The obstetric bleeding in the second half of pregnancy
! The patient with a histologically confirmed diagnosis of trophoblastic disease, molar pregnancy after curettage of the uterus needs in defining the next hormone in dynamic
* Chorionic gonadotropin
* Follicle Stimulating Hormone
* Progesterone
* Testosterone
* Prolactin
! On 11th week of gestation after ultrasound the molar pregnancy was diagnosed. Future tactics
* Extirpation of uterus without appendages
* Prolongation of pregnancy
* Amputation of uterus without appendages
* Curettage of cavity of the uterus
* Chemotherapy
!The placenta previa is localized
* on the fundus of the uterus
* at the posterior side of the uterus
* at the lateral side of the uterus
* at the anterior side of the uterus
* In the lower segment of the uterus, blocking the internal os of the uterus
! At the case of low placentation the lower edge of the placenta is located from the internal os of uterus at a distance less than (cm)
* 9
* 7
* 5
* 3
* 2
!One of the causes of placenta previa is
* Chromosomal abnormalities
* Oligohydramnios, polyhydramnios
* Wrong position of fetus
* Congenital malformations of the fetus
* inflammation processes of the endometrium
!The informative method of diagnosis of placenta previa is
* Anamnesis
* Viewing by the gynecological mirrors
* Vaginal examination
* Ultrasonography
* External obstetrical examination
!A pregnant woman came to maternity hospital complaining on weakness, profuse bleeding from the genital tract. The individual card of the patient says that 2 days before, during the previous visit on 35 weeks of pregnancy, total placenta previa was diagnosed. The future tactics is
* Spontaneous labor
* Preserving therapy
* Amniotomy, induction of labor
* Caesarean section in a planned way
* Cesarean section in a emergency way
!The main clinical symptom of placenta previa is
* Acute pain
* Disturbance of fetal heart rhythm
* Untimely rupture of membranes
* Local tenderness of the uterus and uterine tension
* Bleeding from the genital tract on the background of complete rest
!The main clinical symptom of placenta previa is
* Repeated bleeding from the genital tract
* Local tenderness and tension of the uterus
* Prenatal amniorrhea
* Disturbance of fetal heart rhythm
* The spherical shape of the uterus
!The highest value in the choice of tactic of antenatal care with placenta previa is the
* status of the fetus
* presentation of the fetus
* age of the pregnant
* status of the cervix
* intensity of bleeding
! The most common complication of placenta previa is
* Inversion of the uterus
* Placenta accreta
* Placenta adhaerens
* Prenatal amniorrhea
* Abruptio placentae
! A characteristic for the localization of the placenta at the anterior wall of the uterus and abruptio placentae is
* Prenatal amniorrhea
* Oedema at the anterior abdominal wall
* Local tenderness
* Colicky pains
* Hypotension of uterus
! During surgery of caesarean section, produced in connection with a complete placenta previa, at the delivery of the placenta profuse bleeding begins, the placenta is not separated, which indicates the
* Atonic hemorrhage
* Violation of delivery of the placenta
* Placenta adhaerens
* Placentae accretaecerae
* Abruptio placentae
! The main clinical symptom of abruptio placentaeis
* Symptom of "an hourglass"
* Birth activity anomaly
* Prenatal amniorrhea
* Local tenderness and tension of the uterus
* Bleeding from the genital tract amid complete rest
! The high risk of abruptio placentaeis can be found in pregnant woman with
* anemia
* narrow pelvis
* preeclampsia
* large fetus
* earlytoxicosis
! A pregnant women at her 37 week of pregnancy with placenta previa bleeds from the genital tract in amount of 250 ml. The future tactic is
* Treatment in day hospital
* Hospitalization, caesarean section in a planned way
* Hospitalization, cesarean section at week 40
* Hospitalization, emergency cesarean section
* Hospitalization, observation until spontaneous labor
! The obstetric tactic in the case of abruptio placentae in the first period of labor is
* Forceps
* Vacuum extraction of the fetus
* Operation destroying the fetus
* Induction of labor with oxytocin
* Emergency caesarean section
! Most often the placental abruption occurs in the second period of labor with
* Chorioamnionitis in labor
* Absolute / relative short umbilical cord
* Weakness of birth activity
* Placentae accretaecerae
* Prenatal amniorrhea
! Primarily the medical tactic in placenta previa depends on
* fetal state
* gestational age
* degree of bleeding
* type of placenta previa
* degree of cervical dilatation
! In the case of abruptio placentae the emergency cesarean section is performed under the following conditions of the fetus
* Breech position of fetus
* Viability of fetus
* Only when fetus is alive
* Irrespectively of fetal state
* Only at threatened condition of the fetus
! The absolute indications for cesarean section is
* Uterine scarring
* Low placentation
* Breech presentation of fetus
* Complete placenta previa
* Anatomical contracted pelvis first degree
! A pregnant woman with incomplete placenta previa at her 34 week of pregnancy scantly bleeds from genital tract. She was hospitalized. The future tactic is
* Amniotomy, labor stimulation
* Amniotomy, labor induction
* Planned Caesarean section
* Vaginally childbirth in full-term period
