Physiologic OB Samplex Collection

Page 1 10. Which of the following drugs is associated with the

development of neurotoxicity and cardiotoxicity at
1. A woman in labor may be relieved of uterine virtually identical serum drug levels?
contractile pains by ansesthetic technique applied to a. Chloroprocaine
sensory inputs from b. Tetracaine
a. T11-12 c. Bupivacaine
b. T12-13 d. Lidocaine
c. S2-4 11. Contraindication to epidural analgesia include the
d. Pudendal nerve following, EXCEPT:
2. Pain during vaginal delivery is transmitted primarily a. Serious maternal hemorrhage
through which nerve? b. Infection at puncture site
a. Pudendal nerve c. Hypertension
b. Internal iliac nerve d. Neurological disease
c. Paracervical nerve 12. A dreaded complication of general anesthesia is:
d. Lumbar a. Convulsions
3. Most common complication of spinal anesthesia b. Hypotension
a. Headache c. Hypertension
b. Fever d. Aspiration pneumonitis
c. Hypotension 13. The definition of a normal nonstress test currently
d. Convulsions recommended by ACOG is 2 or more accelerations
4. Which of the following is an effective prophylaxis that peak at ___ bpm or more above baseline, each
against gastric acid aspiriation pneumonia lasting ___ seconds, all occurring within ___ minutes
a. Uterine displacement of beginning the test:
b. Intravenous fluid a. 5; 10; 10
c. Use of antacids b. 10; 15; 15
d. Pre Oxygenations c. 10; 15; 20
5. What can be given for pain relief to a woman in the d. 15; 15; 20
active phase of labor? 14. What is the portion of the fetus that is within the birth
a. Halothane canal and can be felt through the cervix on vaginal
b. Pudendal block examination
c. Spinal anesthesia a. Fetal position
d. Meperidine b. Fetal habitus
6. what is the most appropriate anesthesia to give for c. Fetal presentation
forceps delivery? d. Fetal attitude
a. Local infiltration 15. The following may predispose a fetus to assume a
b. Pudendal block transverse lie EXCEPT
c. Spinal anesthesia a. Uterine anomalies
d. General anesthesia b. Ovarian anomalies
7. What is the most appropriate anesthesia to give for a c. Placental previa
cesarean section for a breech presentation d. Polyhydraminos
a. Local infiltration 16. When the fetal neck is sharply extended, what part of
b. Pudendal block the fetus will be at the foremost portion of the birth
c. Spinal anesthesia canal?
d. General anesthesia a. Vertex
8. What is the appropriate anesthesia to give for b. Sinciput
replacement of acutely inverted uterus c. Face
a. Halothane d. Acromnion
b. Pudendal block 17. In breech presentation, what is the determining point?
c. Spinal anesthesia a. Occiput
d. Meperidine b. Mentum
9. What is the most appropriate anesthesia to give for an c. Sinciput
exploratory laparotomy for a ruptured ectopic d. Sacrum
pregnancy in hypovolemic shock? 18. The following may help the diagnosis of fetal position
a. Local infiltration and presentation EXCEPT:
b. Pudendal block a. Abdominal palpation
c. Spinal anesthesia b. Vaginal examination
d. General anesthesia c. Auscultation
d. Percussion
19. When doing the leopold’s maneuver, the fetal back is b. Administration of atropine to the mother
described as? c. Maternal infection
a. Large nodular mass d. Congenital heart disease, commonly
b. Hard, round and bollotoable associated with irregular fetal heart rate
c. Hard resistant structure pattern
d. Numerous small, irregular, mobile parts e. A,B,C only
20. In the following leopold’s maneuver, the examinaer f. All of the above
must face the mother’s feet. (actually multiple 31. Beat to beat variability
answers) a. Important index of the autonomic nervous
a. LM1 system function
b. LM2 b. Beat to beat oscillation of the baseline fetal
c. LM3 heart rate
d. LM4 c. Changes of the fetal heart rate is defined as
21. When doing a vaginal exam, the following may be baseline variability
ascertained EXCEPT: d. Can be appreciated with both internal and
a. Position external electronic fetal monitoring
b. Presentation e. A,B,C only
c. Station f. All of the above
d. Attitude 32. Loss of variability or diminished beat to beat variability
22. This is the first requisite for birth. in fetal compromised is a result of
a. PUT SOME INFO HERE THANKS. a. Fetal hypoxemia
b. Descent b. Fetal academia
c. Depression of the fetal brainstem or fetal
heart itself
d. A and C only
25. The mechanism of labor occurring during this phase e. B and C only
of labor 33. Acceleration represent intact neurohormonal,
a. Latent phase cardiovascular control mechanism linked to fetal
