20mg stat
Sublingual Nifedipine 20mg stat
Oral Nifedipine 10mg Stat
IV hydralazine 5mg stat
