Growth Discrepancies ob30-ob33.

Intrauterine Growth Restriction iugr.

***) All of the following maternal factors are associated with IUGR, except:

Poor nutrition with anemia

Heavy smoking

Toxemia

Gestational diabetes

Alcohol consumption

Answer: D* Gestational diabetes

Macrosomia.

***) With fetal macrosomia all of the following complications are increased, except:

Fetal asphyxia

Brachial plexus injury

Post partum hemorrhage

Cord prolapse

Neonatal hypoglycemia

Answer: D* Cord prolapse

Polyhydramnios.

***) All of the following may cause polyhydramnios, except:

Diabetes mellitus

Multiple pregnancy

Anencephalic fetus

Fetal renal atresia

Fetal esophageal atresia

Answer: D* Fetal renal atresia

***) Polyhydramnios could be associated with all of the following, except:

Renal agenesis

Esophageal atresia

Anencephaly

Duodenal atresia

Illeal atresia

Answer: A* Renal agenesis

Oligohydramnios.

***) All of the following anomalies are associated with severe maternal oligohydramnios, except:

Potter's syndrome

Dysplastic kidneys

Pulmonary hypoplasia

Musculoskeletal abnormalities

Gastrointestinal tract obstructions

Answer: E* Gastrointestinal tract obstructions

***) All of the following are associated with oligohydramnios, except:

Renal agenesis

Esophageal atresia

Pulmonary hypoplasia

Urethral atresia

Amnion nodosum

Answer: B* Esophageal atresia

Fetus and Delivery ob33-ob35.

Pelvis.

***) The shortest antero-posterior diameter of the pelvis is:

True conjugate

Diagonal conjugate

Obstetrical conjugate

Antero-posterior diameter of plane of midpelvis

Antero-posterior diameter of inferior straight

Answer: C* Obstetrical conjugate

***) In young women the most common type of pelvis is:

Anthropoid pelvis

Android pelvis

Platypelloid pelvis

Gynecoid pelvis

Rachitic pelvis

Answer: D* Gynecoid pelvis

***) The android pelvis characteristically has the following, except:

A narrow sacroischiatic notch

A parallel pelvic side walls

A narrow sub-pubic angle

A prominent ischial spines

A narrow outlet A-P diameter

Answer: B* A parallel pelvic side walls

Fetal Skull.

***) Regarding the head vertex, all the following are true except:

It is bounded in front by the anterior fontanel and the coronal sutures

It is the area between the 2 halves of the frontal and the 2 parietal bones

It is the area bounded behind by the posterior fontanel and the lambdoidal suture

It is the area bounded laterally by lines passing through the parietal eminences

It is felt in the majority of cases during vaginal examination

Answer: B* It is the area between the 2 halves of the frontal and the 2 parietal bones

***) The posterior fontanel is defined:

The area lies between the sagittal suture and the lambdoid suture

The area lies between the coronal and sagittal sutures

The area lies between the coronal and temporal sutures

The area lies between the anterior and lambdoid sutures

The area lies between the sagittal suture and biparietal bones

Answer: A* The area lies between the sagittal suture and the lambdoid suture

***) The longest anterio-posterior diameter of the fetal head is:

Occipito-frontal diameter

Suboccipito-pregmatic diameter

Occipito-mental diameter

Submento-pregmatic diameter

Mento-vertical diameter

Answer: E*Mento-vertical diameter

***) In normal developing fetus at 36 weeks pregnancy, the most like measurement of the BPD (biparietal diameter) of the head is:

9.5 cm

9 cm

12 cm

8.5 cm

8 cm

Answer: A* 9.5 cm

***) Regarding biparietal diameter, all the following are true except:

The biparietal diameter is the distance between the parietal eminences

The measurement is 9.5 cm

In vertex presentation it is the largest presenting diameter

It is measured by ultrasound scanning for the maturity of fetus

It has no relation to the engagement of the head in the pelvis

Answer: E* It has no relation to the engagement of the head in the pelvis

***) Engagement of the fetal head refers to the relationship between:

Biparietal diameter and ischial spines

Biparietal diameter and pelvic brim

Vertex and pelvic outlet

Vertex and ischial spine

Head and pelvic outlet

Answer: B* Biparietal diameter and pelvic brim

***) In primigravida at full-term in labor, the most common position of the head is:

ROT (right occiput transverse)

LOT (left occiput transverse)

LOA (left occiput anterior)

ROA (right occiput anterior)

DOP (direct occiput posterior)

Answer: C* LOA (left occiput anterior)

***) Cephalohematoma is most commonly found over the:

Frontal bone

Temporal bone

Parietal bone

Occipital bone

Ethmoid bone

Answer: C* Parietal bone

Malpresentation and Malposition.

***) The transverse lie in multipara at term in labor best treated by:

External version

Internal version and extraction

Pitocin induction

Cesarean section

Internal version, than oxytocin induction

Answer: D* Cesarean section

***) One of the following is absolute indication for cesarean section:

Brow presentation

Anterior face presentation

Occipito-posterior position

Right occipital presentation

Transverse arrest of the head

Answer: A* Brow presentation

***) In case of face presentation during labor, all of the following are felt on vaginal examination, except:

Chin

Mouth

Nose

Anterior fontanel

Orbital ridge

Answer: D* Anterior fontanel

***) The most common cause of breech presentation is:

Polyhydramnios

Placenta previa

Prematurity

Hydrocephalus

Multiple pregnancy (twin gestation)

Answer: C* Prematurity

***) Breech presentation is associated with the following, except:

Prematurity

Polyhydramnios

Oligohydramnios

Hydrocephaly

Postmaturity

Answer: E* Postmaturity

***) Breech presentation diagnosed antenatally at 37 weeks gestation, is best managed by:

Cesarean section

External cephalic version

X-ray maturity

Ultrasonography and observation

Oxytocin infusion of lower femoral epiphysis are seen by X-ray

Answer: B* External cephalic version

***) Non-engagement of the fetal head in the second stage of labor is due to all of the following, except:

Mal position

Hydrocephaly

Contracted pelvis

Compound presentation

Anencephaly

Answer: E* Anencephaly

***) A high head at term could be due to the following except:

Wrong dates

Cephalopelvic disproportion

Placental abruption

An occipito-posterior position

Placenta previa

Answer: C* Placental abruption

***) In face presentation with head not engaged in mento-posterior position the ideal treatment is:

Forceps delivery as mento-posterior

Forceps rotation to mento-anterior then forceps delivery

Vacuum delivery

Cesarean section

Internal podalic version and breech extraction

Answer: D* Cesarean section