b. Deceleration phase behavioral states:
c. Phase of maximum slope a. True
d. Acceleration phase b. False
26. Embryonic period lasts for _____ Weeks 34. Clinical circumstances result to late deceleration
a. 6 weeks a. Hypotension from continuous lumbar
b. 7 weeks epidural anesthesia
c. 8 weeks b. Uterine hyperactivity caused by oxytocin
d. 9 weeks stimulation
27. This is the greatest transverse diameter of the fetal c. Maternal disease such as hypertension and
head diabetes
a. Suboccipitobregmatic diameter d. And those with chronic placental dysfunction
b. Occipitofrontal diameter such as collagen vascular disease
c. Biparietal diameter e. A,B,C only
d. Occitpitomental diameter f. All of the above
28. This refers to the modal characteristic that prevail 35. Variable decelerations
apart from the periodic changes a. Represents fetal heart rate reflexes due to
a. Variability cord compression and changes in
b. Baseline fetal heart rate oxygenation
c. Accelerations/decelerations b. Mediated via the vagal nerve and the vagal
d. Uterine contraction response may be due to chemoreceptors or
29. Potentially low BUT normal baseline fetal heart rate baroreceptors
have been attributed to c. Commonly seen in cases of
st
a. During the process of the 1 stage of labor oligohydramnions
b. Head compression from the occiput d. A and B only
posterior position e. All of the above
c. During full cervical dilation and effacement 36. Relative contraindication/s to internal fetal heart rate
and the fetal head station is +1 monitoring
d. A and C only a. HIV infected mother
e. B and C only b. Hepatitis B infected mother
30. Causes of fetal tachycardia c. Herpes simplex virus
a. Administration of terbutaline to the mother d. Intact membranes
 e. A,B,C 46. What is the condition associated with elevation of
f. All of the above maternal serum
37. Three tier fetal heart interpretation system: Category a. Obesity
II-intermediate b. Neural tube defects
a. Animal baseline variability c. Fetal death
b. Bradycardia d. Something here I cant see
c. Absent baseline variability not accompanied 47. What diagnostic procedure replaced amniocentesis in
by recurrent decelerations the diagnosis of (if you have an idea let me know)
d. Early deceleration: present or absent a. Chorionic villus sampling
e. A,B,C only b. Maternal serum testing
f. All of the above c. Cordocentesis
38. Initial evaluation and treatment of non-reassuring fetal d. Specialized XXXXXX
heart rate pattern 48. Which test is not included in the triple testing to
a. Changing maternal position diagnose trisomy 21?
b. Vital signs assessment a. Alpha fetoprotein
c. Discontinuation of any labor stimulant b. HCG
d. Delivery c. Inhibin alpha
e. A,B,C only d. Unconjugated xxxxx
f. All of the above 49. What condition is associated with an absent nasal
39. Indications for amnionfusion bone in the first trimester
a. An intervention for variable and prolonged a. Trisomy 18
decelerations b. Trisomy 21
b. Oligohydramnions c. Cephalocoele
c. Dilute and washout thick meconium
d. Prophylaxis with prolonged rupture of Matching
membrane
A. Limb contractures
e. A,B,C only
B. Cephalocoele
f. All of the above C. Vatoer
40. Complications of Amnioinfusion D. Spina bifida
a. CANT SEE THE PICTURE MAKE JUST E. Trisomy 18
PUT SOME NOTES. LOL
b. Uterine hypertonus 50. Malformation (D, Spina bifida)
c. Abnormal fetal heart tracing 51. Deformation (A, Limb contractures)
52. Disruption (B, Cephalocoele)
d. Choriamnioitis
53. Syndrome (E, Trisomy 18)
e. Cord prolapse 54. Association (C, Vater)
f. Uterine rupture
g. Maternal cardiac/respiratory compromise
h. Placental abruption
i. Maternal death 55. What hormone regulates the secretion of FSH and
LH?
Page 5 - 6 a. CRH
b. GnRH
43. An abnormal development of a genetically normal c. TRH
fetus because of ---- in uterine environment is called: d. ?????
a. Malformation 56. This category of drugs make up approximately 65% of
b. Deformation all medications
c. Disruption a. Category A
44. An intrinsic abnormaility in the fetus programmed in b. Category B
development c. Category C
a. Malformation d. Category D
b. Deformation 57. Related to renal tubular agenesis and anuria
c. Disruption a. Cigarette smoking
45. A cluster of anomalies or defects having the same b. Alcohol intake
case c. Antifungal medication
a. Sequence d. ACE inhibitors
b. Association 58. Not considered to be teratogenic but have adverse
c. Syndrome fetal effects when used (CANT SEE WHAT
d. Something here I cant see TRIMESTER IT IS).
