1
Q
- Conjugata Vera can be determined with the use of:
- C. externa
- C. diagonale
- Vertical diameter of Michaelis rhomboid
- Frank’s diameter
A
- 1.C. externa
* 2.C. diagonale
* 3.Vertical diameter of Michaelis rhomboid
* 4.Frank’s diameter
2
Q
- Fetal Lie is defined as:
- Relation of fetus to left and right uterine walls
- Relation of longitudinal fetal axis to longitudinal uterine axis
- Location of a fetus in the lower or upper part of uterine cavity
- Relation of the head and extremities to the fetal trunk
- Relation of the fetal spine to anterior or posterior walls of the uterus
A
- 1.Relation of fetus to left and right uterine walls
* 2.Relation of longitudinal fetal axis to longitudinal uterine axis
3
Q
- Position is defined as:
- Relation of longitudinal fetal axis to longitudinal uterine axis
- Relation of the fetal spine to anterior or posterior walls of the uterus
- Location of a fetus in the left or right part of uterine cavity
- Relation of the fetal spine to left or right walls of the uterus
- Relation of a fetus to the lower or upper part of uterine cavity
A
*4.Relation of the fetal spine to left or right walls of the uterus
4
Q
- Visus is defined as:
- Relation of the fetal spine to left or right walls of the uterus
- Fetal location closer to anterior or posterior uterine wall
- Relation of longitudinal fetal axis to longitudinal uterine axis
- Relation of the fetal spine to anterior or posterior walls of the uterus
- Relation of the head and extremities to the fetal trunk
A
- 1.Relation of the fetal spine to left or right walls of the uterus
* 4.Relation of the fetal spine to anterior or posterior walls of the uterus
5
Q
- Check all possible variants of fetal lie:
- Oblique and transverse
- Cephalic and breech
- Anterior and posterior
- Longitudinal, transverse, oblique
- Flexed and extended
A
*4.Longitudinal, transverse, oblique
6
Q
- Bone pelvis is divided on:
- Large and small pelvis
- Inlet, wide part, narrow part, outlet
- Large pelvis, small pelvis and pelvic cavity
- Inlet, pelvic cavity, outlet
- Wide part and narrow part
A
*1.large and small pelvis
7
Q
- Sutures which form fonticulus major are:
- Sagittal and lambdoid
- Sagittal, frontal
- Sagittal, coronal
- Coronal, lambdoid
- Sagittal, frontal, coronal
A
*5.sagittal, frontal, coronal
8
Q
- Landmarks of the small pelvis inlet include:
- Upper-inner brim of symphysis, linea innominata, sacral prominence
- Middle point of inner symphyseal surface, linea innominata, sacral prominence
- Upper brim of symphysis, middle points of lamina acetabule, sacral prominence
- Upper brim of symphysis, linea innominata, first sacral vertebral bone
- Lower brim of symphysis, fossae iliacae, sacral promontory
A
*1.upper-inner brim of symphysis, linea innominata, sacral prominence
9
Q
- Inner muscular layer of the pelvic floor includes:
- m. Transversus Perinei Profundus
- m. Bulbocavernosus
- m. Obturatorius Internus
- m. Iliacus Internus
- m. Levator Ani
A
*5.m. Levator Ani
10
Q
- Middle muscular layer of the pelvic floor includes:
- m. Levator Ani
- m. Piriformis
- m. Psoas Major
- m. Transversus Perinei Profundus
- m. Ischiocavernosus
A
*4.m. Transversus Perinei Profundus
11
Q
- Middle point of inner symphyseal surface and junction of the 2-nd and 3-rd sacral vertebral bones are connected with:
- Transverse diameter of the narrow part plane of small pelvis
- Anteroposterior diameter of the narrow part plane of small pelvis
- Anteroposterior diameter of the wide part plane of small pelvis
- Transverse diameter of the wide part plane of small pelvis
- Anteroposterior diameter of the small pelvis outlet
A
*3.anteroposterior diameter of the wide part plane of small pelvis
12
Q
- through ischial spines goes:
- Transverse diameter of the wide part plane of small pelvis
- Transverse diameter of the narrow part plane of small pelvis
- Transverse diameter of the small pelvis outlet
- anteroposterior diameter of the narrow part plane of small pelvis
- anteroposterior diameter of the wide part plane of small pelvis
A
*2.transverse diameter of the narrow part plane of small pelvis
13
Q
- Through middle points of both laminae acetabuli goes:
- Transverse diameter of the wide part plane of small pelvis
- Transverse diameter of the small pelvis inlet
- Transverse diameter of the narrow part plane of small pelvis
- anteroposterior diameter of the wide part plane of small pelvis
- anteroposterior diameter of the narrow part plane of small pelvis
A
*1.transverse diameter of the wide part plane of small pelvis
14
Q
- Small oblique diameter (diameter suboccipitobregmaticus) of the fetal head goes from:
- Anterior angle of the anterior fontanel to the undersurface of the occipital bone
- The middle point of anterior fontanel to the undersurface of the occipital bone
- Glabella to occipital tubercle
- The central part of os hyoideus to anterior angle of anterior fontanel
- The chin to the most prominent portion of the occipital bone
A
*2.the middle point of anterior fontanel to the undersurface of the occipital bone
15
Q
- Large oblique diameter (diameter mentooccipitalis) of the fetal head goes from:
- The middle point of anterior fontanel to the undersurface of the occipital bone
- Anterior angle of anterior fontanel to the undersurface of the occipital bone
- Glabella to occipital tubercle
- Central part of os hyoideus to anterior angle of anterior fontanel
- The chin to the most prominent portion of the occipital bone
A
*5.the chin to the most prominent portion of the occipital bone
16
Q
- Direct diameter (diameter frontooccipitalis) of the fetal head goes from:
- The middle point of anterior fontanel to the undersurface of the occipital bone
- Anterior angle of anterior fontanel to the undersurface of the occipital bone
- Glabella to occipital tubercle
- The chin to the most prominent portion of the occipital bone
- The central part of os hyoideus to anterior angle of fonticulus major
A
*3.glabella to occipital tubercle
17
Q
- Conjugata Diagonalis – is the distance from:
- Upper brim of symphysis bone to sacral promontory
- Lower brim of symphysis to the middle point of sacral promontory
- Middle point of inner symphysis pubis surface to sacral promontory
- Lower brim of symphysis pubis to the point under processus spinosus of the 5-th lumbar vertebral bone
