Obstetrics Platings 14-15 Pulmonary Diseases in Pregnancy (COO)

Breech (RCB) 11. Diaphragm is known to elevate during
1. The lower extremities are flexed at the hips and pregnancy
extended at the knees • 4cm
• Frank Breech
12-14. Hallmark of asthma
nd
2. Type of version used for the delivery of the 2 • Bronchial smooth muscle contraction
twin • Mucosal edema
• Internal podalic version • Mucosal hypersecretion

3. Maneuver to keep the fetal head flexed as it is 15. Normal FEV1 should be at least
delivered • 80%
• Mauriceau maneuver
16. What prostaglandin could be used postpartum?
4. Used for breech decomposition • PGE2
• Pinard’s maneuver
17. The most common cause of pneumonia in
5. Fetal presentation is altered by physical pregnancy
manipulation through the maternal abdomen • Streptococcus pneumoniae
substituting the breech for the occiput
• External cephalic version 18. Would you recommend pneumococcal vaccine
to your pregnant patient?
6-8. Give the 3 managements of an entrapped • No, it is not needed in
aftercoming head in breech vaginal delivery immunocompromised women
• Duhrssen incision • Yes, it will lessen their chances of
• Zavanelli’s maneuver developing the disease
• Symphysiotomy
19. The most common complication of varicella
9-10. Give 2 anatomical landmarks to identify the pneumonia
breech presentation on vaginal examinations • Secondary skin infection
• Anus or genitals
• Fetal ischial tuberosities 20. This should be suspected in pregnant women
diagnosed w/ fungal pneumonia
• HIV or AIDS

     
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Cesarean Delivery and Peripartum Hysterectomy (DFE) Preterm Birth (LRA)
A 1. Easy access A. Classical 11. What is the weight in grams of a late preterm baby?
C 2. The rectus abdominis muscle B. Pfannenstiel • 500 - 1500 grams.
are transected to widen the C. Maylard
opening 12. What stage of gestation is considered to be late preterm?
• 34 -36 weeks
B 3. With repeat cesarean delivery,
reentry is difficult due to scarring 13. What is currently considered as the present threshold of
viability?
• <26 weeks
B 4. Vertical incision within the A. Kerr incision
lower uterine segment B. Kronig incision 14. What is the stage of microbial infection in the amniotic
C. Classical fluid?
incision • Stage 3

C 5. Vertical incision of the upper 15. Interval between pregnancy

segment of the uterus • <18weeks to >59months

A 6. Transverse incision of the lower 16. Corticosteroid is not recommended before this weeks of
uterine segment Gestation
• 24 weeks AOG
7. To prevent adverse neonatal sequelae from neonatal
prematurity elective cesarean delivery should be scheduled 17. Uterine distention as a cause of preterm birth is due to
at this substance
• 39 weeks AOG • CAP genes

8. For patients scheduled for cesarean delivery, oral intake 18. Cervical dilatation of 2-3cm is predicted to deliver
should be scheduled how many hours before the operation before
• 8 hours • 34 weeks AOG

9. Interdelivery interval associated with threefold increase 19. Tocolytic agents do not markedly prolong gestation but
risk of symptomatic rupture during subsequent trial of labor may delay delivery in some woman to up to how many
is hours
• 18 months • 48 hours

10. The most favorable factor for VBAC 20. Tocolytic agent with neuroprotective effect
• Prior vaginal delivery. • MgSO4

     
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Gastrointestinal Disorders (LRA) Antepartum Hemorrhage (AVSJ)
1. Bronchial asthma and other allergic d/o may cause 1. In which type of hemorrhage in abruptio placenta where
hyperemesis gravidarum there is increased risk of consumptive coagulopathy
• True • Concealed hemorrhage

2. Diagphragmatic hernia upon diagnosis in pregnant
woman needs repair even if the woman is asymptomatic
• True
3. During pregnancy, esophageal peristalsis ha low speed
but high amplitude
• False
2. Gross examination that will confirm the diagnosis of
abruption placenta
• Circumscribed depression on maternal suface
covered by dark clotted blood
3. Most frequent associated risk factor in placental abruption
• Hypertension

