The physiology of the fetus. Anatomical and physiological characteristics of a newborn

! The respiratory rate per minute of a healthy newborn is

* 10-20

* 20-30

* 30-60

* 60-90

* 90-120

 

! The normal hemoglobin in a healthy newborn is (g / l)

* 63-112

* 113-132

* 133-182

* 183-232

* 233-282

 

! Group reflexes among newborns, reflecting the state of the facial, trigeminal, hypoglossal and glossopharyngeal nerves

* Grasping, plantar, protective

* Crawling, support, automatic walk

* Asymmetrical neck-tonic, search

* Search, sucking, Babkin's reflex

* Babkin's reflex, search, grasping

! One of the signs of the immaturity of newborn

* large lips of pudendum cover small lips of pudendum

* Solid ear and nasal cartilages

* The absence of vernix

* Dense bones of the skull

* Body weight of 2500.0 grams or more

! One of the signs of the immaturity of newborn

* Dense bones of the skull

* The absence of vernix

* Solid ear and nasal cartilages

* Body weight of 2500.0 grams or more

* Low position of the umbilical ring

! Signs of preterm infants

* beef-steak hand

* Reduced skin turgor

* Lean vernix caseosa

* Dense bones of the skull, narrow joints and springs

* Soft bones of the skull, wide joints and springs

! The most constant and true sign of maturity of newborn is his

* weight

* length

* Head circumference

* Abdominal circumference

* Chest circumference

! One of the signs of maturity term infants is

* Length less than 47 cm

* Testicles descended into the scrotum

* Body weight less than 2500.0 grams

* Location of the umbilical ring is closer to the xiphoid process

* Soft bones of the skull, wide joints and springs

! Symptoms of genital crisis of newborn girls

* Hypertrophy of the clitoris

* Hypertrichosis, hirsutism

* Hypertrophy of the clitoris, hirsutism

* Hypertrophy of the labia minora

* Breast tenderness, bleeding from the genital tract

! Symptoms of genital crisis of newborn boys

* monorchism

* hypospadias

* hypertrichosis

* cryptorchidism

* Breast engorgement

! One sign of the postmaturity of newborn are

* Thick skull bones, narrow joints and springs

* Low position of the umbilical ring

* Lanugo on the back, shoulders, chest,

* Soft ear and nasal cartilages

* Abundance of vernix

! Physiological jaundice in the newborn is caused by

* Congenital hepatitis

* Hemolytic disease

* Rh-conflict pregnancy

* Mechanical blockage biliary tract

* Reduction in the functional activity of hepatocytes

! To adaptation (borderline) states of the neonatal period is applied

* Weight loss of 15% of the birthweight

* Hemolytic jaundice

* Toxic erythema

* Vesicles-pustulosis

* conjunctivitis

! According to the "Main clinical protocols and orders of the MH of RK in obstetrics and neonatology" (2010), assessment of the newborn at birth is used to determine

* The availability of hypothermia

* Further tactics

* Blood group and Rh factor

* Contraindications to vaccination

* Feasibility of breastfeeding

! According to the "Main clinical protocols and orders of MH of RK in obstetrics and neonatology" (2010), an adequate breathing of the newborn, the presence of malformations and birth trauma can take it to one of the following groups

* Immediately start resuscitation

* Care for healthy newborns

* Special care baby close

* Special care for the small baby

* Caring for a child with congenital / birth trauma

! A full physical examination of the newborn, its weighing, measuring and processing of umbilical cord are made through the next period of time after childbirth

* 20 seconds

* 2 minutes

* 20 minutes

* 2 hours

* 2 days

! Breastfeeding of a newborn is conducted

* When the newborn is ready to be fed

* When the mother is ready to feed

* 12 hours after birth

* At the request of the mother

* At the request of a doctor

! Providing temperature adaptation, maternal colonization microflora, early initiation of breastfeeding, psycho-emotional contact between mother and child, the formation of kinship allows to contact

* With other family members

* "Skin to skin" on the father's chest

* "Skin to skin" on the mother's breast

* With a midwife, delivering a baby

* With a doctor, inspecting the newborn

! In the case of caesarean section provide thermal protection for the newborn home microflora colonization and establishment of family ties allows to contact

* "Skin to skin" on the father's chest

* "Skin to skin" on the mother's breast

* With a midwife, delivering a baby

* "Skin to skin" to other family members

* With a doctor, inspecting the newborn

 

Physiology of fetus. Anatomical and physiological characteristics of a newborn.