- Lower brim of symphysis pubis to the junction of the 2-nd and 3-rd sacral vertebral bones
A
*2.lower brim of symphysis to the middle point of sacral promontory
18
Q
- Conjugata Externa - is the distance between:
- Upper brim of symphysis bone and processus spinosus of the 4-th lumbar vertebral bone
- Upper brim of symphysis bone and the upper angle of the Michaelis rhomboid
- Lower brim of symphysis bone and the middle point of sacral promontory
- Lower brim of symphysis bone and the upper angle of the Michaelis rhomboid
- The most outstanding points of iliac crests
A
*2.upper brim of symphysis bone and the upper angle of the Michaelis rhomboid
19
Q
- Conjugata Vera - is the distance from the:
- Middle of upper-inner brim of symphysis bone and the middle point of sacral promontory
- Upper brim of symphysis bone to sacral promontory
- Upper brim of symphysis bone to processus spinosus of the 5-th lumbar vertebral bone
- Lower brim of symphysis to the middle point of sacral promontory
- Middle of inner surface of symphysis bone to sacral promontory
A
*1.middle of upper-inner brim of symphysis bone and the middle point of sacral promontory
20
Q
- Dimensions of the small pelvis inlet plane are:
- Direct - 11 cm, transverse - 13 cm
- Direct - 10 cm, transverse - 12 cm
- Direct - 11 cm, transverse - 13 cm, oblique - 12 cm
- Direct - 11 cm, transverse - 12 cm, oblique - 11 cm
- Direct - 10 cm, transverse - 13 cm, oblique - 12 cm
A
*3.direct - 11 cm, transverse - 13 cm, oblique - 12 cm
21
Q
- The least dimension of the small pelvis is:
- Direct diameter of the small pelvis inlet
- Anteroposterior diameter of the narrow part plane of the small pelvis
- Anteroposterior diameter of the narrow part plane of the small pelvis
- Transverse diameter of the narrow part plane of the small pelvis
- Transverse diameter of the small pelvis outlet
- Oblique diameters of the small pelvis inlet
A
- 2.anteroposterior diameter of the narrow part plane of the small pelvis
* 3.anteroposterior diameter of the narrow part plane of the small pelvis
22
Q
- The largest dimension of the small pelvis is:
- Anteroposterior diameter of the wide part plane of the small pelvis
- Transverse diameter of the wide part plane of the small pelvis
- Transverse diameter of the small pelvis inlet
- Oblique diameters of small the pelvis inlet
- Anteroposterior diameter of the small pelvis outlet
A
*3.transverse diameter of the small pelvis inlet
23
Q
- Average circumference of the wrist is:
- 12 cm; is used for determination of the pelvic shape
- 14 cm; is used for determination of the pelvic bones thickness
- 16 cm; is used for determination of the pelvic dimensions
- 18 cm; is used for determination of the external conjugate
- 20 cm; is used for determination of the diagonal conjugate
A
*2.14 cm; is used for determination of the pelvic bones thickness
24
Q
- Conjugata Vera is determined:
- with pelvimeter
- with internal obstetric investigation
- through measurement of external conjugate, diagonal conjugate, vertical diameter of Michaelis rhomboid and Frank’ diameter
- by measurement of external dimensions of the large pelvis
- with the use of Soloviev index
A
*3.through measurement of external conjugate, diagonal conjugate, vertical diameter of Michaelis rhomboid and Frank’ diameter
25
25. Diagonal conjugate is measured for determination of:
1. External conjugate
2. Anatomical conjugate
3. Obstetrical conjugate
4. Anteroposterior diameter of the narrow part plane of the small pelvis
5. Station level of the presenting part
*3.obstetrical conjugate
26
26. Normal size of the diagonal conjugate is:
1. 14 cm
2. 11 cm
3. 13 cm
4. 10 cm
5. 9 cm
*3.13 cm
27
27. In OP (occiput posterior), flexed attitude:
1. At the level of pelvic inlet the head performs deflexion
2. At the level of pelvic outlet the head performs flexion and then deflexion
3. In time of crowning distention of vulvar ring achieves 35 cm in circumference
4. Caput succedaneum (cephalic birth tumor) is formed in the region of anterior fontanel
5. The centre of forehead serves as a leading point
*2.at the level of pelvic outlet the head performs flexion and then deflexion
28
28. In brow presentation at the level of pelvic outlet the head performs:
1. Flexion
2. Deflexion
3. Internal rotation
4. Flexion and then deflexion
5. Maximal deflexion
*4.flexion and then deflexion
29
29. In OA (occiput anterior), flexed attitude:
1. Anterior fontanel serves as a leading point
2. At the level of pelvic inlet the head performs deflexion
3. Occipital tubercle serves as a fixation point
4. Caput succedaneum (cephalic birth tumor) is formed in the region of posterior parietal bone
5. Fetal head is delivered due to deflexion
*5.fetal head is delivered due to deflexion
30
30. The shape of the head in fetuses delivered in breech presentation is:
1. Dolichocephalic
2. Ball-like
3. Brachiocephalic
4. Abnormal
5. Tower-like
*2.ball-like
31
31. Internal rotation of the head occurs:
1. in the wide part plane of the small pelvis
2. at the level of pelvic floor
3. begins in the wide part plane of the small pelvis and ends at the level of pelvic floor
4. at the level of pelvic inlet
5. begins at the level of pelvic inlet and ends at the level of pelvic floor
*3.begins in the wide part plane of the small pelvis and ends at
32
32. Umbilical cord compression in breech delivery occurs after:
1. Delivery of umbilical ring
2. Delivery of fetal buttocks
3. Trunk delivery to the level of lower angle of anterior scapula
4. Internal cephalic rotation
5. Crowning of the fetal buttocks
*3.trunk delivery to the level of lower angle of anterior scapula
33
33. Anterior fontanel serves as a leading point in:
1. OA; flexed attitude
2. First degree head deflexion
3. OP; flexed attitude
4. Brow presentation
5. Face presentation
*2.first degree head deflexion
34
34. Fetal head is delivered with circumference which corresponds to frontooccipital diameter in:
1. The first degree head deflexion
2. OP; flexed attitude
3. Face presentation
4. OA; flexed attitude
5. Brow presentation
*1.the first degree head deflexion
35
35. Caput succedaneum (cephalic birth tumor) means:
1. Haemorrhage to the scalp soft tissues
2. Haemorrhage under periosteal capsule of the cranial bone
