MCQ 1. The following is true regarding pregnancy a. Fetal heart can be heard by daptone at 12 week of gestation b.

routine test for infectious disease VDRL, blood and Rhesus group, HIV toxoplasma and rubella c. Rubella vaccination is contraindicated in pregnancy 3. Normal labour a. Progressive dilatation about 1cm in 1hour in primigravida b. 2nd stage of labour id divided into pelvic & perineal phase c. Onset of labour is progressive cervical dilatation with abdominal contraction d. the action line is 4 hour to the right of alert line e. prolonged 3rd stage if placenta is not delivered after 30minutes 4. Regarding breech a. The commonest cause is prematurity b. elective LCSC is more safe than assisted vaginal delivery c. ECV offer at 35 week d. It increase successful of vaginal delivery in primigravida e. Extended breech increase cord of prolapse compare from other type of breech. 5. Regarding CTG a. Should be done at left lateral or semi-recumbent b. BFHR at 100-160 bpm c. Variability modified by fetal sleep and activity 6. Regarding HPT in pregnancy a. significant proteuniria is at least more that 200mg in 24 hour collection b. cerebral oedema is the manifestation of eclampsia c. delivery is the definitive treatment 7. Maternal infection true matched with fetal outcome a. Parvovirus B19 nonimmune hydrop fotalis b. Trypanoma pallidum Hungtington triad c. Chicken pox Varricolla d. Bacterial vaginosis preterm labour e. Recurrent genital herpes encephalitis 10. regarding fertilization and implantation e. in N intrauterine pregnancy, hCG level doubles approximately every 36-48hr. 11. Endometriosis a. severity is based on the revised American Fertility soceity . b. ground glass appearance in ultrasound is suggestive of endometriosis

c. continuous use of COCA is beneficial 12. PCOS a. acantosis nigrican b. Recurrent miscarriage c. U/s feature significant to diagnose PCOS d. Clomiphene is used to induce ovulation e. increase testosterone level 15. The following statements is/are true regarding adenomyosis of uterus d. myomectomy is a treatment of choice e. It undergoes sarcomatous changes

OBA 2. 31/ G3P2/ 20 w of gestation. She had history of premature delivery at 28 weeks of gestation. Routins ultrasound showed shortening cervux with funneling of endocervix. The most likely diagnosis: a. Cervical dystocia b. cervical incompetence c. Premature labour d. threatened miscarriage e. Uterine abnormalities 4. 28 y/o primid come for booking at 18w of gestation. Urine result 3+ glycosuria. No history of diabetes. What action should take? a. repeat dipstick b. do MOGTT c. Fasting Blood Sugar d. BSP e. Random blood sugar 5. 32 y/o lady with amenorrhea 4months. Her cycle irregular as she lactating. UPT positive. How to assess her gestation? a. uterine size b. early US c. date of quickening d. calculate form date UPT e. LMP

PMP1 Trigger 1

39 y/o, G5P1+3, PV bleed and blood clot, abdominal pain with increase intensity for the last 1 hour. Last pregnancy was 2 years ago with c0sec due to HPT crisis. 1. Risk Factors 2. History that you would like to get from the patient regarding The current complaint Past History Trigger3 3 days upon admission, she was planned to be discharged after her sugar level was stable and fetal well being was normal 6. What advice would you like to give her upon discharge?

LONG CASES LECTURE R dr.Sudesa n CC 23yo, G1P0 @ 38W+6D reduce fetal movement, 3 times MOGTT due to BMI >30 done but normal readings.currently induced by PGE. PE in running commentary. GDM on insulin, uncontrolled sangat BSP dier. Guna both Short acting ngan long acting insulin with a new onset of asypmtomatic PIH. She has positive family history of bth HPT n DM QUESTION 1. causes of reduce fetal movement 2. Investigation 3. Management (why do you want to induce? when? n how to deliver the baby?) Aper complication GDM on both mom n baby? a - Dalam third trimester, apa yg paling kiter concern ntuk GDM pt? - unexplained fetal death - aper pathophysio baby jadi besar dalam uncontrolled GDM? - nih teori yg dalam 3rd trimester, baby nyer insulin like growth receptor jadi active sbab baby hyperglycaemic. so, rapid growth - aper indication nak cakap baby macrosomic - growth chart - management - ape patut kita risau time nak labour n post-partum if pt GDM n PIH? - if pt ader both GDM n PIH, camaner nak tentukan samada baby ni akan FGR or macrosomic? - guna doppler stadi. uterine n mid-cerebral artery - naper kita induce pt yg ader GDM?

Dr Muna

- apa beza shoulder distocia ngan obstructed labour? - SD - baby stuck kat bahu. obstructed. baby stuck kat kepala. just ader crowning je. thats y obstructed is more risky dapat uterine rupture. dr muna Dr Ziana gdm+IOL contraction + asthma

Prof Roszama n Dr Ruzihan Dr Dalia

PIH+oligohydramnios+IUGR

Post date with no underlying d/s Mrs Ashidah, 30, housewife, G4P3, 34wks, presented with abdominal pain 1day PTA. She was known to hv twin pregnancy at 18wks POA. diabetes complicating pregnancy - for IOL Maternal pyrexia + Upper Resp. Tract Infxn (URTI) intermittent fever+Hx of GDM d/c reduce fetal movement with maternal pyrexia d/t urti. prem contraction, asthma GDM, PIH, UTI, Polyhydramnios PDA

- when to induce labor in post date and type of IOL causes of abdominal pain Complications of twin prenancy in every trimester Investigations to confirm ur diagnosis how do we manage this patient in labour? What is the complication of diabetes complicating pregnancy dx. ix

dr ganesh

Dr. Dalia dr ziana

ix n mx. -Dx -Ix

dr azam Dr.Ganes h Dr.Azam

SHORT CASES LECTURER dr.norazian a FINDINGS 36 Weeks POA, primigravida, S/L/C, uterus smaller than date. QUESTIONS 1. how do we measure BP with patient lying position? 2. causes fetal head not engaged. 3. when does the engagement of fetal

Dr Dahlia

2 previous untred scar, PP type 3

dr muna

Dr Raja

twin (kalu pt tuh uterus larger than date, palpate betui2 tw. cz might be bcz of twin. td sy x dpt appreciate twin.. sy ingt macrosomic baby. Hehe) 19 yo, OA, primid, short stature CFH= 34 wks SFH= 30cm

head occur for primigravida. - so... nak svd ke casesar? - apa risk yg patient leh dapat if pnah ader scar? - PP n placenta accreta - difine accreta, incrita n percreta. morbidly adhered placenta to uterine wall - aper investigation? - U/S, MRI, Doppler - present abd findings. sress kat scar causes of uterus larger than date, n diagnosis pt..

prof roszaman Dr Ziana Dr.Muna dr sudhesan

28w, SFH 27cm, breech uterus smaller than date

- btwn CFH & SFH Discussion about complications of short stature, how to parcipate during intrapartum He asked about pelvimetry, i didnt know, but i explained about CPD, Dr Raja ni suka psycho skit, must be confident with ur answer. what cause breech? What cause uterus smaller than date? causes, features of oligohydramnios, dating scan

Dr Ganesh Prof.Rosza man

Uterus larger than date polyhydramnious d/t deodenal atresia+ positive fluid thrill( mintak tolong dr letak tgn kt tgh)+ sfh 42cm... Uterus Larger than date causes and complication during labor Oligohydramnios