* Bed rest, antispasmodic, hemostatic therapy
! The obstetric tactic in the case of abruptio placentae during the pregnancy is
* Amniotomy, labor stimulation
* Amniotomy, labor induction
* Planned Caesarean section
* Emergency cesarean section
* Vaginally childbirth
! A pregnant woman with full-term gestation was diagnosed abruptio placentae, antenatal fetal death, hemorrhagic shock of I degree. The future tactics is
* labor induction by the oxytocin
* Amniotomy, labor induction
* Planned Caesarean section
* Emergency cesarean section
* Observation before birth activity
! During surgery of caesarean section, done due to abruptio placentae it was detected that the uterus is of bluish-purple color, hypotonic and was diagnosed the Couvelaire uterus. The future tactics is
* Sanation and drainage of the abdominal cavity
* Total hysterectomy with appendages
* Total hysterectomy without appendages
* Subtotal hysterectomy with appendages
* Subtotal hysterectomy without appendages
! During surgery of caesarean section, done due to abruptio placentae it was detected that the uterus is of bluish-purple color, atonic, which indicates the diagnosis of
* atony of uterus
* couvelaire uterus
* placentaeaccretaecerae
* placentaeadhearens
* expansion of varicose veins of the uterus
! A pregnant at her 32 week of pregnancy with gestational hypertension complains to the acute pain in the lower abdomen, bleeding from the genital tract. Objectively, the uterus is tense, local tenderness, fetal heartbeat muffled, 170 heartbeats per minute. The most likely cause of bleeding is
* rupture of uterus
* cervical erosion
* placentaprevia
* expansion of varicose veins of the vagina
* abruptio placentae
Diseases of cardiovascular, respiratory and digestive systems of pregnant women.The management of pregnancy and childbirth.
! At rest the cardiac output during pregnancy increases maximum to (%)
* 10-20
* 20-30
* 30-40
* 40-50
* 50-60
! At physiological progress of pregnancy in the III trimester the heart rate of pregnant increases by following number of beats per minute
* 5-10
* 10-15
* 15-20
* 20-25
* 25-30
! A minimal risk of activation of rheumatic process of pregnant women with rheumatic disease is found in the following weeks of pregnancy
* 12-16
* 22- 28
* 30-32
* 34-36
* 38-40
! A more favorable prognosis for pregnancy and delivery is possible with the following acquired rheumatic heart disease
* Mitral insufficiency without hemodynamic disorders
* Mitral stenosis with hemodynamic disorders
* Aortic malformation without hemodynamic disorders
* Aortic malformation with ciliary arrhythmia
* Decompensated heart disease
! A more favorable prognosis for pregnancy and delivery is possible with the following congenital heart disease
* Tetralogy of Fallot
* Coarctation of the aorta
* Eisenmenger Complex
* Atrial septal defect
* Ventricular septal defect
! In pregnant women with diseases of the cardiovascular system the pulmonary edema most commonly develops in the next period of pregnancy and delivery
* I-st half of pregnancy
* II-nd half of pregnancy
* 1st and/or 3rd stage of labor
* 2nd stage of labor and/or in the early postpartum period
* 3rd stage of labor and/or in the late postpartum period
! The disease of the myocardium in which the carrying of a pregnancy is possible
* acute forms of myocarditis of any etiology
* subacute forms of myocarditis of any etiology
* myocardiodystrophy and myocardiosclerosis with arrhythmia
* myocardiodystrophy without arrhythmias and insufficiency of blood circulation
* chronic myocarditis with cardiac arrhythmias and insufficiency of blood circulation
! The 1 stage insufficiency of blood circulation of pregnant women is characterized by the following clinical signs
* breathlessness, palpitations, edema
* breathlessness and palpitations at rest
* breathlessness and palpitations after physical activity
* breathlessness, palpitations, developments of stagnation in the lungs
* breathlessness, palpitations, edema, enlargement of the liver, developments of stagnation in the lungs
! The delivery of pregnant woman with the open form of tuberculosis should be taken in a special box of the
* Maternity Hospital
* Women's clinic
* Infectious Disease Hospital
* Tuberculosis dispensary
* Multidisciplinary hospital
! The delivery of pregnant woman with the acute dysentery should be taken in a special box of the
* Maternity Hospital
* Women's clinic
* Infectious Disease Hospital
* Tuberculosis dispensary
* Multidisciplinary hospital
! The nonspecific infectious-inflammatory process with mainly affecting of the interstitial tissue, tubular device and walls of the pyelocaliceal system is called
* cystitis
* urethritis
* pyelonephritis
* glomerulonephritis
* urolithiasis disease
! The frequent occurrence of the right pyelonephritis in pregnant women due of compression of the right ureter with the
* enlarged uterus
* diorder of the urodynamics
* rotated uterus to the right
* varicose expanding the left ovarian vein
* varicose expanding the right ovarian vein
! A pregnant woman with chronic pyelonephritis at her 24 week of pregnancy has an increase in temperature to 38 ° C, frequent urination, leukocyturia - 25 in sight, bacteriuria. The clinical picture is
* Urolithiasis
* Acute pyelonephritis
* Gestational pyelonephritis
* Chronic glomerulonephritis
* Exacerbation of chronic pyelonephritis.