 

! The duration of early neonatal period is

* 168 minutes

* 168 hours

* 168 days

* 168 weeks

* 168 months

 

!The duration of early neonatal period (days)

* 1

* 3

* 5

* 7

* 9

 

! The duration of the neonatal period (weeks)

* 1

* 2

* 3

* 4

* 5

 

! The duration of the neonatal period (days)

* 1

* 7

* 14

* 28

* 42

 

! The child from birth up to 4 weeks of life is called

* Newborn

* Child

* Immature

* Fetus

* Mature

 

! Newborn’s normal body temperature is (° C)

* 34,0-34,4

* 34,5-35,4

* 36,5-37,5

* 37,6-38,0

* 38,1-38,5

 

! The respiratory rate per minute of a healthy newborn is

* 10-20

* 20-30

* 30-60

* 60-90

* 90-120

 

! The normal hemoglobin of a healthy newborn is (g / l)

* 63-112

* 113-132

* 133-182

* 183-232

* 233-282

 

! A group of newborn reflexes, reflecting the state of the facial, trigeminal, hypoglossal and glossopharyngeal nerves

* Grasping plantar protective

* Crawling, support, automatic walk

* Asymmetrical neck-tonic, search

* Search, sucking, hand-mouth-head

* hand-mouth-head, search, grasping

 

! A sign of the immaturity of a newborn is

* Dense bones of the skull

* The absence of grease

* Soft ear and nasal cartilages

* Normal location of the umbilical ring

* Bloom only in the upper back, shoulders

 

! A sign of immaturity of a newborn is

* Dense bones of the skull

* The absence of grease

* Solid ear and nasal cartilages

* Body weight 2500.0 grams and more

* Low position of the umbilical ring

 

!. Signs of preterm infants

* Hands of "washerwoman"

* Reduced skin turgor

* Scanty of vernix

* Dense bones of the skull, narrow joints and fontanel

* Soft bones of the skull, wide joints

 

! Heart rate, respiratory activity, reflex irritability, muscle tone and color of the skin - this is the criteria of the scale.

* Apgar

* Bishop

* Solovyov

* Michaelis

* Silverman

 

! The most constant and true sign of maturity is newborn’s

* weight

* length

* Head circumference

* Abdominal circumference

* Chest circumference

 

! One sign of maturity is the full-term newborn’s

* Length of less than 47 cm

* Abdominal circumference

* Head circumference

* Chest circumference

* Body weight of 2500 grams or more

 

! A sign of maturity of term infants are

* Length of a child less than 47 cm

* Testicles descended into the scrotum

* Body weight less than 2500.0 grams

* Location of the umbilical ring is closer to the heart

* Soft bones of the skull, wide joints and springs

 

! A sign of maturity is the full-term newborns

* Length of a child less than 47 cm

* Body weight less than 2500.0 grams

* Labia majora are covered with small

* Location of the umbilical ring is closer to the heart

* Soft bones of the skull, wide joints and springs

 

! Signs of genital crisis of newborn girls

* Malnutrition clitoris

* Hypertrichosis, hirsutism

* Hypertrophy of the clitoris, hirsutism

* Hypertrophy of the labia minora

* Breast tenderness, bleeding from the genital tract.