3. Changes of cranium shape due to cephalic molding
4. Serous-blood imbibition of soft tissues of the presenting part due to venous stasis beneath the apposition girdle
5. Haemorrhage to subcutaneous fat tissue
*4.serous-blood imbibition of soft tissues of the presenting part due to venous stasis beneath the apposition girdle
36
36. The optimal date for the first visit to antenatal clinic is before:
1. 5 weeks
2. 12 weeks
3. 14 weeks
4. 16 weeks
5. 20 weeks
*2.12 weeks
37
37. Perinatal period lasts:
1. from 12 weeks until delivery
2. from 20 weeks until 7-th day after delivery
3. from 28 weeks until 56-th day after delivery
4. from 22 weeks until 7-th day after delivery
5. from 32 weeks until 7-th day after delivery
*4.from 22 weeks until 7-th day after delivery
38
38. Wasserman reaction during pregnancy is to be performed (in Russia):
1. Once
2. Every other month
3. Monthly
4. Three times
5. Twice in each trimester
*4.three times
39
39. In the frame of antenatal care vaginal investigation in the second trimester of pregnancy should be performed:
1. in case of suspicion on placenta praevia
2. for accurate determination of presenting part
3. at every visit
4. once in a trimester
5. only with indications
*5.only with indications
40
40. for accurate determination of gestational age at 30 weeks one can use:
1. X-ray
2. Ultrasonography
3. cardiotocography
4. Amnioscopy
5. Cytology
*2.ultrasonography
41
41. Cessation of menstruation as a sign of early pregnancy is included to the group of:
1. Probable pregnancy signs
2. Supposed pregnancy signs
3. Uncertain pregnancy signs
4. Certain pregnancy signs
*1.probable pregnancy signs
42
42. Doubtful signs of pregnancy include:
1. Palpation of the fetal parts, auscultation of the fetal heart beats
2. Ultrasonic and X-ray imaging of the fetus, detection of the fetal heart activity
3. Cessation of menstruation, vaginal mucosa cyanotic discoloration, changes of uterine size, shape and consistency
4. Changes of appetite, smell sensations, morning sickness, unstable mood
5. Positive biological and immunological pregnancy tests results
*4.changes of appetite, smell sensations, morning sickness, unstable mood
43
43. Immunological pregnancy test (at early stages) is based on the reaction of antiserum with:
1. Progesterone in blood
2. Chorionic gonadotropin in urine
3. pregnandiol
4. Oestrogen
5. Placental lactogen
*2.chorionic gonadotropin in urine
44
44. Maximal symhysiofundal height (SFH) is observed at:
1. 36 weeks
2. 38 weeks
3. 39 weeks
4. 40 weeks
5. at the onset of the first stage of labor
*1.36 weeks
45
45. The third Leopold maneuver is used to determine:
1. symhysiofundal height
2. presenting fetal part
3. fetal position
4. visus
5. free balloting of the head
* 2.presenting fetal part
| * 5.free balloting of the head
46
46. The fourth Leopold maneuver is used to determine:
1. fetal lie
2. Position
3. visus
4. Relation of the presenting part to the small pelvis inlet
*4.relation of the presenting part to the small pelvis inlet
47
47. Labor is divided on several periods:
1. Preliminary
2. Dilation
3. Decent
4. Placental separation and expulsion
5. Postpartum
* 2.dilation
* 3.decent
* 4.placental
48
48. One should regard as the onset of labor:
1. Rupture of membranes (leakage of amniotic fluid)
2. Descent of the fetus down through birth channel
3. Onset of uterine contractions with an interval of 15-20 m
4. Engagement of the head
5. Onset of regular contractions leading to structural changes of the uterine cervix
*5.onset of regular contractions leading to structural changes of the uterine cervix
49
49. Bearing down (pushing) differs from uterine contractions (pains) with:
1. Higher rate of uterine contractions
2. Higher amplitude of uterine contractions
3. With addition of muscle contraction of abdominal wall, diaphragm, pelvic floor
4. With addition of contractions of the muscles, covering internal pelvic surface
5. Due to increased frequency, strength and duration of uterine contractions
*3.with addition of muscle contraction of abdominal wall, diaphragm, pelvic floor
50
50. The name of the first period of labor is:
1. Preliminary period
2. Period of dilation
3. Period of descent (expulsion)
4. Latent period
5. Period of cervical effacement
*2.period of dilation
51
51. The first period of labor lasts from the:
1. Onset of regular contractions until cervical effacement
2. Onset of regular contractions until delivery of a fetus
3. Onset of regular contractions until full dilation of the uterine os
4. Onset of regular contractions until engagement of the fetal head
5. Onset of gripping pains in the lower abdomen until uterine os opening will achieve 7-8
*3.onset of regular contractions until full dilation of the uterine os
52
52. The root distinction of the first period contractions from preliminary (prelabor) contractions is based on differences in:
1. Duration of intervals between contractions
2. Intensity of contractions
3. Presence or absence of structural changes of the cervix
4. Duration of contractions
5. Intensity of pain
*3.presence or absence of structural changes of the cervix
53
53. The second period of labor lasts from:
1. Rupture of membranes until delivery of a fetus
2. Full dilation until delivery of a fetus
3. Head engagement until delivery of a fetus
4. Effacement of cervix until delivery of a fetus
5. Onset of pushing movements until delivery of a fetus
*2.full dilation until delivery of a fetus
54
54. FHR (fetal heart rate) in the second period of labor should be checked:
1. After each “pushing down”
2. Every 15 minutes
3. Every 10 minutes
4. Every 5 minutes
5. In time of the fetal head crowning
*1.after each “pushing down”
55
55. The third period of labor lasts from:
1. from separation of placenta until its expulsion
2. from delivery of a fetus until expulsion of placenta and membranes
3. from delivery of a fetus until placental separation
4. from full dilation of uterine os until expulsion of placenta and membranes
5. for two hours after expulsion of placenta and membranes
*2.from delivery of a fetus until expulsion of placenta and membranes
56
56. Early rupture of membranes means that it occurred:
1. before onset of labor
2. before onset of the second period of labor
3. before 5cm dilation of uterine os