! One of the contraindications for prolongation of pregnancy is the following kidney disease
* urolithiasis disease
* Gestational pyelonephritis
* Pyelonephritis of single kidney
* Exacerbation of chronic pyelonephritis
* Exacerbation of chronic calculous pyelonephritis
! The form of chronic glomerulonephritis, in which the prognosis for life is less favorable
* hypertension
* nephrotic
* mixed
* latent
* acute
! At the first visit in the analysis of bacteriological tests of midstream urine of the somatic healthy pregnant woman was found 106 microbial bodies in 1 ml. The clinical picture is
* Urolithiasis
* Acute pyelonephritis
* Gestational pyelonephritis
* Asymptomatic bacteriuria
* Exacerbation of chronic pyelonephritis.
! The pregnant with right nephrectomy in anamnesis about hydronephrosis came to women's clinic at 8 week of pregnancy. The examination to address the issue about prolongation of pregnancy should be at the
* polyclinics
* the day hospital
* women’s clinic
* Department of Neurology
* Department of Pathology of pregnant
! In the laboratory analysis of urine by the Nechiporenko of pregnant: leukocytes - 4000, erythrocytes - 1000, cylinders 0-1 in the field of view, which corresponds to the
* norm
* pyelonephritis
* preeclampsia
* glomerulonephritis
* urate diathesis
! The relative density of the morning urine of a healthy person varies
* 1,005, tо 1,014
* 1,015, tо 1,026
* 1,027, tо 1,030
* 1,031, tо 1,035
* 1. 036, tо 1,046
! The thyroid gland of the fetus begins to function at the next weeks of pregnancy
* 5-11
* 12-16
* 17-22
* 23-32
* 33-40
! The symptoms such as palpitations, increased nervousness, hand tremors, sweating are the following disease of the thyroid gland
* Diffuse toxic goiter
* Nodular toxic goiter
* Autoimmune thyroiditis
* Endemic goiter
* hypothyroidism
! The symptoms such as lethargy, drowsiness, memory loss, dry skin, persistent constipation are the following disease of the thyroid gland
* Diffuse toxic goiter
* Autoimmune thyroiditis
* Nodular toxic goiter
* Endemic goiter
* hypothyroidism
! The surgical treatment of pregnant women with diffuse toxic nodular goiter is advisable in the following weeks of pregnancy
* 5-11
* 12-14
* 17-22
* 23-28
* 29-32
! One of the complications in pregnant women with hyperthyroidism is
* anemia
* hypotension
* long time carrying of pregnancy
* noncarrying of pregnancy
* Polyhydramnios, oligohydramnios
! The most frequent complication at the second stage of labor among pregnants with diabetes is
* shoulder dystocia
* Placenta previa
* Cervical dystocia
* Excessive labor activity
* Untimely amniorrhea
! In anamnesis of pregnant woman with diabetes at the period of 8-9 weeks in the biochemical analysis of the blood the level of glucose was 6.6 mmol/L and glycosuria. The clinical picture is
* prediabetes
* gestational diabetes
* mild diabetes
* moderate diabetes
* severe diabetes
! When hospitalizing a pregnant woman with diabetes in 25-26 weeks of pregnancy her severe condition, confused mind and smell of acetone breath were marked. The clinical picture is
* eclampsia
* Renal coma
* Hypoglycemic coma
* Hyperglycemic coma
* Acute cardiovascular insufficiency
! A pregnant woman with diabetes at the 28-29 week has deterioration of state after the injection of 20 units of insulin in 30 minutes, weakness, dizziness, palpitations, trembling of the limbs. Objectively she is excited, the face hyperemic, blood pressure is 110/70, pulse 100 beats per minute, skin is moist. The clinical picture is
* eclampsia
* pre-eclampsia
* Renal coma
* Hyperglycemic coma
* Hypoglycemic coma
! To address the issue about prolongation of pregnancy with diabetes needs the examination in the 1-st trimester of pregnancy at the
* polyclinics
* the day hospital
* women’s clinic
* Department of Endocrinology
* Department of Pathology of pregnant
Obstetric injuries
! Rupture of the posterior commissure and the skin of the perineum corresponds to the following type of birth canal trauma