 

! Signs of genital crisis of newborn boys

* Monorchism

* Hypospadias

* Hypertrichosis

* Cryptorchidism

* Breast engorgement

 

! A sign of the extended stay of newborn is

* Thick skull bones, narrow joints and springs

* Low position of the umbilical ring

* Lanugo on the back, shoulders, chest,

* Soft ear and nasal cartilages

* Abundance of grease

 

! A sign of the extended stay of newborn is

* Body weight more than 4000 grams

* Soft ear and nasal cartilages

* The length of the newborn, more than 47 cm

* Ample vernix on the body

* Increasing the density of the skull bones, narrow joints and springs

 

! Clinical forms of weight loss of a newborn

* Acute and chronic

* Mild, moderate, severe

* Minimum, maximum

* Physiological, pathological

* Compensated, decompensated

 

! Physiological weight loss relatively to the initial one at the time of birth is (%)

* 0-2

* 3-10

* 11-18

* 19-26

* 27-35

 

! Transient weight loss of newborns from the original mass is observed on the following day

* 12

* 3-4

* 5-6

* 7-8

* 9-10

 

!. The body weight of infants at birth is 3000.0 grams, on the 5th day of life - 2850.0 grams. Transient weight loss of a newborn is

* Border

* Pathological

* Physiological

* Compensated

* Decompensated

 

! Physiological jaundice of a newborn is caused by

* Congenital hepatitis

* Hemolytic disease

* Rh-conflict pregnancy

* Mechanical blockage biliary tract

* Reduction in the functional activity of hepatocytes

 

! Adaptation (border) states of the neonatal period is

* Weight loss of 10-15% to the original mass

* Hemolytic jaundice

* Toxic erythema

* Vesicles-pustulosis

* conjunctivitis

 

 

! According to the "main clinical protocols and orders of the HM RK in obstetrics and neonatology" (2010), assessment of the newborn at birth is used to determine

* The availability of hypothermia

* Further tactics

* Blood group and Rh factor

* Contraindications to vaccination

* Feasibility of breastfeeding

 

! Assessment of the newborn is done on the following time after birth

* 30 seconds

* 60 seconds

* after 15 minutes

* In 2 hours

* Immediately

 

! Apgar score to determine the state

* Newborn

* Puerperal

* Pregnant

* Mothers

* Fetus

 

!Caring for the health of newborns in the first 2 hours after birth is

* bathing

* weighing

* Processing of umbilical cord

* Measurement of body

* Contact "skin to skin" on the mother's breast

 

Abnormal labor

!Slow labor is more common among women with
* Pre-labor discharge of amniotic fluid
* Rh-negative blood factor
* Low body mass index
* Macrosomia
* pre-eclampsia

!. Objective routine method for diagnosing abnormalities of labor
* partograph
* Palpation of the uterus
* ultrasonography
* Auscultation of fetal heart
* Doppler study

! On partograph the curve number I corresponds to the following type of labor

* normal labor
* precipitate labor
* Prolonged latent phase of labor
* incoordinated uterine activity

* Prolonged active phase of labor

! On the partograph the curve number II corresponds to the following form of labor

* false labor
* precipitate labor
* Prolonged latent phase of labor
* incoordinated uterine activity

* Prolonged active phase of labor

 

! The weakness of expulsive efforts is an indication for
* amniotomy
* Induction of labor
* Vacuum extraction (ventouse) of the fetus
* Caesarean section operation
* Dynamic observation of partograph

! Management at prolonged latent phase of a woman with intact fetal bladder
* amniocentesis
* cesarean section
* Epidural anesthesia
* induction of labor with oxytocin
* Amniotomy, augmentation with oxytocin

! In the partograph the curve number III corresponds to the following form of labor

* normal labor
* precipitate labor
* Prolonged active phase of labor

* Prolonged latent phase of labor
* incoordinated uterine activity

! The management at the case of the secondary weakness of labor among women with a satisfactory fetal
* cesarean section
* Epidural anesthesia
* forceps
* intravenous induction administrat of oxytocin
* Intravenous administration of oxytocin labor induction

! Regular monotonous labor pains happen every 6 minutes lasting 25 seconds within 2 hours are typical for
* False labor
* Slow labor

* precipitate labor
* Normal labor
* Incoordinate uterine activity

! A secondary weakness of the 2nd stage of labor, a threatened condition of the fetus, fetal head is on the pelvic floor. The management is
* cesarean section
* induction with oxytocin
* forceps
* induction with prostaglandins
* Treatment of threatened fetus condition