4. before 7cm dilation of uterine os
5. before onset of pushing movements
*4.before 7cm dilation of uterine os
57
57. Prelabor rupture of membranes means that it occurred:
1. before onset of labor
2. during the first period of labor
3. before 38 weeks of pregnancy
4. before 7 cm dilation of uterine os
5. after 5 cm dilation to the full
*1.before onset of labor
58
58. Preterm rupture of membranes leads to increased risk of:
1. Maternal obstetrical trauma
2. Preterm detachment of the placenta
3. Septic complications
4. Obstetrical trauma of a fetus
5. Precipitate labor
*3.septic complications
59
59. Retarded rupture of membranes leads to increased risk of:
1. Septic complications
2. Weak labor activity
3. Preterm detachment of the placenta
4. Maternal obstetrical trauma
5. Obstetrical trauma of a fetus
*3.preterm detachment of the placenta
60
61. In breech presentation one should begin to perform maneuver:
1. after full dilation of uterine os
2. when buttocks will descent to the small pelvic cavity
3. in time of buttocks crowning
4. after delivery of the fetal trunk until umbilical ring
5. after onset of pushing activity
*3.in time of buttocks crowning
61
62. The newborn assessment according to Apgar score:
1. Is based on assessment of 5 parameters
2. Includes data about acid-alkaline balance [ÊÙÑ]
3. Affords to assess the degree of IUGR
4. Should be performed once at the first minute after birth
5. Should be performed by neonatologist daily
*1.is based on assessment of 5 parameters
62
63. Fetus is regarded as large when the birth weight is more or equals:
1. 3000 g
2. 3500 g
3. 3800 g
4. 4000 g
5. 4500 g
*4.4000 g
63
64. APGAR score includes assessment of:
1. Birth weight, length, gestational age
2. Heart rate, respiration movements rate, skin color, reflexes, tonus of muscles
3. Heart rate, respiration movements rate, skin color
4. Consciences, degree of depression
5. Heart rate, general condition
*2.heart rate, respiration movements rate, skin color, reflexes, tonus of muscles
64
65. Weekly weight gain in the second half of pregnancy should not be more than:
1. 100-150 g
2. 150-200 g
3. 200-300 g
4. 300-400 g
5. 400-500 g
*4.300-400 g
65
66. Signs of pregestosis in the second half of pregnancy are:
1. Nonstability and asymmetry of BP,
2. Decrease of 24 h diuresis until 600-500 ml
3. Oedema of ankles and proteinuria
4. Levels of proteinuria achieve 0,033 - 0,066 g/l
5. Retinopathy, angiopathy of retinal vessels
*1.nonstability and asymmetry of BP,
66
67. Frequent forms of early toxicosis are:
1. Oedema, pregnancy associated hypertension
2. Hypersalivation (ptyalism)
3. Pregnancy associated hypertension, preeclampsia
4. Dermatoses, chorea
5. Emesis gravidarum
* 2.hypersalivation (ptyalism)
| * 5.emesis gravidarum
67
68. Pure forms of gestosis are:
1. oedema, pregnancy associated hypertension
2. gestosis which occurred in uncomplicated pregnancy
3. gestosis which occurred in the absence of extragenital diseases
4. gestosis which occurred in the absence of genital diseases
5. preeclampsia and eclampsia
*3.gestosis which occurred in the absence of extragenital diseases
68
69. Monosymptomatic forms of gestosis include:
1. pregnancy associated oedema
2. Preeclampsia
3. Pregnancy associated nephropathy
4. eclampsia
5. pregnancy associated hypertension
* 1.pregnancy associated oedema
| * 5.pregnancy associated hypertension
69
70. Polysymptomatic forms of gestosis include:
1. Pregnancy associated oedema
2. Pregnancy associated hypertension
3. Pregnancy associated nephropathy
4. Preeclampsia
5. Eclampsia
* 3.pregnancy associated nephropathy
* 4.preeclampsia
* 5.eclampsia
70
71. Nephropathy is assessed as a first degree state when:
1. BP = 150/90, proteinuria = 0, 99 g/l, oedema of ankles and abdominal wall, retinal oedema
2. BP = 130/90, proteinuria = 3, 3 g/l, oedema of ankles, abdominal wall and face, retinal oedema
3. BP = ÀÄ 140/100, proteinuria = 1, 65 g/l, oedema of ankles and abdominal wall, irregular diameter of the retinal vessels
4. BP = 140/90, proteinuria = 0, 66 g/l, oedema of ankles, irregular diameter of the retinal vessels
5. BP = 170/100, proteinuria = 1, 32 g/l, oedema of ankles and abdominal wall, retinal oedema
*4.BP = 140/90, proteinuria = 0, 66 g/l, oedema of ankles, irregular diameter of the retinal vessels
71
72. Nephropathy is assessed as a second degree state when:
1. BP = 140/80, proteinuria = 0, 66 g/l, oedema of ankles, irregular diameter of the retinal vessels
2. BP = 160/90, proteinuria = 1, 65 g/l, oedema of ankles and abdominal wall, retinal oedema
3. BP = 150/90, proteinuria = 3, 3 g/l, oedema of ankles and abdominal wall, retinal haemorrhages
4. BP = 180/120, proteinuria = 0, 99 g/l, oedema of lower extremities, retinal oedema
5. BP = 130/80, proteinuria = 0,132 g/l, mild oedema of ankles, retinal vessels - unchanged
*2.BP = 160/90, proteinuria = 1, 65 g/l, oedema of ankles and abdominal wall, retinal oedema
72
73. for correction of hypoproteinemia and hypovolemia in pregnancies complicated with gestosis one can use:
1. 5 % glucose solution, haemodes, glucose-novocaine solution
2. neocompensan, reopolyglukin, polyfer
3. haemodes, Ringer-Lock solution, lactasole, blood transfusion
4. poliglukin, Natrii bicarbonates solution, mannitol
5. albumin, protein, conserved plasma
*5.albumin, protein, conserved plasma
73
74. Zangemeister triad includes:
1. hypovolemia
2. vascular spasm, increased vascular walls permeability
3. oedema
4. proteinuria
5. hypertension
* 3.oedema
* 4.proteinuria
* 5.hypertension
74
75. If the classical Zangemeister triad (arterial hypertension, edema, and proteinuria) is present, diagnosis of preeclampsia can be made after detection of:
1. Irregular diameter of the retinal vessels
2. BP over 190/110
3. Complaints of pains in epigastrium
4. Proteinuria over 3, 3 g/l
5. Retinal oedema
*3.complaints of pains in epigastrium
75
76. Which stage of eclamptic attack is characterized with tonic convulsions?
1. 1-st
2. 2-nd
3. 3-rd
4. 4-th
5. 2-nd and 3-rd
*2. 2-nd
76
77. Which stage of eclamptic attack is characterized with clonic convulsions?
1. 1-st
2. 2-nd
3. 3-rd
4. 4-th
5. 2-nd and 3-rd
*3.3-rd
77
78. The need for routine intensive observation in early postpartum period in labor ward can be explained with increased risk of development of:
1. Acute heart failure
2. Hypotonic bleeding
3. Infectious-toxic shock
4. Acute respiratory failure
5. Eclampsia
*2.hypotonic bleeding
78
79. Substantial engorgement of mammary glands usually occurs:
1. in pregnancy
2. on 1-2 day of puerperium
3. on 3-4 day of puerperium
4. on 4-5 day of puerperium
5. on 5-6 day of puerperium
*3.on 3-4 day of puerperium
79
80. Secretory activity of mammary glands is regulated by:
1. Oestrogens
2. Progesterone
3. Oxytocin
4. LH
5. Prolactin
*5.prolactin
80
81. On the 1-st day of puerperium uterine fundal height is at the level of:
1. Umbilicus
2. Fingers above the umbilicus
3. Fingers beneath the umbilicus
4. at the midpoint between umbilicus and symphysis
5. Fingers above the umbilicus
*1.umbilicus
81
82. On the 5-th day of puerperium uterine fundal height is at the level of:
1. Finger beneath the umbilicus
2. Fingers beneath the umbilicus
3. Finger above symphysis
4. Fingers beneath the umbilicus
5. At the midpoint between umbilicus and symphysis
*5.at the midpoint between umbilicus and symphysis
82
83. Average uterine mass immediately after labor is:
1. 50-80 g
2. 150-200 g
3. 300-500 g
4. approximately 1000 g
5. approximately 2000 g
*4.approximately 1000 g
83
84. In normal uncomplicated puerperium proper restoration of internal os of cervical channel is completed by the:
1. 3rd day
2. 10th day
3. 30th day
4. 21st day
5. at the end of postpartum period
*2.10th day
84
85. At the early postpartum period normal discharge from uterus should be:
1. To some extent bloody
2. Bloody
3. Serous
4. In moderate amount
5. Abundant
* 2.bloody
| * 4.in moderate amount
85
86. Verification of normal involution of the uterus is based on the assessment of the:
1. State of external cervical os
2. General condition of puerpera
3. Results of vaginal investigation
4. Uterine size and consistence
5. Character and amount of lochia
* 4.uterine size and consistence
| * 5.character and amount of lochia
86
87. On the 3rd-4th day of puerperium lochia usually are:
1. Bloody-serous
2. Serous-bloody
3. Serous
4. mucus-like
5. Absent
*1.bloody-serous
87
88. Full postpartum restoration of endometrium structure occurs:
1. from the 10th-15th day
2. during 2-3 week
3. during 4-5 week
4. during 6 week
5. during 8-10 week
*4.during 6 week
88
89. Restoration of epithelial lining in the region of placental bed should be completed during the:
1. 1-st week of puerperium
2. 2-nd week of puerperium
3. 6-th week of puerperium
4. 3-rd week of puerperium
5. 4-th week of puerperium
*3.6-th week of puerperium
89
90. At the end of the 1-st day of puerperium width of internal os equals:
1. Width of hand
2. 4 fingers
3. 2 fingers
4. 1 fingers
5. Finger tip
*3.2 fingers
90
91. Retarded restoration of normally sized nonpregnant uterus in puerperium is called:
1. Uterine subinvolution
2. Lochiometra
3. Hematomata
4. Endometritis
5. Metroendometritis
*1.uterine subinvolution
91
92. Which of the following puerpurae are to be moved to the observational (2nd) post-delivery division?
1. puerperae after operative delivery
2. infected puerpera
3. puerperas with perineal sutures
4. puerperas with high risk of septic complications
5. puerperas after complicated labor
*2.infected puerpera
92
93. Most frequent causes for bleeding in the 1-st trimester of pregnancy include:
1. Varicose dilation of vaginal veins
2. Placenta praevia
3. Threatened abortion
4. Uterine rupture
5. Ectopic pregnancy
* 3.threatened abortion
| * 5.ectopic pregnancy
93
94. Most frequent causes for bleeding at the late stages of pregnancy include:
1. Threatened abortion
2. Uterine rupture
3. Placenta praevia
4. Molar pregnancy
5. Preterm separation of placenta
* 3.placenta praevia
| * 5.preterm separation of placenta
94
95. Basic clinical manifestations of placenta praevia include:
1. Pain in lower abdominal region
2. Bleeding in the 2-nd or 3-rd trimesters of pregnancy
3. External bleeding in labor
4. IUGR
5. Fetal malposition
* 2.bleeding in the 2-nd or 3-rd trimesters of pregnancy
* 3.external bleeding in labor
* 5.fetal malposition
95
96. In case of placental praevia external obstetrical investigation reveals:
1. Increased uterine tonus
2. Painful palpation of lower uterine segment
3. Normal uterine tonus
4. Fetal malposition, high station of presenting part
5. Abnormal uterine contours
* 3.normal uterine tonus
| * 4.fetal malposition, high station of presenting part
96
97. Main prerequisite for performing vaginal investigation in case of suspecting placenta praevia has:
1. Intact amniotic membranes
2. Maintained rules of aseptics
3. Adequate analgesia
4. FHR (fetal heart rate) monitoring
5. Prepared operational theater
*5.prepared operational theater
97
98. Separation of normally located placenta is defined as preterm if it occurred:
1. in the 1-st period of labor
2. during pregnancy
3. in the 2-nd period of labor
4. in the preliminary period
5. in the 3-rd period of labor
* 1.in the 1-st period of labor
* 2.during pregnancy
* 3.in the 2-nd period of labor
* 4.in the preliminary period
98
99. Preterm separation of normally located placenta:
1. May be the result of abdominal trauma
2. Most frequently occurs as the result of vascular lesions due to gestosis, chronic hypertension, and renal disease
3. Leads to IUGR
4. May occurs in the 2-nd period of labor due to retarded rupture of membranes
5. Occurs more frequently with oligohydramnios than with polyhydramnios
* 1.may be the result of abdominal trauma
* 2.most frequently occurs as the result of vascular lesions due to gestosis, chronic hypertension, and renal disease
* 4.may occurs in the 2-nd period of labor due to retarded rupture of membranes
99
100. Etiological factors for preterm separation of placenta include:
1. short umbilical cord
2. retarded rupture of fetal membranes
3. preterm rupture of membranes (PROM)
4. rapid outflow of amniotic fluid in case of polyhydramnios
5. pathological preliminary period
* 1.short umbilical cord
* 2.retarded rupture of fetal membranes
* 4.rapid outflow of amniotic fluid in case of polyhydramnios
100
101. Manifestations of preterm separation of placenta may include:
1. Severe abdominal pains
2. Profuse external bleeding
3. Uterine tetanus
4. Intrauterine hypoxia or death
5. Squeezing pains in lower abdomen
* 1.severe abdominal pains
* 3.uterine tetanus
* 4.Intrauterine hypoxia or death
101
102. Complete placenta praevia is indication for caesarean section:
1. Only in combination with other relative indications
2. Only if birth passage is not ready for delivery
3. Only in combination with bleeding
4. Only if the fetus is alive
5. It is absolute indication for CS
*5.it is absolute indication for CS
102
103. In case of complete placenta praevia CS is performed only:
1. If fetus is alive
2. In lower uterine segment
3. If there is threat to life
4. In case of bleeding
5. CS should be elective
*5.CS should be elective
103
104. Progressive preterm separation of placenta during pregnancy is indication for:
1. CS
2. Induction of labor
3. Delivery per vias naturals (vaginal labor)
4. Supravaginal uterine amputation (subtotal hysterectomy)
*1.CS
104
105. The term “Placenta adhaerens” means:
1. Slight invasion of villous chorion to miometrium
2. Insufficient adhesion of villous chorion to decidua
3. Growth of villous chorion through basal layer of endometrium
4. Villous chorion has reached serous membrane (perimetrium)
5. Deep invasion of villous chorion to miometrium
*3.growth of villous chorion through basal layer of endometrium
105
106. Placenta Adhaerens:
1. Is more frequent in postterm pregnancy and in gestoses