* First degree laceration of perineum
* Second degree laceration of perineum
* Third degree laceration of perineum
* First degree laceration of cervix
* Second degree laceration of cervix
! Rupture of the skin and muscles of the perineum, the vaginal wall corresponds to the following type of birth canal trauma
* First degree laceration of cervix
* Second degree laceration of cervix
* First degree laceration of perineum
* Third degree laceration of perineum
* Second degree laceration of perineum
! Unrepaired second degree laceration of perineum subsequently leads to following possible complications
* Dyspareunia
* Urinary fistulas
* Rectovaginal fistula
* Prolapse of the vaginal walls
* Varicose of vagina veins
! Rupture of the skin and muscles of the perineum, the vaginal wall, the external anal sphincter and rectal mucosa corresponds to the following type of birth canal trauma
* First degree laceration of cervix
* Second degree laceration of cervix
* First degree laceration of perineum
* Second degree laceration of perineum
* Third degree laceration of perineum
! The most common cause of vaginal rupture during delivery
* Preeclampsia
* Postterm labor
* precipitate labor
* Premature labor
* Pre-labor discharge of amniotic fluid
! Usually cervix is lacerated in its
* posterior lip
* lateral lip
* anterior lip
* lateral and posterior lips
* lateral and anterior lips
! Cervical laceration of I degree is its rupture up
* To 2 cm
* To fundus of uterus
* To fallopian tubes
* For more than 2 cm, not reaching the vault
* Reaching the vault or going over it
! Cervical laceration of II degree is its rupture up
* To 2 cm
* To fundus of uterus
* To fallopian tubes
* For more than 2 cm, not reaching the vault
* Reaching the vault or going over it
! Cervical laceration of III degree is its rupture up
* To 2 cm
* To fundus of uterus
* To fallopian tubes
* For more than 2 cm, not reaching the vault
* Reaching the vault or going over it
! Postpartum bright bleeding from maternal passages. After the speculum inspection of the cervix, cervical laceration is found with the transition to the vaginal vault. The clinical picture corresponds to the following diagnosis
* Uterine rupture
* vaginal laceration
* cervical laceration I stage.
* cervical laceration II stage.
* cervical laceration III st.
! Classification of uterine rupture according to the time of occurrence
* Complete, incomplete, crack
* During pregnancy and childbirth
* threatening, beginning, accomplished
* Spontaneous, violent, mixed
* In the fundus, corpus, lower segment of the uterus and separation from the vaginal vaults
! Classification of uterine rupture according to etiology and pathogenesis
* Complete, incomplete, crack
* During pregnancy and childbirth
* threatening, beginning, accomplished
* Spontaneous, violent, mixed
* In the fundus, corpus, lower segment of the uterus and separation from the vaginal vaults
! Classification of uterine rupture localization
* Complete, incomplete, crack
* During pregnancy and childbirth
* threatening, beginning, accomplished
* Spontaneous, violent, mixed
* In the fundus, corpus, lower segment of the uterus and separation from the vaginal vaults
! Classification of uterine rupture according the clinical course
* Complete, incomplete, crack
* During pregnancy and childbirth
* threatening, beginning, accomplished
* Spontaneous, violent, mixed
* In the fundus, corpus, lower segment of the uterus and separation from the vaginal vaults
! Classification of uterine rupture according to the type of damage
* Complete, incomplete, crack
* During pregnancy and childbirth
* threatening, beginning, accomplished
* Spontaneous, violent, mixed
* In the fundus, corpus, lower segment of the uterus and separation from the vaginal vaults
! Incomplete rupture of the uterus is the damage of its following layers
* All
* Serous
* Mucous
* Serous and muscular.