a. NSAID
 b. Antifungals 4. This incision done on the abdomen has the cosmetic
c. Ace inhibitors advantage
d. Hydantoin a. Vertical incision
b. Transverse incision
59. Graby baby syndrome
c. Kerr Incision
a. Aminoglycosides d. Kronig incision
b. Chloramphenicol 5. The following are indications for classical cesarean
c. Sulfonamides section EXCEPT
60. Increases the risk for hypospadias a. Placenta previa with anterior implantation
a. DES b. Transverse fetus with back up presentation
b. Danazol c. Difficulty in exposing the lower uterine
segment
c. Both
d. Massive maternal obesity
d. Neither 6. Indications in the performance of periparitum
61. The following are essential for a particular substance hysterectomy include EXCEPT
to become a potential teratogen a. Arrest hemorrhage from intractable uterine
a. The substance must be able to cross the atony
placenta b. Laceration of major uterine vessel bleeding
b. Exposure must occur during a critical c. Lower segment bleeding associated with the
uterine incision or placental implantation
developmental period
d. Grandmutliparity
c. The cause and effect may be biologically 7. The stage of labor that gives the general efficacy of
plausible the uterus is
d. The suspected teratogen must cause a a. Latent phase
defect in animals b. Accelerated phase
e. All of the above c. Maximum slope
d. Deceleration phase
62. Also known as “all or none period”
8. The second stage of labor can be describe as
a. Preimplantation period a. A median duration of 2 hours from nulliparas
b. Implantation period and one hour for multiparas
c. Embryonic period b. Begins with full cervical dilatation and
d. Fetal period ends with fetal expulsion
e. All c. Stats from the latent phase until the
63. This is the period most crucial for structural deceleration phase
d. Can be affected by sedation
malformations
9. The pelvic inlet is considered contracted if
a. Preimplantation period a. Shortest AP diameter is less than 10.0 cm
b. Implantation period b. Greatest transverse diameter is less than
c. Embryonic period 14.0 cm
d. Fetal period c. Oblique diameter is less than 14 cm
e. All d. All of the above
64. Most common cause of mental retardation 10. The prognosis for a vaginal birth in face presentation
is better in
a. Cigarette smoking
a. Mento-anterior position
b. ACE inhibitors b. Mento-lateral positon
c. Carbamazepine c. Mento-posterior position
d. Ethyl alcohol d. None of the above
11. When the fetal head between the orbital ridge and the
Page 3 anterior fontanel presents in the pelvic inlet, it is
a. Vertex
1. Eperldine when given intramuscularly would have its b. Face
maximal analgesia effect at about ___________. c. Brow
a. Immediately d. All of the above
b. 1 to 2 hours 12. McRoberts maneuver is
c. 30 to 45 minutes a. Sharply flexing the legs upon the woman’s
d. 2 to 4 hours abdomen
2. A narcotic antagonists capable of reversing b. Straightening the sacrum in relation with the
respiratory depression induced by epoid narcotics lumbar vertebrae
a. Meperidine c. Rotation of the symphysis pubis toward the
b. Buterphanol patients head
c. Succignylcholine d. All of the above
d. Nalexone 13. An agent that interferes with normal maturation and
3. Early in labor, the pain of uterine contractions is function of an organ (after organogenesis) and after
transmitted predominantly through birth
a. T11 and T12 a. Teratogen
b. S2 to S4 b. Trophogen
c. Pudendal nerves c. Hadegen
d. T7 to T8 d. Antigen
 14. A lower amniotic fluid volume index at 20-30 wks a. One sixth
AOG can lead to b. Equal
a. Hypoplastic left heart c. One half
b. Hypoplastic right heart d. One third
c. Pulmonary hypoplasia 24. The cord at term normally has
d. All are correct a. Two arteries and two veins
e. A & B only b. Two arteries and one vein
15. FDA category of drug in which no available human c. Two veins and one artery
data can support its effect but have been found to d. One vein and one artery
have adverse fetal effects in animal studies is 25. Maximal levels of hCG is attained at about _______
a. Category A a. 7 to 9 days
b. Category B b. 8 to 10 weeks
c. Category C c. 10 to 12 weeks
d. Category D d. 20 weeks
e. Category X 26. The principle (up to 90%) of progesterone
16. Predisposing factors to puerperal fever include the biosynthesis in human pregnancy
following EXCEPT a. Maternal cholesterol
a. Hemoglobin of 11 gm/dl b. Maternal DHEA-S
b. Malnourished patient c. Maternal alpha-OHDHEA-S
c. Primigravid delivered to a 9 lb baby via NSD d. Fetal LDL Cholesterol
with multiple cervical lacerations 27. A 21 year old Gravida 1 Para 0 pregnancy uterine 38
d. Prolonged labor weeks was diagnosed to have intrauterine Fetal
17. This regimen in the treatment of Pelvic infection Death. The following are expected to decreased in the