2. Is the result of structural-morphological changes of endometrium
3. Is characterized with partial invasion of villous chorion to miometrium
4. Is characterized with close attachment of villous chorion to decidua
5. Is indication for hysterectomy
* 2.is the result of structural-morphological changes of endometrium
* 4.is characterized with close attachment of villous chorion to decidua
106
107. Placenta accreta
1. Is a common finding in gestosis
2. May be complete and incomplete (partial)
3. Is indication for manual separation and removal of placenta
4. Is the result of structural-morphological changes of endometrium
5. Is indication for hysterectomy
* 2.may be complete and incomplete (partial)
3. Is indication for manual separation and removal of placenta
* 4.is the result of structural-morphological changes of endometrium
* 5.is indication for hysterectomy
107
108. True placenta accreta means:
1. Close attachment of villous chorion to decidua
2. Invasion of villous chorion to miometrium
3. Villous chorion reaching serous membrane (perimetrium)
4. Villous chorion developing in spongy layer of decidua
* 2.invasion of villous chorion to miometrium
| * 3.villous chorion reaching serous membrane (perimetrium)
108
109. In case of total placenta accreta
1. Spontaneous separation of placenta is impossible
2. Invasion of villous chorion to miometrium occurrs
3. Bleeding is usually absent
4. It is always associated with bleeding in the 3-rd period of labor
5. Hysterectomy is indicated
* 1.spontaneous separation of placenta is impossible
* 2.invasion of villous chorion to miometrium occurrs
* 3.bleeding is usually absent
* 5.hysterectomy is indicated
109
110. Major etiological factors of placenta adhaerens and placenta accreta include:
1. Post term pregnancy
2. Gestosis
3. Structural-morphological changes of endometrium
4. Chronic hypertension, renal disease
5. Increased proteolytic chorionic activity
* 3.structural-morphological changes of endometrium
| * 5.increased proteolytic chorionic activity
110
111. Indications for hysterectomy include:
1. Placenta adhaerens
2. Partial placenta accreta
3. Placenta praevia
4. Uterine atonic bleeding
* 2.partial placenta accreta
| * 4.uterine atonic bleeding
111
112. Bleeding in early postpartum period may be due to:
1. Soft tissues lacerations of the birth channel
2. Hypotonic or atonic uterus
3. Preterm detachment of normally located placenta
4. Placenta praevia
5. Congenital or acquired coagulopathy
* 1.soft tissues lacerations of the birth channel
* 2.hypotonic or atonic uterus
* 5.congenital or acquired coagulopathy
112
113. Necessary steps in case of bleeding in early postpartum period are:
1. To empty urinary bladder
2. To begin restoration of the lost blood volume
3. To perform manual exploration of the uterine cavity and outer-inner massage
4. To use uterotonics
5. Immediately to perform laparotomy in case of atony
* 1.to empty urinary bladder
* 2.to begin restoration of the lost blood volume
* 3.to perform manual exploration of the uterine cavity and outer-inner massage
* 4.to use uterotonics
* 5.immediately to perform laparotomy in case of atony
113
114. Prolonged missed labor (intrauterine fetal death)
1. May lead to hypotonic bleeding
2. May cause anomalous placental attachment
3. Can lead to maternal intoxication
4. May lead to transition of tissue thromboplastin substances to maternal blood circulation
5. May be etiological factor of coagulopatic haemorrhage
* 4.may lead to transition of tissue thromboplastin substances to maternal blood circulation
* 5.may be etiological factor of coagulopatic haemorrhage
114
115. Bi-manual massage of the uterus (fist massage)
1. Is performed in case of hypotonic bleeding
2. Is used in case of uterine rupture
3. Is one of the methods for restoration of contractile uterine capacity
4. Is used in the cases of pathological placental attachment
5. Ensures the process of placental separation
* 1.is performed in case of hypotonic bleeding
| * 3.is one of the methods for restoration of contractile uterine capacity
115
116. Abuladze (Bayer) maneuver
1. Is indicated in case of placenta adherens
2. Should be performed after external massage of the uterus
3. Is used in case of hypotonic hemorrhage
4. Is to be used for delivery of placenta if signs of placental separation are positive
5. Is one of the methods for assisted placental delivery
* 4.is to be used for delivery of placenta if signs of placental separation are positive
* 5.is one of the methods for assisted placental delivery
116
117. Operation “Manual exploration of the uterine cavity walls” is indicated in case:
1. Of vaginal bleeding in combination with negative signs of placental separation
2. 30 m after postpartum period if signs of placental separation are negative
3. Hypotonic hemorrhage
4. Of retained placental fragments
5. Suspicion on retained placental fragment
* 3.hypotonic hemorrhage
* 4.of retained placental fragments
* 5.suspicion on retained placental fragment
117
118. Pregnant women with the uterine scars should be hospitalized:
1. at the first antenatal visit
2. at the age of 26-28 wks
3. at 32-34 wks
4. not less than 2 wks before expected date of delivery
*4.not less than 2 wks before expected date of delivery
118
119. Symptoms of threatened uterine rupture in case of cephalo-pelvic disproportion include:
1. Uneasy behavior
2. Sudden cessation of uterine contractions
3. Oedema of the anterior cervical “lip”
4. Difficulties of spontaneous micturition
5. Contraction ring at the level of umbilicus (navel)
* 1.uneasy behavior
* 3.oedema of the anterior cervical “lip”
* 4.difficulties of spontaneous micturition
* 5.contraction ring at the level of umbilicus (navel)
119
120. Actual complete uterine rupture is characterized with:
1. Development of flabbiness, lethargy
2. Difficulty in palpation of small fetal parts
3. Abdominal distention
4. Intrauterine fetal death
5. Hypertonic uterine dysfunction
* 1.development of flabbiness, lethargy
* 3.abdominal distention
* 4.intrauterine fetal death
120
121. Perineal laceration:
1. Usually occurs suddenly
2. Is impossible to forecast
3. Commonly begins from the region of fourchette
4. Is more common in primiparas
5. May lead to serious consequences for women’s health
* 3.commonly begins from the region of fourchette
* 4.is more common in primiparas
* 5.may lead to serious consequences for women’s health
121
122. Perineal lacerations occur:
1. Most commonly in the 3rd degree
2. Approximately in 20-30% of all labors
3. More frequently in cases of ‘high’ perineum
4. More commonly in elderly primiparas (> 30 yr)
5. More frequently in postterm delivery
* 3.more frequently in cases of ‘high’ perineum
* 4.more commonly in elderly primiparas (> 30 yr)
* 5.more frequently in postterm delivery
122
123. Perineal damage is defined as the 2-nd degree laceration if it involves:
1. The fourchette and perineal skin
2. The mucosa, the skin, the fascia and muscles of the perineal body
3. The rectal mucosa
4. The anal sphincter
5. If the length of laceration exceeds 3 cm
*2. The mucosa, the skin, the fascia and muscles of the perineal body
123
124. Perineal damage is defined as the 3-rd degree laceration if:
1. The length of laceration exceeds 3 cm
2. The mucosa, the skin, the fascia and muscles of the perineal body are involved
3. The rectal mucosa is involved
4. If laceration goes deeply to paravaginal fat tissue
*3.the rectal mucosa is involved
124
125. Cervical lacerations are more common for:
1. Precipitate labors
2. Cervical dystocia
3. For primiparas of 20-24 yr
4. Labors of LOA (left occipitum anterior) variants