* mucosa and muscularis
! Uterine rupture occurs more frequently
* In the I stage of labor
* In the III stage of labor
* In the period of exile
* During pregnancy
* In the early postpartum period
! What must be done when uterine rupture along the scar is likely to happen
* Epidural anesthesia
* fetal destruction operation
* induction of labor with oxytocin
* Caesarean section routinely
* Emergency laparotomy, caesarean section
! Normally, changes in pubic symphysis during the pregnancy should not exceed
* 0,4-0,5 cm
* 0,6-0,7 cm
* 0.8-0.9 cm
* 1,0-1,1 cm
* 1,2-1,3 cm
! To confirm the separation of symphysis pubis in pregnancy, the following examination must be done
* ultrasonography
* percussion
* palpation
* Doppler
* Radiography
! Treatment of symphysis pubis diastasis after labor
* Operational
* Physiotherapy
* Medication
* Spa
* Bed rest, pillowtop hammock
! Long term position of the fetus head in one plane may cause
* nuchal arms
* prolapse of cord loops
* Stormy labor
* genitourinary fistula formation
* neglected transverse presentation
! The classification of obstetric fistula
* Typical, atypical
* Primary, secondary
* Intact, infected
* Complicated, uncomplicated
* Spontaneous, violent
! In puerperal week after childbirth of macrosomic fetus involuntary leakage of urine from the vagina occurs. The clinical picture corresponds to the following diagnosis
* Enteric fistula
* Ureteral fistula
* Vesicovaginal fistula
* Cervicovaginal fistula
* Vaginal-perineal fistula
! In a puerperal week after forceps delivery involuntary discharge of feces from the vagina is marked. The clinical picture corresponds to the following diagnosis
* Enteric fistula
* Ureteral fistula
* Vesicovaginal fistula
* Cervicovaginal fistula
* Vaginal-perineal fistula
! Treatment of obstetric fistula
* Douching
* Physiotherapy
* Ointment tampons
* surgery
* Antibiotic therapy
! In a puerperal week after birth vesico-vaginal fistula is found, surgical treatment is required. Optimal time after delivery for reconstructive and plastic surgery is
* 6-12 years
* 6-12 days
* 6-12 hours
* 6 -12 weeks
* 6-12 months
Postpartum hemorrhages
! Active management of the third stage of labor to reduce the probability of postpartum hemorrhage involves the use within the first minute after birth oxytocin 10 IU in the next part of the body
* shoulder
* hip
* buttocks
* forearm
* cervix
! Coagulation factors (fresh frozen plasma, cryoprecipitate, platelets), Antifibrinolytics, YII recombinant blood factor - are drugs used for the causal treatment of postpartum obstetric hemorrhage caused by one of the following reasons
* Trauma - trauma of the birth canal
* Thrombin – impaired coagulation
* Tissue - delay part of placenta in the uterus
* Dysfunctional uterine bleeding
* Tone - a disorder of the contractile function of the uterus
! Massage of the uterus, uterotonics, bimanual compression of the uterus - causal treatment of postpartum obstetric hemorrhage caused by one of the following reasons
* Trauma - trauma of the birth canal
* Thrombin – impaired coagulation
* Tissue - delay part of placenta in the uterus
* Dysfunctional uterine bleeding
* Tone - a disorder of the contractile function of the uterus
! Closure of gaps soft tissues of the birth canal, the correction of inversion of the uterus, uterine rupture laparotomy - causal treatment of postpartum obstetric hemorrhage caused by one of the following reasons
* Trauma - trauma of the birth canal
* Thrombin – impaired coagulation
* Tissue - delay part of placenta in the uterus
* Dysfunctional uterine bleeding
* Tone - a disorder of the contractile function of the uterus
! Polyhydramnios, multiple pregnancy, large fetal lead to hyperinflation of the uterus and are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! Precipitate and prolonged labor, high parity lead to the depletion of the uterus and are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! Chorioamnionitis, fever during labor are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! Uterine myoma, placenta previa are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! Defect of the placenta, uterine scar, high parity, placenta accreta are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! In caesarean section fetal malposition and malpresentation are risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! During vaginal delivery the scar on the uterus is a risk factor of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
!A high parity, placenta location in fundus of the uterus, a wrong management of the 3rd stage of labor are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! Hereditary coagulopathy, liver disease, hematoma, preeclampsia, eclampsia, HELLP-syndrome, fetal death, chorioamnionitis are clinical risk factors of postpartum hemorrhage due to
* disorder of the contractile function of the uterus ("T" - the tone)
* Dysfunctional uterine bleeding
* Delay part of placenta in uterine ("T" - tissue)
* Coagulation disorders ("T" - thrombin)
* Trauma of the birth canal ("T" - injury)
! One of the main causes of bleeding in the late postpartum period is
* uterine atony
* syndrome of intravascular coagulation
* vaginal lacerations
* cervical lacerations
* retained placental fragments
! After delivery of macrosomic fetus in early postpartum period hemorrhage begins. The uterus is flabby, bleeding with clots. Blood loss is 600.0 and continues. The most probable cause of bleeding is
* syndrome of intravascular coagulation
* Uterine rupture
* Uterine atony
* vaginal lacerations
* perineal lacerations
! In early postpartum period uterus is flabby, bleeding with clots. Blood loss is 700 ml and goes on. The most probable cause of bleeding
* Uterine atony
* syndrome of intravascular coagulation
* vaginal lacerations
* cervical lacerations
* perineal lacerations
! When a defect of placenta is found, the recommended management is
* Speculum examination of the cervix
* Waiting for 30 minutes
* intravenous uterotonics
* Instrumental removing of placental fragments
* Manual removing of placental fragments
!After placental expulsion bright bleeding starts. The uterus is firmly contracted. There is no defect of placenta. The most probable cause of bleeding is
* Birth canal laceration
* syndrome of intravascular coagulation
* Uterine atony
* Thrombophilia
* Uterine rupture
! The indication for blood transfusion is hemoglobin level less than (g / l)
* 70
* 80
* 90
* 100
* 110
! Early postpartum hemorrhage due to uterine atony begins. Introduction of uterotonics and bimanual compression were done, but uterus is still soft. Blood loss is 800 ml and goes on. Further management
* Laparotomy, a surgical hemostasis
* Curettage
* Manual examination of the uterus
* Laparotomy, adnexectomy
* Laparotomy, hysterectomy
! After delivery of macrosomic fetus in early postpartum period hemorrhage begins. Blood loss is 500 ml and continues. The placenta is not damaged. Recommended management is
* introduction of uterotonics
* Laparotomy, subtotal hysterectomy
* Bimanual compression of the uterus
* Manual examination of the uterus
* Laparotomy, a surgical hemostasis
! Recommended management in case of placenta accreta
* Intravenous methylergometrinum
* Manual removal of the placenta
* Intravenous oxytocin
* Curettage
* Laparotomy, hysterectomy.
