MIDWIFERY NATIONAL EXAM PRACTICE MCQ'S -2
QUESTIONS AND DETAILED ANSWERS|ALREADY GRADED
A
What you explain to women about GBS screening... Correct Ans-
Transient micro-organism found in the vagina and bowel.
Screening is RISK BASED approach...
o previous GBS-affected infant
o GBS bacteruria this pregnancy
o preterm (< 37 weeks) labour and imminent birth
o intrapartum fever > 380C
o membrane rupture > 18 hrs.
Via HVS/rectal/MSU ?36/40
Early-onset neonatal Group B Streptococcus (GBS) infection is the
leading cause of infectious disease in the newborn.
What details you must discuss with women with GBS risk factors...
Correct Ans- - risks & treatment
- involvement of AB's
- any Hx of penicillin allergy
,GBS cases - management... Correct Ans- • All newborn babies showing
signs of sepsis should undergo immediate referral and assessment from a
paediatrician. This will include a full blood count and blood cultures.
While waiting for culture results antibiotic therapy is recommended for
at least 48-hours.
• suspected chorioamnionitis - immediate assessment and referral to a
paediatrician. Antibiotic therapy is recommended for babies showing
signs of sepsis.
• Healthy-appearing babies born at > 35-weeks gestation to women with
GBS risk factors and who have received appropriate antibiotics > 4-
hours before birth require no investigations or treatment, but should be
observed closely for at least 24 hours post-partum. This includes close
observation at home.
• Well-appearing babies born at > 35-weeks gestation to women with
GBS risks factors who have received either no or inadequate (< 4-hours)
antibiotics during labour should be observed closely for at least 24-
hours. It is recommended that this be in hospital and that referral may be
considered.
• Well-appearing babies born at < 35-week gestation to women without
chorioamnionitis, who have not received antibiotics > 4 hours before
birth need close observation for at least 48-hours. It is recommended that
this be in hospital and that referral may be considered.
,placenta previa Correct Ans- • bleeding from an abnormally located
placenta
Which of the following are associated with placenta previa?
1. Prev C/S
2. Prev uterine curettage
3. Primips
4. Anaemia
5. Male fetus
6. Congentital abnormality
a. 1 and 3
b. 2, 4, 5
c. 1, 2, 4, 5, 6
d. all of the above Correct Ans- c. 1, 2, 4, 5, 6
- Prev C/S
- Prev placenta curettage
- abortion
- Endometriosis
- Multiparty
, - Age
-Anaemia
- Smoking (enlarged placenta)
- Multiple preg
- congentital abnorm
- MALE fetus
- placental abnormality: Biparietal
What is the best practice if placenta previa/vasa previa is diagnosed at or
beyond 32/40?
a. Consultation
b. USS at 36/40
c. Transfer of care
d. USS in 2 weeks time Correct Ans- c. Transfer of care
Realistically..
can compromise shared care
What should be your management plan if after a USS you find EFW <
10th percentile on customised growth chart, or abdominal circumference
(AC) < 5th
percentile on ultrasound, or discordancy
QUESTIONS AND DETAILED ANSWERS|ALREADY GRADED
A
What you explain to women about GBS screening... Correct Ans-
Transient micro-organism found in the vagina and bowel.
Screening is RISK BASED approach...
o previous GBS-affected infant
o GBS bacteruria this pregnancy
o preterm (< 37 weeks) labour and imminent birth
o intrapartum fever > 380C
o membrane rupture > 18 hrs.
Via HVS/rectal/MSU ?36/40
Early-onset neonatal Group B Streptococcus (GBS) infection is the
leading cause of infectious disease in the newborn.
What details you must discuss with women with GBS risk factors...
Correct Ans- - risks & treatment
- involvement of AB's
- any Hx of penicillin allergy
,GBS cases - management... Correct Ans- • All newborn babies showing
signs of sepsis should undergo immediate referral and assessment from a
paediatrician. This will include a full blood count and blood cultures.
While waiting for culture results antibiotic therapy is recommended for
at least 48-hours.
• suspected chorioamnionitis - immediate assessment and referral to a
paediatrician. Antibiotic therapy is recommended for babies showing
signs of sepsis.
• Healthy-appearing babies born at > 35-weeks gestation to women with
GBS risk factors and who have received appropriate antibiotics > 4-
hours before birth require no investigations or treatment, but should be
observed closely for at least 24 hours post-partum. This includes close
observation at home.
• Well-appearing babies born at > 35-weeks gestation to women with
GBS risks factors who have received either no or inadequate (< 4-hours)
antibiotics during labour should be observed closely for at least 24-
hours. It is recommended that this be in hospital and that referral may be
considered.
• Well-appearing babies born at < 35-week gestation to women without
chorioamnionitis, who have not received antibiotics > 4 hours before
birth need close observation for at least 48-hours. It is recommended that
this be in hospital and that referral may be considered.
,placenta previa Correct Ans- • bleeding from an abnormally located
placenta
Which of the following are associated with placenta previa?
1. Prev C/S
2. Prev uterine curettage
3. Primips
4. Anaemia
5. Male fetus
6. Congentital abnormality
a. 1 and 3
b. 2, 4, 5
c. 1, 2, 4, 5, 6
d. all of the above Correct Ans- c. 1, 2, 4, 5, 6
- Prev C/S
- Prev placenta curettage
- abortion
- Endometriosis
- Multiparty
, - Age
-Anaemia
- Smoking (enlarged placenta)
- Multiple preg
- congentital abnorm
- MALE fetus
- placental abnormality: Biparietal
What is the best practice if placenta previa/vasa previa is diagnosed at or
beyond 32/40?
a. Consultation
b. USS at 36/40
c. Transfer of care
d. USS in 2 weeks time Correct Ans- c. Transfer of care
Realistically..
can compromise shared care
What should be your management plan if after a USS you find EFW <
10th percentile on customised growth chart, or abdominal circumference
(AC) < 5th
percentile on ultrasound, or discordancy