5. For contracted pelvises
* 1.precipitate labors
| * 2. Cervical dystocia
125
126. Cervical lacerations may cause:
1. Uterine prolapse
2. Puerperal sepsis
3. Preterm labors
4. Development of precancerous lesions of cervix
5. Fetal malpositions during next gestations
* 2.puerperal sepsis
* 3.preterm labors
* 4.development of precancerous lesions of cervix
126
127. Vaginal wall lacerations:
1. Are more common for precipitate labors
2. Are more common with large fetuses
3. More frequently occur in the upper third part of vagina
4. May lead to profuse hemorrhages
5. Are repaired with silk sutures
* 1.are more common for precipitate labors
* 2.are more common with large fetuses
* 4.may lead to profuse hemorrhages
127
128. In modern obstetrics the most common variant of CS is:
1. Corporal CS
2. CS in lower uterine segment
3. Vaginal CS
4. Extraperitoneal CS
5. Sectio caesarea parva
*2.CS in lower uterine segment
128
129. Delivering obstetrical operations include:
1. CS
2. Perineotomy
3. Application of the forceps or vacuum-extraction
4. Craniotomy
5. Amniotomy
* 1.CS
* 2.perineotomy
* 3.application of the forceps or vacuum-extraction
129
130. Indications for CS include:
1. Complete placenta praevia
2. Breech presentation
3. Contracted pelvis of 3-4 degree
4. Uterine scar insufficiency
5. Threatened uterine rupture
* 1.complete placenta praevia
* 3.contracted pelvis of 3-4 degree
* 4.uterine scar insufficiency
* 5.threatened uterine rupture
130
131. Obstetrical forceps:
1. Are used for finishing labors
2. May be used at the end of the 1-st period of labor
3. Afford to exclude the need for bearing down
4. Are used for correction of the head engagement
5. Afford to change fetal position and visus
* 1.are used for finishing labors
| * 3.afford to exclude the need for bearing down
131
132. Among the prerequisites for forceps applications are:
1. Alive fetus
2. Intact fetal membranes
3. Large fetal head segment engaged to the small pelvis inlet
4. Full dilation of the uterine os
5. Normal pelvic dimensions
* 1.alive fetus
* 4.full dilation of the uterine os
* 5.normal pelvic dimensions
132
133. Indications for the forceps application may include:
1. Cephalo-pelvic disproportion
2. Intrauterine fetal death
3. Secondary hypotonic uterine dysfunction
4. Preeclampsia
5. Preterm labor
* 2.intrauterine fetal death
* 3.secondary hypotonic uterine dysfunction
* 4.preeclampsia
133
134. The trial traction during forceps application
1. Affords to determine necessary traction force to be applied
2. Is performed to determine the level of the head station
3. Affords to determine the correctness of the forceps application
4. Requires special localization of the operator’s hands
* 3.affords to determine the correctness of the forceps application
* 4.requires special localization of the operator’s hands
134
135. Indications for perineotomy include:
1. Threatened perineal rupture
2. Fetal hypoxia
3. Secondary hypotonic uterine dysfunction
4. Intranatal fetal death
5. Cephalo-pelvic disproportion
* 1.threatened perineal rupture
* 2.fetal hypoxia
* 3.secondary hypotonic uterine dysfunction
135
136. Indications for decapitation are:
1. Neglected transverse fetal lie
2. Transverse fetal lie complicated with threatened uterine rupture
3. Breech presentation complicated with intranatal fetal death
4. Hydrocephaly
5. Antenatal death of the fetus in cephalic presentation
*1.neglected transverse fetal lie
136
137. The 1-st elective hospitalization in gestations complicated with cardiovascular disease is indicated:
1. In the I trimester (before 12 wks)
2. In case of aggravation of the condition
3. If there is some associated obstetrical complication
4. At the age of 28-32 wks
5. If there are signs of cardiovascular insufficiency
*1.in the I trimester (before 12 wks)
137
138. In women where pregnancies are associated with chronic hypertension there is increased risk of:
1. Early toxicosis
2. Gestosis
3. Spontaneous preterm pregnancy termination
4. Intrauterine growth restriction
5. Anomalous placental attachment
* 2.gestosis
* 3.spontaneous preterm pregnancy termination
* 4.intrauterine growth restriction
138
139. Postural hypotensive syndrome (Vena cava inferior- syndrome):
1. is more common in primigravidas
2. May be cured with caffeine, cordiamine, mesaton
3. Is manifested with severe fall of BP, tachycardia, and skin pallor
4. Occurs at the late stages of pregnancy in the position on the back
5. Is relieved in the left recumbent position
* 3.is manifested with severe fall of BP, tachycardia, and skin pallor
* 4.occurs at the late stages of pregnancy in the position on the back
* 5.is relieved in the left recumbent position
139
140. Proper management of labor in pregnancies complicated with chronic hypertension includes:
1. Preterm amniotomy
2. Term amniotomy
3. Labor analgesia
4. I/V use of the magnesium sulphate
5. Use of uterotonics
* 1.preterm amniotomy
| * 3.labor analgesia
140
141. Etiological factors of the fetal malposition include:
1. Contracted pelvis
2. Polyhydramnios
3. Mullerian duct anomalies
4. Multifetal pregnancy
5. Placenta praevia
* 1.contracted pelvis
* 2.polyhydramnios
* 3.Mullerian duct anomalies
* 4.multifetal pregnancy
* 5.placenta praevia
141
142. Symptoms of the fetal malposition are:
1. Excessive symhysiofundal height
2. High station of the presenting fetal part
3. Absence of the presenting part above the small pelvis inlet
4. fetal head palpated at the uterine fundus
5. Enlargement of the uterine transverse dimensions
* 3.absence of the presenting part above the small pelvis inlet
* 5.enlargement of the uterine transverse dimensions
142
143. Classical maneuvers for breech deliveries:
1. Are not used in modern obstetrics
2. Include two steps: assisted delivery of arms followed by delivery of the head
3. Are performed in time of buttocks crowning
4. Are performed only with maternal indications
5. Are performed after delivery of lower angle of the anterior scapula if pushing down activity is ineffective
* 2.include two steps: assisted delivery of arms followed by delivery of the head
* 5.are performed after delivery of lower angle of the anterior scapula if pushing down activity is ineffective
143
144. Tzovjanoff manoeuvre in clear breech presentation:
1. Affords to prevent fetal expulsion until full uterine os dilation
2. Allows to maintain normal fetal attitude
3. allows to convert clear breech presentation into mixed or leg (footling) presentation
4. Does not require perineotomy
5. Allows to prevent extension of the arms
* 2.allows to maintain normal fetal attitude
| * 5.allows to prevent extension of the arms
144
145. Tzovjanoff maneuver in footling breech presentation
1. Allows maintaining normal fetal attitude
2. Affords to prevent preterm delivery of the legs
3. Allows to convert footling breech presentation into mixed presentation
4. Reduces the rate of fetal obstetrical traumas
5. Affords to prevent extension of the arms
* 2.affords to prevent preterm delivery of the legs
* 3.allows to convert footling breech presentation into mixed presentation
* 4.reduces the rate of fetal obstetrical traumas
145
146. Classical inner-outer (bimanual) obstetrical version on the leg may be performed only in case of:
1. Full dilation of the uterine os
2. Ruptured fetal membranes
3. Intact fetal membranes
4. Sufficient motility of the child
5. Fetal size being relevant to the pelvic size (adequate)
* 1.full dilation of the uterine os
* 2.ruptured fetal membranes
* 4.sufficient motility of the child
* 5.fetal size being relevant to the pelvic size (adequate)