! According to Clinical protocols (2010) in the early postpartum period postpartum vaginal blood loss at 600.0 and against the background necessary to make uterotonic
* Manual removal of the placenta and isolation
* Bimanual compression of the uterus
* Laparotomy, a surgical hemostasis
* Curettage
* Laparotomy, hysterectomy
Purulent septic diseases of newborns.
! One of the clinical forms of common infectious newborn skin diseases is
* sepsis
* erythema
* omphalitis
* conjunctivitis
* exfoliative dermatitis of Ritter
! One of the clinical forms of common infectious mucosal diseases among newborns is
* omphalitis
* pneumonia
* conjunctivitis
* necrotic flegmona
* Figner’s pseudofurunculosis
! One of the clinical forms of common infectious diseases of the umbilical wound among newborns is
* omphalitis
* pneumonia
* conjunctivitis
* necrotic flegmona
* Figner’s pseudofurunculosis
! Classification of sepsis among newborns
* Early and late
* Prenatal, postnatal
* Acute, subacute, chronic
* Primary, secondary, metastatic
* Compensated, decompensated
! The ways of spread of nosocomial infection among newborns
* Endogenous, exogenous, combined
* Primary, secondary, metastatic
* Parenteral, canalicular, contact
* Hematogenous, lymphogenous, intra canalicular
* Contact, enteral, airborne
! Mother and newborn’s rooming-in in the ward prevents from
* incidence of newborns with intrauterine sepsis
* spread of infection in the postnatal department
* Infection of the child with the hands of personnel
* Bacillus carrier among medical personnel
* Infection of medical personnel
! One of the basic contributing factors of infectious and inflammatory diseases among full term infants is
* asphyxia
* macrosomia
* Congenital malformations
* Artificial feeding
* Intrauterine growth retardation
! The divisional pediatrician diagnosed a necrotic phlegmon of the right shoulder of the newborn. The future management of the doctor is
* ambulatory monitoring
* monitoring in the day hospital
* consultation of allergist, dermatologist.
* planned hospitalization to the surgical department
* emergency hospitalization to the surgical department
!Currently the lethality of postnatal sepsis is
* 11-20%
* 21-30%
* 31-40%
* 41-50%
* 51-60%
! The duration of dispensary observation of children who endured neonatal sepsis is
* 3 days
* 3 weeks
* 3 months
* 3 quarters
* 3 years
Malpositions of fetus
!A variant of location of the fetus in the uterus, in which the fetal breech is located at the entrance of the pelvis minor, corresponds to the following fetal presentation:
* frontal
* breech
* facial
* cephalic
* anterior cephalic
!If the legs of the fetus are bended in the hip joints and straightened in the knee joints and extended along the body and the fetal breech is located at the entrance of the pelvis minor, it corresponds to the following fetal presentation:
* footling
* knee
* complete breech
* footling breech
* frank breech
! If the fetus legs are fully bent in the knee joints and pressed to the tummy are located at the inlet of the true pelvis, it corresponds to the following fetal presentation :
* frank breech
* footling breech
* complete breech
* knee
* footling
! If one or both feet of the fetus or his knees are located at the inlet of the true pelvis, it corresponds to the following fetal presentation
* footling
* complete breech
* frank breech
* full knee
* incomplete knee
! If the legs of the fetus are straightened in the hip joints and bent in the knee joints, it corresponds to the following breech fetal presentation:
* complete breech
* incomplete footling
* frank breech
* footling
* knee
!If the legs of the fetus are bent in the hip joints and straightened in the knee joints, it corresponds to the following breech fetal presentation
* complete breech
* frank breech
* full footling
* knee
* footling
! At the breech presentation, the head of the fetus is born with the following size:
* occipitofrontal
* vertical
* suboccipitobregmatic
* suboccipitofrontalis
* occipitomental
! For the prognosis of vaginally delivery with breech fetal presentation the most favorable version is
* complete breech
* frank breech
* incomplete footling
* full footling
* knee
! Leading point of the fetus in frank breech presentation is
* anterior hip
* posterior hip
* perineum
* breech
* anus
! At the frank breech presentation to maintain the normal location of the fetus limbs the following is used
* Mauriceau – Levre maneuver
* Tsovyanov manual aid
* external version
* partial breech extraction
* total breech extraction
!At the footling presentation Tsovyanov manual aid helps to
* birth of the head
* birth of the shoulder girdle
* extraction of the arms and head
* maintain the normal location of the fetus extremities
* change of the footling presentation to frank breech
! At the fetal breech presentation Mauriceau – Levre maneuver helps to
* change of the footling presentation to frank breech
* maintain the normal location of the fetus extremities
* birth of the shoulder girdle
* birth of the arms