4. Sigmoidoscopy is cortraindicated in pregnant patient 4. Give one advantage of early amniotomy in placental
• False abruption
• Decrease bleeding from implantation site
5. The most serious complication of parenteral feeding is • Reduce entry into maternal circulation of
catheter sepsis thromboplastin
• True
5. MGT: Placental abruption-fetus is already dead
6. There is a positive association b/w placental abruption • Vaginal delivery
and hyperemesis gravidarum
• True 6. Most characteristic finding in Placenta previa
• Painless bleeding
7. Misoprostol can be given in pregnant patient to treat…
• False 7.
• Placenta accreta
8. Antacids are first line therapy for Peptic ulcer because it
provides coating at the ulcer base 8. Define low-lying placenta
• False • Placenta is implanted in lower uterine segment
such that placental edge does not reach the s but
9. Most cases of acute diarrhea are caused by infectious is in close proximity to it
agents 9. What is the best way to confirm previa
• True • Ultrasound

10.In IBD, most used treatment regimens may be continued 10.

during pregnancy. • Scheduled CS
• True

Dystocia Part 1 (NER)

     
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Operative Vaginal Delivery (DFE) Fetal Growth Disorders (RCB)
1. 2 most important discriminator of risk for both mother 1. Uterine fundal height in cm coincides within 2 weeks of
and fetus gestational age
• Station of fetal head • 18-30 weeks
• Degree of rotation
2. Most frequently abnormal w/ fetal growth restriction
2. 2 most important Functions of obstetric forceps because soft tissue predominates
• Traction • Abdominal circumference
• Rotation
3. Fetus >4500g
3. ? • Macrosomia

4. 2 fetal indications for operative vaginal delivery
• Non reassuring fetal heart pattern
• Premature placental separation
• Prolapse umbilical cord
5. Where is the flexion point?
• Sagital suture
4. A dreaded complication of Erb’s palsy
• Shoulder dystocia
5. Somatic growth restriction result from preferential
shunting of oxygen and nutrients to the brain, w/c allows
normal brain and head growth
• Brain sparing

6. Define as when the operator attempts the delivery w/ full 6. An example of Adipokines
knowledge that vaginal delivery would fail • Leptin
• Trial of operative vaginal delivery
7. An early insult results in a relative decrease in cell
7. Forceps used to deliver deep transverse arrest number and size
• Kielland forceps • Symmetrical growth restriction

8. Growth restriction caused by preeclampsia

• Asymmetrical growth restriction

9. Seen in Doppler velocimetry w/ FGR

• Absent or reversed end-diastolic flow

10. Pathologic growth restriction due to decrease fetal

urination
• Oligohydramnios

     
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Hypertension (RCG) Cardiovascular Disorders (FAV)
Matching Type: 1-2. Give the changes in the CVS during pregnancy in
A. Preeclampsia distinct in the following procedures:
B. Gestational Hypertension • ECG – slight left axis deviation, ST wave
C. Eclampsia changes
D. Chronic Hypertension • Xray – slight cardiomegaly, bigger cardiac
E. Preeclampsia superimposed on chronic silhouette
hypertension 3-5. What are the S/Sx both normal pregnancy and pregnant
women and patient w/ heart disease
1. 28 y/o G1P0 28 weeks, BP 150/100mmHg with bipedal • Edema
edema • Fatigue
• B – Gestational Hypertension • Dyspnea, irritability, exercise intolerance

2. 38 y/o G1P0 w/ history of chronic glomerulonephritis 3 6. NYHA classification of patient w/ cardiac insufficiency
years ago even at rest
• D – Chronic hypertension • Class IV

3. 30 y/o G1P0 14-16 weeks, BP:160/100mmHg w/ +2 7. What’s the WHO risk score of #6
proteinuria • 4
• E – Preclampsia superimposed on chronic
hypertension 8-10. What postpartum conditions that can cause cardiac
failure
4. 32y/o G1P0 28 weeks BP:140/90mmHg w/ 3g 24 hr urine • Hemorrhage
protein • Infection
• A – Preeclampsia • Anemia
5. 32y/o G1P0 29 weeks BP:140/90mmHg w/
thrombocytopenia, developing grand mal seizure few hours
prior to consultation
• C – Eclampsia