 

! Strong uterine contraction with a frequency of more than one every 2 minutes, rapid cervical dilatation are features of
* False labor
* weak labor
* precipitate labor
* normal labor

* incoordinated uterine activity

! Irregular, painful, long uterine contractions and slow cervical dilatation are symptoms of
* weak labor
* precipitate labor
* normal labor

* False labor
* incoordinated uterine activity

 

!One of the complications of induction is overdose of oxytocin, which can lead to
* False labor
* Persistent weakness of labor
* Secondary weakness of labor
* Untimely discharge of amniotic fluid
* incoordinated uterine activity

!. The management of precipitate labor is
* cesarean section
* Spinal anesthesia
* Introduction of tocolytics
* Epidural anesthesia
* Induction with oxytocin

 

! Contraindications for oxytocin infusion is
* cephalopelvic disproportion
* pre-labor discharge of amniotic fluid
* second stage of labor
* normal size of pelvis
* average size of fetus

 

! One of the contraindications for labor induction is
* Scar on the uterus after cesarean section corporal
* pre-labor membrane rupture
* Active phase and second stage of labor
* Normal sizes pelvis
* The average size of the fetus

 

! Labor induction is contraindicated in women with the following
* Increased sensitivity to oxytocin
* Post-term pregnancy
* pre-labor discharge of amniotic fluid
* Chorioamnionitis
* Preeclampsia

Physiology of postpartum period

! Postpartum period is divided into

* Early and late

* Urgent, overdue

* Primary, secondary

* Acute, subacute, chronic

* Compensated, decompensated

 

!. The duration of early postpartum period is

* 24 seconds

*24 minutes

* 24 hours

*24 days

*24 weeks

 

! The duration of early postpartum period (hour) is

* 1

* 6

* 12

* 24

* 48

 

! The duration of post-partum period (weeks) is

* 2-3

* 4-5

* 6-8

* 9-11

* 12-13

 

! Postpartum period begins after the delivery of the placenta, and continues

* 6 years

* 6 months

* 6 weeks

* 6 nights

* 6 hours

 

! Uterus weight after childbirth is 1000 grams. As a result of the evolution at the end of the postnatal period it weighs

* 6

* 60

* 600

* 6000

 

! Physiological postpartum uterine involution corresponds to a decrease of the height of the uterine fundus a day (cm)

* 1

* 2

* 3

* 4

* 5

 

! When does the physiological involution of postpartum uterine cervical canal end with the formation of the next day?

* 2

* 10

* 20

* 30

* 42

 

! Physiological involution of the uterus after childbirth occurs due to

* Parity

* Agalactia

* Diet and hygiene puerperal

* Aseptic inflammation of the uterus

* Uterine contractile activity

 

!. The discharge from the genital tract after delivery is called

* Beli

* blood

* Lochia

* Exudate

* Transudate

 

! In physiological postpartum period the composition of lochia is

* Blood, urine, pus, fecal fragments

* Transudate, pus, mucus, fragments perimetry

* Whites, serous exudate, fragments of endometrial

* Blood, mucus, muscle cells and fragments of decidua

* Mucus fragments of endocervical, stratified squamous epithelium

 

! During the physiological postpartum period in the uterus a special wound secret - lochia is formed, which in the first 3 days is called

* Lochia alba

* Lochia serosa

* Lochia rubra

* Lochia albo-serosa

* Lochiarubro-serosa

 

! During the physiological postpartum period in the uterus a special wound secret - lochia is formed, which in the first 4-7 hours is called

* Lochia alba

* Lochia serosa

* Lochiarubra

* Lochia albo-serosa

* Lochiarubro-serosa

 

!. During the physiological postpartum period in the uterus a special wound secret - lochia is formed, which on the 8th day is called

* Lochia alba

* Lochia serosa

* Lochi arubra

* Lochia albo-serosa

* Lochiarubro-serosa

 