* birth of the head
! After membrane rupture in the first stage of labor a woman with breech presentation has a high risk of following complications
* neglected transverse presentation of the fetus
* inadequate labor activity
* precipitate labor
* prolapse of umbilical cord
* nuchal arms
! Nulliparous with complete breech presentation is in the second stage of labor. The fetus is delivered spontaneously until scapula, but there is no further progress during 2 of powerful muscular contractions. The future tactic is
* cesarean section
* augmentation of labor with oxytocin
* Tsovyanov manual aid
* partial breech extraction
* total breech extraction
!In the right position, at anterior variety of breech presentation, the sacrum of the fetus is faced to
* Left, posterior
* Right, posterior
* Left, anterior
* Right, anterior
* To the linea alba
! The picture shows the next fetal lie, position and variety of position
* Oblique, right, anterior
* Transverse, right, posterior
* Longitudinal, breech, left, posterior
* Longitudinal, breech, right, posterior
* Longitudinal, breech, left, anterior
!The picture shows the next fetal lie, position and variety of position
*Transverse, right, posterior
* Oblique, footling presentation, left, anterior
* Longitudinal, footling breech presentation, right, anterior
* Longitudinal, frank breech presentation, left, anterior
* Longitudinal, complete breech presentation, right, posterior
!The picture shows the next fetal lie, position and variety of position
*Longitudinal, complete footling breech presentation, right, posterior
* Longitudinal, incomplete footling breech presentation, left, posterior
* Longitudinal, incomplete footling breech presentation, left, anterior
* Transverse, frank breech presentation, right, anterior
* Longitudinal, complete breech presentation, left, posterior
!At the ultrasonography of pregnant woman with full-term of pregnancy, the both twins are at the longitudinal lie and breech presentation. The Bishop's score by the vaginal examination is 10 points. The preferred birth plan is
* Planned caesarean section
* Emergency caesarean section
* Amniotomy, labor induction with oxytocin
* Vaginal delivery , in the development of inadequate uterine inertia - Cesarean section
* Vaginal delivery, in the development of inadequate uterine inertia – augmentation of labor
!For multiparous with full-term of pregnancy, breech fetal presentation of both twins the preferred birth plan is
* Vaginal delivery
* External version
* Total breech extraction
* Planned caesarean section
* Emergency caesarean section
!The transverse fetal presentation is determined by the
* back
* head
* breech
* chin
* extremities
!The picture shows the next fetal lie, position and variety of position
* Transverse, left, anterior
* Transverse, right, anterior
* Transverse, right, posterior
* Longitudinal, left, posterior
* Oblique, right, posterior
!In a full-term pregnancy with the fetal transverse lie the following is shown
* External version
* Planned caesarean section
* emergency caesarean section
* vaginal delivery
* Cesarean section with the beginning of labor activity
! Neglected transverse lie is characterized by prolapse of:
* foot
* arm
* umbilical cord
* both arms
* nuchal arms
! Hospitalization of pregnant woman with transverse lie for delivery is recommended at (weeks)
* 32-34
* 34-35
* 36-37
* 38-40
* 41-42
! The indication for elective cesarean section in case of fetal transverse lie is
* The second stage of labor
* The first stage of labor
* prenatal discharge of waters
* full-term gestational age
* prolapse of fetal extremities, umbilical cord
! The indication for emergency cesarean section in case of fetal transverse lie is
* The second stage of labor
* prenatal discharge of waters
* The first stage of labor
* full-term gestational age
* prolapse of fetal extremities, umbilical cord
! Fetal oblique lie was revealed at full-term of pregnancy. Management of labor is
* planned caesarean section
* emergency caesarean section
* external version
* External cephalic version
* Prophylactic manual rotation
Contracted pelvis
! Women's pelvis is considered an anatomically contracted pelvis, when at least one of pelvic dimensions is reduced by (cm)
* 0,5
* 0,6-1,4
* 1,5-2,0
* 2,1- 2,5
* 2,6-3,0
! The clinically contracted pelvis is the discrepancy of pelvic sizes of the woman in labor to the
* Fetal weight
* Fetal height
* Fetal head
* Circumference of the fetus shoulders
* Fetal abdominal circumference
!Etiology of contracted pelvis is diagnosed on the basis of medical history of
* life
* disease
* parity
* gynecological
* Obstetric and gynecological
!Indirectly, thecontracted pelvis of women can be indicated by the
* height
* excessive weight
* proportional body type
* degree of development of mammary glands
* disproportional body type
!The special methods of examination allowing to estimate the pecularities of the pelvic structure and some of pelvic dimensions
* observing with gynecological mirrors
* Vaginal examination
* Measurement of Solovyov index