6. Transient occipital blindness due to extensive occipital

lobe edema
• Amaurosis

7. Aggressive management of severe pre eclampsia at 20-

32wks w/ no HELLP syndrome
• Glucocorticoids administration then deliver
after 48 hours

8-10. GOALS in the management of ECLAMPSIA

• Forestall convulsion
• Prevent ICH and organ damage
• Delivery of healthy newborn

     
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Neoplastic Disease (AJB) Hepatic, Gallbladder, & Pancreatic Diseases
1-3. Triple test to evaluate solid breast tumors (COO)
• BSE/CBE
1-3. Differential Diagnosis for Idiopathic
• Imaging
• Biopsy Cholestasis in Pregnancy:
• Pre-eclampsia
4. Breast cancer in pregnant patient usually has a advance • Cholelithiasis
stages of disease • Acute Viral Hepatitis
• True

5. Vaccination of HIV can be given to patient after 1st 4. Most common cause of acute liver failure
trimester • Acute Fatty Liver
• False
5-6. Type of Hepatitis virus related to chronic
6. CIN1 in pregnancy is manage by cryotherapy in 2nd and
3rd trimester
Hepatitis
• False • Hepatitis B
• Hepatitis C
7. Radical hysterectomy in situ plus pelvic
lymphadenectomy is the preferred treatment for small
7-8. Common mode of transmission for Hepatitis
invasive CA stage 1 – 2A?
• True B
• Sexual
8. Classical ceasarean delivery is the preferred mode of • Contaminated Needles
delivery in pregnant women w/ cervical cancer
• True
9. Anti-hypertensive drugs given to pregnant
9. The most common complication of ovarian masses is esophageal varices patient
ovarian torsion and hemorrhage • Beta Blockers
• True
10. Treatment option for esophageal varices
10. Culposcopy or colposcopy cervical punch biopsy is
diagnostic choice to r/o invasive cervical cancer
• Endoscopic Band Ligation
• False

     
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Post-Partum Hemorrhage (RCJ) Thyroid and Other Endocrine Disorders (CCT)
1. MC site involved in rupture of uterus 1. Hyperthyroidism
• Lower uterine segment
• Increased FT4, decreased TSH
2. During delivery of products of conception, this clinical
scenario predisposes patient to uterine rupture 2. Hypothyroidism
• Internal version of second twin • Increased FT4, decreased TSH
3. Pre-existing uterine injury or anomaly that predisposes
patient for possible uterine rupture 3. Subclinical Hyperthyroidism
• Histerotomy • Normal FT4, decreased TSH
• Previous history of abortion w/ instrumentation
• Previous history of ruptured uterus 4. Subclinical Hypothyroidism
• Normal FT4, increased TSH
4. Clinical risk factor for the development of post partum
hemorrhage involving genital tract trauma
• Operative vaginal delivery 5. Isolated maternal Hypothyroxemia
• Decreased FT4, normal TSH
5. Conservative nonsurgical proceedures done if other
standard measures to prevent uterine atony fail 6. Prolactinemia
• Bimanual uterine massage
• Internal Uterine Tamponade
• Serum prolactin assay

6. The ff. is are the conditions in which conservative 7. Hyperparathyroidism

surgical management can be performed which, .... reserved • Serum calcium
for women with intraoperative finding
• Low transverse uterine scar
8. Primary hyperaldosteronism
7. Laceration to skin, mucous membrane, anal sphincter • Plasma aldosterone: renin ratio
• Third degree
9. Cushing's
8. Genital tract hematoma may not be obvious externally
• 24hr urine cortisol
• Paravaginal

CASE: (hindi niya sinabi yung case, pero parang ganito) 10. Pheochromocytoma
24 y/o, as the doctor was pulling the cord, fleshy mass noted • 24 hr urine free catecholamines or urine
in the vaginal introitus upon which the placenta is adherent... VMA
9. Based on the scenario, what is the classification of uterine
inversion
• Prolapse

10. Of the above case, what is the classification of inversion

based on onset?
• Acute

     
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