! In the case of physiological epithelization during puerperium the inner surface of the uterus, except placental site finishes on day

* 10

* 20

* 30

* 42

! In physiological postpartum period epithelialization of placental site ends on day

* 5

* 10

* 20

* 30

* 42

 

! When saline during the postnatal period uterine ligaments are restored by the end of the next week

* 1

* 2

* 3

* 4

* 5

 

! Postpartum lactation is influenced by

* LH

* FSH

* Oxytocin

* Prolactin

* Vasopressin

 

! The intensified blood flow to the breast and its engorgement can be noted on the following day of postpartum period

* 12

* 3-4

* 5-6

* 7-8

* 9-10

 

! During physiological postpartum period mammary glands produce "mature breast milk" on day

* 12

* 3-4

* 5-6

* 7-8

* 9-10

 

! During physiological postpartum period mammary glands produce "colostrum" from the following day

* 1-2

* 3-4

* 5-6

* 7-8

* 9-10

 

! In physiological postpartum period mammary glands produce "transition milk" from the following day

* 1-2

* 3-4

* 5-6

* 7-8

* 9-10

 

Postpartum purulent-septic diseases

! Among postpartum diseases the purulent-septic complications are

* 1-2%;

* 3-4%;

* 4-6%;

* 7-9%;

* 10-12%

! The most common cause of postpartum septic diseases are

* Aerobes

* Anaerobes

* Association of viruses and chlamydia

* Association of aerobes and anaerobes

* Association of protozoa and yeast

 

! According to Sazonov - Bartels classification one of the clinical forms of the first phase of the spread of postpartum septic infection is

* sepsis

* peritonitis

* parametritis

* Postpartum ulcer

* Pelvioperitoniist

 

! According to Sazonov - Bartels classification one of the clinical forms of the second phase of the spread of postpartum septic infection is

* sepsis

* peritonitis

* parametritis

* Postpartum ulcer

* Pelvioperitonitis

 

! According to Sazonov - Bartels classification one of the clinical forms of the third phase of the spread of postpartum septic infection is

* sepsis

*peritonitis

* parametritis

* Postpartum ulcer

* Pelvioperitonitis

 

! According to Sazonov - Bartels classification one of the clinical forms of the fourth stage of the spread of postpartum septic infection is

* sepsis

* peritonitis

* parametritis

* Postpartum ulcer

* Pelvioperitonitis

 

! The most common form of postpartum septic infection is

* mastitis

* peritonitis

* parametritis

* Endometritis

* Pelvioperitonitis

 

! Puerperal on the 5th day after birth increased body temperature to 37,5oS, lower abdominal pain during labor - manual removal of placenta detainees are often, leukocytosis - 13,2h109 / l, leukocyte formula shift to the left, ESR - 45 mm / hour. The clinical picture corresponds to the following diagnosis

* salpingitis

* parametritis

* Pelvioperitonitis

* Endometritis, severe

* Endometritis, a mild form

 

! puerperal on the 2nd day after birth increased body temperature to 39,0oS, abdominal pain, weakness, lochia with ihoroznym smell, tachycardia, chills, during labor - manual removal of placenta detainees are often, leukocytosis - 19,2h109 / l , leukocyte formula shift to the left, ESR - 50 mm / h. The clinical picture corresponds to the following diagnosis

* salpingitis

* parametritis

* Pelvioperitonitis

* Endometritis, severe

* Endometritis, a mild form

 

! puerperal on the 2nd day after birth increased body temperature to 39,0o C, abdominal pain, weakness, lochia with ihoroznym smell, tachycardia, chills, during labor - manual removal of placenta detainees are often, leukocytosis - 15,2h109 / l, leukocyte formula shift to the left, ESR - 40 mm / h. Diagnosed with endometriosis, severe. Medical tactic

* Vitamin

* Antibiotic

* Acupuncture

* hysterectomy

* Plazmotransfuzion

 

! The choice of antibiotic therapy among postpartum women with septic infection is carried out taking into account the

* Indicators of leukocytosis

* patient’s condition

* Susceptibility

* Localization of inflammation

* The duration of the postpartum period

 