following CS has been proven to be effective in 90- fetal blood
97% of cases a. Estriol
a. Ooxycycline + Gentamycin b. HCG
b. Clindamycin 900 mg + Gentamycin c. Progesterone
c. Clindamycin + Azte??? d. All of the above
d. None of the above e. A and B only
18. Aerobes commonly responsible for female genital 28. First sign of onset of Labor
infection include a. Regular uterine contractions
a. Enterococcus b. Bloody show
b. Peptococcus c. Cervical dilatation
c. Fusobacterium d. Term pregnancy
d. All are correct 29. Characteristics of Uterine Contractions
e. A & B only a. Hypoxia of the relaxed myometrium
b. Nerve compression of the fundus
Page 4 c. Stretching of the cervix during dilatation
d. All of the above
19. It is that portion of the uterus which is of special 30. Full cervical dilatation
obstetrical significance because it forms the lower a. 8 cm
uterine segment during pregnancy b. 10 cm
a. Cul-de-sac c. 8 mm
b. Isthmus d. 10 mm
c. Cornu 31. Classical mechanism of labor
d. Infundibulum a. Preparatory division
20. The cardinal ligament, which is the densest portion of b. Dilatational division
connective tissue at the pelvic floor is also known as c. Pelvic division
a. Uterosacral Ligament d. Latent phase
b. Infundibulopelvic ligament 32. Characteristics of Phase 3
c. Suspensory ligament a. Paternal – infant bonding
d. Transverse cervical ligament b. Milk let down reflex
e. A and D only c. Uterine subinvolution
21. The pelvic diaphragm consists of the following d. A & B
muscles 33. Most common mechanism of placental separation
a. Levator ani and Puborectalis a. Schultze mechanism
b. Ischiocavernosus and coccygeus b. Duncan mechanism
c. Levator ani and coccygeus c. Both
d. Ischiocavernosus and puborectalis d. Neither
22. This portion of the deciduua parietalis and decidua 34. Most frequently identified chromosomal anomaly
basalis remains after delivery and gives rise to new associated with first-trimester abortions
endometrium a. Monosomy X
a. Zona sponglosa b. Trisomy
b. Zona compacta c. Triploidy
c. Zona fasciculate d. Tetraploid
d. Zona basalis 35. The following may increase the risk of abortion
23. At term, the placental weight may be roughly ______ EXCEPT
that of the fetal weight a. Smoking
 b. Alcohol c. Hepatitis B
c. Caffeine 15. Variable decelerations
d. Contraceptives a. Suggest cord compression
36. When should contraception be started after an 16. Early decelerations
abortion in women who wish to prevent pregnancy a. Gradual decrease and return baseline
a. Soon after abortion associated with a contraction
b. 2 weeks after abortion b. Seen in active labor between 4 and 7 cm
c. 4 weeks after abortion dilatation
d. 6 weeks after abortion c. Cause vagal nerve activation
37. Factors that may increase amniotic fluid index (AFI) 17. External electronic fetal monitoring
include the following a. No need to rupture bag of waters
a. Fluid restriction b. No need for uterine invasion
b. Dehydration c. Does NOT provide the precision of FHR
c. High altitude measurement
d. A, B, C 18. Causes of fetal tachycardia
e. A and B a. Maternal fever
38. During the second trimester the following control the b. Cardiac arrhythmia
amniotic fluid volume c. Fetal compromise
a. Fetal urination 19. Increase the variability of fetal HR
b. Fetal swallowing a. Fetal breathing
c. Amniotic epithelium b. Fetal movement
d. A, B, C c. Advancing gestation
e. A and B

This was a team effort. Thanks!!!

1. Internal electronic fetal monitor

a. Coiled metal electrode is directly attached to
fetus
2. External electronic fetal monitor (indirect)
a. Utilize external detectors to monitor fetal
heart action and uterine activity
3. Baseline fetal heart activity
a. Modal characteristics that prevail apart from
periodic accelerations or decelerations
associated with uterine contractions
4. Fetal bradycardia
a. Fetal heart rate below 110 bpm
5. Fetal tachycardia
a. Fetal heart above 160 bpm
6. Sympathetic influence
a. Responsible for acceleration of fetal HR
7. Parasympathetic influence
a. Responsible for slowing fetal HR or
deceleration
8. Wandering baseline
a. Baseline rate is unsteady
b. Seen in cases of neurologically abnormal
fetus
c. Rate is between 120- 160 bpm
9. Short term variability
a. Reflects instantaneous change in fetal heart
rate of one beat to the next
10. Long term variability
a. Oscillatory changes that occur during the
course of 1 minute with a result of waviness
of the baseline
11. Late decelerations
a. Manifest uteroplacental insufficiency
12. Reactive heart rate
a. 15 beats above 120 bpm lasting for at least
15 seconds
13. Most reliable sign of fetal compromise
a. Reduced baseline heart rate variability
14. Contraindications for internal electronic fetal
monitoring
a. HIV
b. Herpes simplex virus