Third Trimester Bleeding (Ante partum Hemorrhage).
***) All of the following may cause ante-partum hemorrhage, except:
Placenta previa
Abruptio placenta
Vaginal varicose
Cervical carcinoma
Moniliasis
Answer: E* Moniliasis
***) 32 weeks intrauterine pregnancy with mild vaginal bleeding, which appeared suddenly, uterus is soft, good FSH, oblique lie, one of the following is the proper management:
Vaginal examination with starting of blood transfusion
Hospitalization, bed rest, ultrasound exam, prepare blood
Immediate CS
Examination under anesthesia, than rupture of membranes and oxytocin drip
Induction with prostaglandin vaginal supports
Answer: B* Hospitalization, bed rest, ultrasound exam, prepare blood
***) Mild painless vaginal bleeding at 33 weeks of pregnancy should be treated by:
Artificial rupture of membranes
Expectant conservative treatment
Cesarean section
Immediate vaginal delivery
Pelvic examination
Answer: B* Expectant conservative treatment
***) In ante-partum hemorrhage fetal blood cells could be identified in one of the following conditions:
Placenta circumvallate
Placenta marginalis
Placenta membranacea
Battledore insertion of the cord
Velamentous insertion of the cord
Answer: E* Velamentous insertion of the cord
Spontaneous Abortions.
***) In inevitable abortion, all the following are true except:
The cervical os will be dilated
The pain is colicky in nature
The conceptual sac may be felt by pelvic examination
Usually there is no vaginal bleeding
The uterine size is compatible
Answer: D* Usually there is no vaginal bleeding
***) One of the following is true in a case of incomplete abortion:
The internal cervical os is closed
The fetal heart activity is heard
Human chorionic gonadotropin (hCG) injections should be given
The vaginal bleeding is painless
Evacuation of the uterus is needed
Answer: E* Evacuation of the uterus is needed
***) A major hazard of missed abortion is:
Pulmonary embolism
Systemic allergies
Bone marrow depression
Coagulopathy
Toxemia
Answer: D* Coagulopathy
***) All of the following are signs of missed abortion, except:
Vaginal bleeding
Distorted gestational sac
Absence of fetal heart activity
Small for gestational age uterus
Absence of fetal movements
Answer: A* Vaginal bleeding
***) In missed abortion all of the following are true, except:
The uterus is larger than date
The uterus is smaller than date
The fetus is dead
Can cause coagulopathy
Menstruation does not occur
Answer: A* The uterus is larger than date
***) The most common type of bacteria present in septic abortion is:
E.Coli
Pseudomonas
Beta-hemolytic streptococcus
Bacteroids
Peptostreptococcus (anaerobic streptococcus)
Answer: E* Peptostreptococcus (anaerobic streptococcus)
***) The most common cause of abortion in the 1st trimester is:
Physical trauma
Uterine retroversion
Abnormality of the conceptus
Systemic maternal infection
Incompetent cervix
Answer: C* Abnormality of the conceptus
***) The most common cause for 2nd trimester abortion is:
Fetal abnormality
Placental insufficiency
Incompetent cervix
Fibroid uterus
Rh isoimmunization
Answer: C* Incompetent cervix
***) One of the following is the commonest cause of vaginal bleeding during the first half of pregnancy:
Hydatiform mole
Abruptio placenta
Ectopic pregnancy
Abortion
Placenta previa
Answer: D* Abortion
***) Criteria for abortion due to cervical incompetence include all of the following, except:
First trimester abortion
Water before blood
Short and minimal labor pains
Cervix admits number 8 hegar dilator
Barrel-shaped cervix by H.salpingogram
Answer: A* First trimester abortion
***) With cervical incompetence, all the following are true except:
May be congenital
It is associated with previous dilatation
It is associated with painless premature labor
It is diagnosed by follicular phase hysterography
It is common cause of second trimester abortion
Answer: D* It is diagnosed by follicular phase hysterography
***) If a patient who has threatened abortion did not abort, the risk of the fetus being abnormal is:
The same as in patient without bleeding
Slightly increased
Moderately increased
Markedly increased
99 to 100%
Answer: B* Slightly increased
***) A 23 year old lady G1P0, 6 weeks pregnant has developed bleeding over the past 2 days. Which of the following is the likely cause of her bleeding:
Hydatidiform mole
Abruption placenta
Ectopic pregnancy
Abortion
Uterine rapture
Answer: D* Abortion
***) Therapy for threatened abortion should include:
Progesterone injection
Dilatation and curettage
Prolonged bed rest
Restricted activity
Prostaglandins suppositories
Answer: D* Restricted activity
***) Extrusion of an abortus from the fimbriated end of the tube is called:
Spontaneous abortion
Delivery
Tubal abortion
Decidual cast
Aria-Stella phenomenon
Answer: C* Tubal abortion
***) A 26 year old woman whose last menstrual period was 2.5 months ago develops bleeding, uterine cramps, and passes tissues per vagina. Two hours later she is still bleeding heavily, the most likely diagnosis is:
Twin pregnancy
Threatened abortion
Inevitable abortion
Premature labor
Incomplete abortion
Answer: E* Incomplete abortion
***) A 24 year old woman, 10 weeks pregnant presented with vaginal bleeding, lower abdominal pain and temperature 39.5 degrees and a history of introducing sharp object per vagina for self abortion. The most likely diagnosis is:
Choriocarcinoma
Hydatidiform mole
Pelvic inflammatory disease
Septic abortion
Twisted ovarian cyst
Answer: D* Septic abortion
***) Definitive initial therapy in septic abortion is:
Curettage after antibiotics
Hysterectomy
Bed rest and antibiotics
Hysterotomy
Outpatient antibiotics
Answer: A* Curettage after antibiotics
***) The treatment of incomplete abortion in a patient of 10 weeks gestation is:
Administration of syntocinon only
Administration of ergometrine only
Hysterectomy
Evacuation of the uterus
Prostaglandin vaginal pessary
Answer: D* Evacuation of the uterus
***) The clinical features of threatened abortion include all the following except:
Slight bleeding per vaginal
Size of the uterus corresponds to period of amenorrhea
Mild abdominal pain
The cervix is closed
The cervix is opened
Answer: D* The cervix is closed