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Exam (elaborations)

Exam (effects) Causes of diseases 2.2 Theme 7 (STD, pregnancy, childbirth, reproductive anatomy, contraception and hormones)

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I've reviewed Theme 7 Answers.pdf and the questions mainly revolve around these four main topics: Sexual health & STDs — risk groups, chlamydia, HIV post-exposure prophylaxis, SENSE centers, condom use. Pregnancy & childbirth — maternal circulation changes, fetal heart rate monitoring, complications (pre-eclampsia, diabetes, postpartum haemorrhages), birth interventions. Reproductive anatomy & embryology — development of internal and external genitalia, hormone balance (FSH/LH/estrogen), abnormalities such as hypospadias and CBAVD. Contraception, endocrinology & fertility — pill types and side effects, DMPA, endometriosis, menopause, pituitary gland problems (Sheehan), fertility disorders Nowadays, it's no longer called theme 7, but these are the topics that will be used for an exam in, I think, semester 2, so check if the topics match your exam!

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20160331 G2020 2.2.2 ENG – VERSION A


Closed book part

• Time closed book part: 45 minutes
• Total time assessment: 120 minutes
• When you are finished with the closed book part, you need to submit this by using the
button ‘Submit’ (at the bottom of your screen). You will get a warning if you did not give
an answer for all the questions. Click ‘Cancel’ to return to the questions to fill in the
missing answers.
• After submitting the closed book part, you cannot return to the questions and the given
answers of the closed book part. This is the same for the open book part.
• After submitting the closed book part you will automatically continue with the open book
part.
• You are allowed to use your books after the signal of the invigilators.
• You are not allowed to take the assessment, or parts of it, with you. Doing so will be
judged as fraud.

To start the closed book part of the test you need to use the ‘Submit’ button at the
bottom of your screen.

B 1. Unprotected sexual intercourse is a risk factor for STD (Sexually Transmuittable Diseases) . Which
of the following groups of young people , 12-24 years of age, are known to report always using a
condom when having sex with their last partner?

o (a) young heterosexual men and women
(b) boys of Moroccan and Turkish descent
o (c) men who have sex with men (MSM)



A 2. The most common STD in the western world is an infection with Chlamydia trachomatis. Infertility is
a late complication of Chlamydia infection. This statement is:

(a) Right
(b) False


C 3. The most pronounced functional change in the maternal haemodynamic system during pregnancy is:

(a) increased heart rate
(b) reduced ventricular stroke volume
(c) increased cardiac output
(d) increased peripheral vascular resistance


B 4. When examining a pregnant woman, physicians will check the foetal heart rate. A normal frequency
is:

(a) always more than 150 beats/min
(b) always between 110 and 160 beats/min
(c) varying from 80 to 180 beats/min




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, 20160331 G2020 2.2.2 ENG – VERSION A


(d) constant at 130 beats/min


D 5. Which foetal heart rate pattern is associated with foetal hypoxia?

(a) recurrent accelerations
(b) base heart rate between 110 and 160 beats/min
(c) early decelerations
(d) late decelerations



C 6. With a second-degree postpartum perineal rupture:

(a) the superficial anal sphincter is torn partially
(b) the anal mucosa is torn
(c) the superficial anal sphincter is not torn
(d) the deep anal sphincter is torn completely

D 7. One tool for foetal heart rate monitoring is the NST (nonstress test) using CTG (cardiotocography).
This involves:

(a) separate registrations of uterine contractions and foetal movement
(b) separate registrations of foetal and maternal heart rhythms
(c) simultaneous registrations of uterine contractions and foetal ECG
(d) simultaneous registration of uterine contractions and foetal heart rate




D 8. What is a caput succedaneum in the context of childbirth?

(a) the round head of a breech presentation baby
(b) the flexed head of a baby in cephalic presentation
(c) the head of the woman giving birth (due to thrombosis)
(d) an accumulation of fluid under the skin of the lowest lying part of the head of the baby


B 9. The recommended method for calculating the expected date of delivery (40 weeks) is:

(a) if the cycle is regular, adding 40 weeks to the first day of the last period
(b) transvaginal ultrasound scan between 10 and 12 weeks to determine foetal crown-coccyx
length
(c) transabdominal ultrasound between 12 and 16 weeks to measure foetal biparietal diameter




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, 20160331 G2020 2.2.2 ENG – VERSION A


A 10. Pregnancy changes the carbohydrate metabolism in such a way that:

(a) the tissues respond less to insulin
(b) the tissues respond better to insulin
(c) insulin production decreases
(d) blood glucose levels are lower



C 11. Which of the statements below is true?
Consequences of Rhesus immunization for the neonate:

(a) are caused by IgM crossing into the placenta
(b) can be assessed by measuring foetal haemoglobin in the maternal blood
(c) can be assessed by means of Doppler sonography



B 12. The most common cause of vaginal bleeding during the third trimester of pregnancy is:

(a) ectropion
(b) idiopathic
(c) placenta praevia


A 13. Which type of cell division takes place in the germ cells?

(a) meiosis
(b) mitosis
(c) both meiosis and mitosis



B 14. What is the most common indication for caesarean section in the United States and probably also in
the Netherlands?

(a) foetal infection
(b) non-progressing labour
(c) foetal distress
(d) mother’s request


C 15. If a child suckles at a nipple, this stimulates the mother to produce:

(a) oestrogens
(b) dopamine agonists
(c) oxytocin
(d) ADH




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, 20160331 G2020 2.2.2 ENG – VERSION A


A 16. What is a risk factor for pre-eclampsia?

(a) nulliparity
(b) single pregnancy
(c) low BMI (<20)
(d) Caucasian (Western European) descent



A 17. Neonatal encephalopathy is usually caused by:

(a) hypoxia during birth
(b) foetal infection
(c) breech presentation
(d) forceps delivery


C 18. During childbirth, the partogram is a graphical representation of:

(a) the action line during labour
(b) foetal descent against time
(c) cervical dilation against time
(d) the latent phase of dilation


A 19. The planes of Hodge are virtual planes through the pelvis of a woman giving birth. These planes are
used to:

(a) describe the degree of engagement of the child’s presenting part
(b) indicate the position of the cervix
(c) indicate the degree of dilation with respect to the symphysis
(d) measure pelvic instability by means of an X-ray


C 20. What are the successive phases of a normal parturition?

(a) engagement-dilation-birth
(b) dilation-rotation-birth
(c) dilation-expulsion-placental expulsion
(d) expulsion-birth-placental expulsion


A 21. In the foetal circulation, which vessel carries the highest volume of oxygen-poor blood?

(a) umbilical artery
(b) pulmonary artery
(c) ductus venosus
(d) ductus arteriosus




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