! In the case of postpartum endometritis non-pharmacological treatment includes

* Uterine massage

* Balanced diet

* Acupuncture

* Local hypothermia

* UV exposure

 

! In the postpartum endometritis indication for curettage of the uterus is the presence of

* Hematometra

* Hematocolpos

* Subinvolution of uterus

* Placental tissue residues

* Residues decidua

 

! To indicate puerperal sepsis, if the primary site of infection takes place, the following number of symptoms of systemic inflammatory response syndrome is enough

* At least 1

* At least 2

* At least 3

* At least 4

* At least 5

 

! For the systemic inflammatory response syndrome in addition to the more than 38°С of hyperthermia, tachycardia greater than 90 beats per 1 minute, 20 tachypnea more than 20 per 1 minute, leukocytosis more 12x10^9/ l, the following is also true

* Hypothermia less than 36°С, leukopenia less 4.0x10^9/ l

* hypothermia with less than 36.6°С, leucopenia less 5.0x10^9/ l

* hypothermia with less than 36.6°С, leucopenia less 6.0x10^9/ l

* hyperthermia with 37°С, bradycardia less than 60 beats per 1 minute

* hyperthermia with 37.5°С, bradycardia less than 50 beats per 1 minute

 

 

! Obstetric peritonitis after cesarean section is most often caused by

* Vaginal hematoma

* unstable suture on uterus

* unstable suture on vagina

* unstable suture on cervix

* unstable suture on perineum

 

! At the case of peritonitis after cesarean section the following must be done

* Hysteroscopy, drainage of the uterus

* Laparotomy, abdominal drainage

* Laparoscopy, abdominal drainage

* Laparotomy, amputation of the uterus, abdominal drainage

* Laparotomy, hysterectomy, abdominal drainage

 

! The main role in the treatment of obstetric peritonitis is given to the next type of therapy

* surgical

* symptomatic

* Physiotherapy

* Detoxification

* Immunomodulators

 

!. The most common cause of septic shock are

* Fungi of Candida

* Viruses, protozoa

* Anaerobic microorganisms

* Gram-negative bacteria

* Gram-positive microorganisms

 

! Septic shock - suddenly emerging and progressive dysfunction of vital systems, arising from the crisis and microcirculation due macrocirculation

* Severe endometritis

* Massive bleeding

* Anaphylaxis medication

* Transfusion of incompatible blood

* Exo-and endotoxins of microorganisms

 

! There are the following phases of septic shock development

* True, false

* Early, beginning, late

* Warm, cold, irreversible shock

* Primary, secondary, metastatic

* Beginning, intermediate, terminal

 

! The most common cause of puerperal mastitis is

* Bacteroides spp.

* Escherichia coli

* Candida albicans

* Staphilococcus aureus

* Streptococcus hemolyticus

 

! The patient on the 5th day after birth temperature increase to 38,0 ° C, bloating and tenderness of the right breast. Objectively, the right breast is uniformly increased in volume, painful, hyperemic skin, cracked nipples. The clinical picture corresponds to the following diagnosis

* Serous mastitis

* Abscess, mastitis

* Infiltrative mastitis

* Abscessed mastitis

* Gangrenous mastitis

 

!At the case of serous mastitis the following treatment must be fulfilled

* Surgery

* Antibacterial

* Suppression of lactation

* UV irradiation of a mammal gland

* Extracorporeal detoxification

 

! puerperal on the 10th day after birth raising the temperature to 39 ° C, chills, loss of appetite, poor sleep, pain in the right breast for 5 days, the doctor did not address. Objectively, the right breast is increased in volume, skin hyperemia, deep in the gland seal areas and fluctuations painful. The clinical picture corresponds to the following diagnosis

* Lactostasis

* Hypogalacty

* Serous mastitis

* Purulent mastitis

* Infiltrative mastitis

 

! At the case of purulent mastitis the main treatment is

* Surgery

* Antibacterial

* Suppression of lactation

* UV irradiation of a mammal gland

* Extracorporeal detoxification