* Examination of the external genitalia
* Examination by Leopold maneuvers
! Thickness of the pelvic bones can be judged by the
* Conjugata diagonalis
* Conjugata externa
* Conjugata vera
* Index of Solovyov
* Michaelis rhombus
!In the basic of classification of a contracted pelvis is used the indicator of
* Index of Solovyov
* external conjugate
* Conjugata vera
* diagonal conjugate
* sizes of the Michaelis rhombus
!The size of obstetrical conjugate at the I degree of contracted pelvis (cm)
* lower than 5,5
* lower than 6,5
* 7,5-6,5
* 9-7,5
* 9-11
!The size of obstetrical conjugate at the II degree of contracted pelvis (cm)
* lower than 5,5
* lower than 6,5
* 7,5-6,5
* 9-7,5
* 9-11
! The size of obstetrical conjugate at the III degree of contracted pelvis (cm)
* lower than 5,5
* lower than 6,5
* 7,5-6,5
* 9-7,5
* 9-11
! The size of obstetrical conjugate at the IV degree of contracted pelvis (cm)
* lower than 5,5
* lower than 6,5
* 7,5-6,5
* 9-7,5
* 9-11
! Currently, the most common form of contracted pelvis is
* generally contracted pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* funnel-shaped pelvis
* simple flat pelvis
!If the size of obstetrical conjugate is normal, but the transverse dimensions are reduced by 0.5-1.0 cm, this pelvis is called
* generally contracted pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* funnel-shaped pelvis
* simple flat pelvis
! The picture shows the next form of anatomically contracted pelvis
* obliquely contracted pelvis
* simple flat pelvis
* flat rachitic pelvis
* transverse contracted pelvis
* generally contracted pelvis
!The pelvic sizes of the nulliparous with height of 162 cm, weight of 52 kg, are 23-26-28-20 cm. These dimensions correspond to the following form of the anatomically contracted pelvis
* generally contracted pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* simple flat pelvis
* obliquely contracted pelvis
! If all the dimensions are reduced to 1.5-2.0 cm, this pelvis is called
* generally contracted pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* funnel-shaped pelvis
* simple flat pelvis
! The pelvic sizes of the nulliparous with height of 152 cm, weight of 54 kg are 23-25-29-18 cm. These dimensions correspond to the following form of the anatomically contracted pelvis
* generally contracted pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* simple flat pelvis
* obliquely contracted pelvis
!The pecularity of mechanism of labor in case of generally contracted pelvis is
* Marked extension of the head
* Head does not perform internal rotation
* Marked flexion of the head at the entrance to the pelvis
* Asynclitism
* Prolonged high standing of the head with the sagittal suture in the transverse dimension of the plane of pelvic inlet
! The pelvis, which is characterized by decrease obstetric conjugate and increase of all other anteroposterior diameters, as well as with flat sacrum and wide pubic arch is called
* generally contracted pelvis
* flat rachitic pelvis
* transverse contracted pelvis
* funnel-shaped pelvis
* simple flat pelvis
! The pelvis in which the sacrum is more deeply embroiled to the pelvis without changing the shape and curvature of the sacrum and all anteroposterior diameters of this pelvic cavity are moderately shortened is called
* generally contracted pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* simple flat pelvis
* funnel-shaped pelvis
! The asynclitism, prolonged transverse low standing of the head with the sagittal suture, extension of the head are peculiarities of mechanism of the labor at the next form of a contracted pelvis
* contracted pelvis
* simple flat pelvis
* transverse contracted pelvis
* flat rachitic pelvis
* generally contracted pelvis
! A parturient woman during the second stage of labor at vaginal examination the cervical dilatation is full, there are no amniotic membranes, fetal head is pressed to the plane of the inlet of pelvis, the sagittal suture is in the transverse size and shifted to the pubis. The clinical presentation corresponds to the following insertion
* Occipital posterior
* Occipital anterior
* Anterior asynclitism
* Posterior asynclitism
* Brow presentation
! The issue of a clinically contracted pelvis is solved definitively in the next opening of the cervix (cm)
* 6
* 7
* 8
* 9
* 10
! The difficult urination, swelling of cervix uteri, pathological retraction ring, painfullness of lower segment are symptoms of following obstetric situation
* Uterine rupture
* Incoordinated uterine activity
* Clinically contracted pelvis
* Anatomically contracted pelvis
* Precipitate labor
! One of the serious complications of clinically contracted pelvis is
* Uterine rupture
* infection
* obstetric fistulae
* disorder of urination
* Separation of the symphysis pubis
!The special obstetrical examination, which allows to determine the location of the fetal head is
* Vaginal examination
* External obstetric examination
* Speculum examination
* Examination of the external genitalia
* Ultrasound examination