Errorless answers)
Best immediate treatment of severe post-partum haemorrhage after delivery of a complete
placenta:
A. IV Ergometrine
B. Blood transfusion
C. Evacuation of uterus without blood transfusion
D. Bimanual compression of the uterus
E. Aortic compression correct answers D
In severe PET:
A. The cardiac output is lowered
B. Peripheral vascular resistance is lowered
C. Blood volume is decreased by 10-15%
D. Blood coagulability is decreased correct answers C
PET:
A. Decreased blood volume by 10-15%
B. Increased susceptibility to blood loss
C. Increased cardiac output
D. Increased PVR correct answers Unknown stem
In severe PET:
A. Usually increased PVR
B. Decreased blood volume
C. Decreased albumin
D. Shift of ODC to left
E. Low left & right filling pressures
F. Blood volume increased to 35% above pre-pregnancy levels
G. Fibrin in glomeruli correct answers Unknown stem
Severe PET:
A. Hypovolaemia
B. Decreased colloid osmotic pressure
C. Left shift oxygen dissociation curve
D. Hypernatraemia
E. Increased aldosterone correct answers Unknown stem
A persistent fall in foetal heart rate 20 seconds after the peak of a contraction is an indication for:
A. Observation
B. The supine position
C. A vaginal examination
D. The head down position
,E. Immediate LSCS correct answers This is a late decel
C- VE for diagnosis (crowning/cord prolapse), if reassuring, scalp pH, if persistent --> LSCS
Repeated dips in foetal heart rate for 20 seconds after uterine contractions. Most appropriate
immediate management is:
A. IV Atropine
B. IV Ephedrine
C. PV examination
D. Cephalopelvimetry
E. Emergency LSCS correct answers C- PV exam (?cord prolapse, about to deliver)
Uterine relaxation might be required in:
A. Breech delivery
B. Manual removal of placenta
C. Transverse lie for caesarian section
D. Assisted delivery for breech correct answers All are true
1) Assisted breech delivery (to assist obstruction to shoulder/head)
2) Retained placenta being removed manually
3) Uterine constriction ring to be relieved
4) Transverse lying second twin for operative delivery
5) Inverted uterus
A woman already in the lateral tilt position for LSCS with epidural in situ, develops profound
hypotension. The immediate treatment is:
A. IV crystalloids
B. IV Ephedrine
C. IM Methoxamine
D. IV colloid
E. Trendelenburg correct answers A) IV crystalloid
Phenylephrine or metaraminol would be pressors of choice
In relation to foetal outcome, which of the following is most important:
A. Induction-delivery time
B. Displacement of the uterus
C. Minimal Thiopentone on induction
D. The use of 100% oxygen
E. Keeping inhalational agent use to a minimum correct answers A- induction to delivery time
During labour, which hormone levels are increased?
A. TSH
B. Gastrin
C. Insulin
D. B-endorphins
E. Thyroxine
, F. Aldosterone correct answers Gastrin, insulin, B-endorphins, thyroxine, aldosterone all
increase
TSH is not
During pregnancy, which hormone levels are not increased?
A. Insulin
B. ACTH
C. Thyroxine
D. Prolactin
E. Growth hormone correct answers GH is not increased
Factors which do NOT contribute to the increased risk of aspiration pneumonitis during
pregnancy include
A. increased gastrin production
B. a tendency for the stomach to be pushed up against the left diaphragm
C. increased acidity of gastric secretion
D. increased volume of gastric secretion
E. decreased secretion of the hormone motilin correct answers A- increased acidity and volume
are not due to gastrin
Supine hypotension during late pregnancy is associated with
A. a rise in the systemic vascular resistance
B. a rise in the cardiopulmonary blood volume
C. increased heart rate
D. stable stroke volume
E. a rise in the cardiac index correct answers C- reflex tachy secondary to aorto-cavcal
compression --> supine hypotension --> baroreceptor response?
Supine hypotension during late pregnancy associated with:
A. A rise in systemic vascular resistance
B. A rise in cardiopulmonary blood volume
C. Increased heart rate
D. Stable stroke volume
E. A rise in the cardiac index
F. Increased ?CVP/? venous return correct answers C- increased HR
Uterine tone ?increased/?decreased by:
A. Serotonin
B. Prostaglandin E2
C. Ketamine
D. Verapamil
E. Magnesium
F. Beta-2 agonists
G. GTN correct answers Serotinin- increases tone