146
147. Etiological factors of transverse fetal lie include:
1. Mullerian duct anomalies
2. Contracted pelvis
3. Gestosis
4. Polyhydramnios
5. Contracted pelvis
* 1.Mullerian duct anomalies
* 2.contracted pelvis
* 4.polyhydramnios
* 5.contracted pelvis
147
148. In case of transversal lie:
1. Uterine fundus is higher than in longitudinal lie
2. Uterine fundus is lower than in longitudinal lie
3. Uterus is elongated in the transverse or oblique direction
4. Fetal head is lower than iliac crest
5. Presenting part is absent
* 2.uterine fundus is lower than in longitudinal lie
* 3.uterus is elongated in the transverse or oblique direction
* 5.presenting part is absent
148
149. In case of neglected transverse lie of the dead fetus
1. Uterine rupture is possible
2. There is a high risk of septic complications
3. General narcosis is essential
4. The only mode of delivery - CS
5. Fetus-destructive operation is indicated
* 1.uterine rupture is possible
* 2.there is a high risk of septic complications
* 3.general narcosis is essential
* 5.fetus-destructive operation is indicated
149
150. Maurecau-Levret maneuver:
1. Is used in the frame of classical maneuver
2. Is used for assisted delivery of the arms and head
3. Is used for delivery of aftercoming head in breech presentations
4. Is part of the Tzovjanoff maneuver
* 1.is used in the frame of classical maneuver
| * 3.is used for delivery of aftercoming head in breech presentations
150
151. Anterior asinclitism:
1. Is defined as A. of Litzmann
2. Is defined as A. of Negele
3. Occurs during labor in women with plane pelvises
4. Is diagnosed when sagittal suture has deviated anteriorly
5. Is diagnosed at the time of crowning
* 2.is defined as A. of Negele
| * 3.occurs during labor in women with plane pelvises
151
152. Anomalous uterine activity includes:
1. Primary hypotonic dysfunction of labor forces
2. Secondary hypotonic dysfunction of labor forces
3. Precipitate labor
4. Discoordinated uterine function
5. Pathological preliminary period
* 1.primary hypotonic dysfunction of labor forces
* 2.secondary hypotonic dysfunction of labor forces
* 3.precipitate labor
* 4.discoordinated
152
153. Primary hypotonic dysfunction:
1. Can be an indicaton for CS
2. Is usually diagnosed in the first period of labor
3. Can be an indication for labor stimulation
4. Can be associated with retarded rupture of amniotic membranes
5. Can be diagnosed within 2 hours from the labor onset
* 1.can be an indicaton for CS
* 2.is usually diagnosed in the first period of labor
* 3.can be an indication for labor stimulation
153
154. Secondary hypotonic uterine dysfunction:
1. Can be often seen in case of preterm labor
2. Is mostly seen in case of large fetus
3. Can be complicated with fetal hypoxia
4. Is a common complication in case of flexed attitude
5. Can be complicated with tissue necrosis
* 2.is mostly seen in case of large fetus
* 3.can be complicated with fetal hypoxia
* 5.can be complicated with tissue necrosis
154
155. Precipitate labor
1. Is the most often seen type of abnormal uterine activity
2. Results in uterine-placental blood flow disorders
3. Can result in fetal intracranial injuries
4. Can be complicated with hypotonic haemorrhage in early puerperal period
* 2.results in uterine-placental blood flow disorders
* 3.can result in fetal intracranial injuries
* 4.can be complicated with hypotonic haemorrhage in early puerperal period
155
156. Discoordinated uterine function
1. is rarely diagnosed
2. can manifest as a lower uterine section dominance
3. can manifest as cervical dystocia
4. manifests in dilation arrest
5. requires administration of uterotonics
* 1.is rarely diagnosed
* 2.can manifest as a lower uterine section dominance
* 3.can manifest as cervical dystocia
* 4.manifests in dilation arrest
156
157. For labor stimulation, which of the following can be used?
1. Intravenous bolus injection of 5 units’ oxytocin with 20 ml 40 % glucose solution
2. Intravenous drop by drop injection of 20 units oxytocin with 500 ml 5 % glucose solution
3. Intravenous drop by drop injection of 5 units oxytocin with 500 ml 5 % glucose solution, starting with 8-10 drops per minute
4. Intravenous injection of 1ml 0, 02% methylergometrin solution
5. Intravenous drop by drop injection of 0,5mg enzaprost with 300-500 ml 0, 9% NaCl, starting with 8-10 drops per minute
* 3.intravenous drop by drop injection of 5 units oxytocin with 500 ml 5 % glucose solution, starting with 8-10 drops per minute
* 5.intravenous drop by drop injection of 0,5mg enzaprost with 300-500 ml 0, 9% NaCl, starting with 8-10 drops per minute
157
158. Narcotics usage
1. Is indicated for some types of hypotonic dysfunction treatment
2. Is indicated for precipitate labor treatment
3. Is indicated for the second period of labor analgesia
4. Can influence the fetus state
5. 1ml 2% solution of promedol can fully stop the labor activity
* 1.is indicated for some types of hypotonic dysfunction treatment
* 2.is indicated for precipitate labor treatment
* 4.can influence the fetus state
158
159. Cephalo-pelvic disproportion (clinically contracted pelvis) is usually diagnosed:
1. at the onset of the first period of labor
2. in case of negative Vasten sign
3. during pregnancy
4. at the moment of total or nearly total dilation
5. on detecting the specific uterine shape
*4.at the moment of total or nearly total dilation
159
160. The cephalo-pelvic disproportion (clinically contracted pelvis) diagnosis is based on:
1. The results of external pelvic diameters measurement
2. Diagonal conjugate measurement
3. Diameters of Michaelis rhomboid measurement
4. Internal pelvic surfaces palpation
5. X-ray pelvimetry
* 1.the results of external pelvic diameters measurement
* 2.diagonal conjugate measurement
* 3.diameters of Michaelis rhomboid measurement
* 4.internal pelvic surfaces palpation
* 5.X-ray pelvimetry
160
161. Pregnant women with signs of cephalo-pelvic disproportion (clinically contracted pelvis):
1. Should be hospitalized in obstetrical in-patient department 2 weeks before labor
2. Can be delivered only with CS
3. Should be kept under maternity welfare centre observation before labor
4. Pregnancy in these women must be interrupted at early stages
5. Should undergoes ultrasound before labor
* 1.should be hospitalized in obstetrical in-patient department 2 weeks before labor
* 5.should undergoes ultrasound before labor
161
162. Anatomically contracted pelvis can be diagnosed if:
1. C. vera is 10 cm or less
2. C. diagonalis is 13 cm
3. C. externa is 20-21cm
4. Vertical diameter of Michaelis rhomboid is 11cm
5. All the large pelvis diameters are 2 cm less than normal
* 1.C. vera is 10 cm or less
| * 5.all the large pelvis diameters are 2 cm less than normal
162
163. Labor management in women with anatomically contracted pelvis requires:
1. Pelvis shape and degree of contraction assessment
2. Average circumference of the wrist (Solovev’s index) determination
3. Determination of the expected birth weight
4. Early amniotomy
5. Vasten sign determination
* 1.pelvis shape and degree of contraction assessment
* 2.average circumference of the wrist (Solovev’s index) determination
* 3.determination of the expected birth weight
* 5.Vasten sign determination
163
164. In case of anatomically contracted pelvis the fetus can have the following complications in labor:
1. Cephalohaematoma
2. Pathologic head configuration
3. Fetal hypoxia
4. Intracranial injury
5. Respiratory distress syndrome (RDS)
* 1.cephalohaematoma
* 2. Pathologic head configuration
* 3.fetal hypoxia
* 4.intracranial injury
164
165. Simple flat pelvis is characterized by:
1. Direct small pelvis inlet diameter decreased
2. All pelvic diameters decreased
3. All direct diameters decreased
4. Transverse small pelvis outlet diameter decreased
5. Normal transverse small pelvis diameters
* 3.all direct diameters decreased
| * 5.normal transverse small pelvis diameters
165
166. Anatomically contracted pelvis can result from:
1. rickets
2. congenital abnormalities of the pelvic bones
3. poliomyelitis
4. bone tuberculosis
5. vertebral column injury
* 1.rickets
* 2.congenital abnormalities of the pelvic bones
* 3.poliomyelitis
* 4.bone tuberculosis
* 5.vertebral column injury
166
167. Labor in case of anatomically contracted pelvis is characterized by:
1. High frequency of intracranial injuries in newborns
2. High per cent of surgical interference
3. High incidence of prenatal death
4. High frequency of tissue injuries
5. Prolonged duration
* 1.high frequency of intracranial injuries in newborns
* 2.high per cent of surgical interference
* 4.high frequency of tissue injuries
* 5.prolonged duration
167
168. CS is indicated in case of the first degree pelvic contraction associated with:
1. Post-term pregnancy
2. Large fetus
3. Young primipara
4. IUGR
5. Breech presentation
* 1.post-term pregnancy
* 2.large fetus
3. Young primipara
4. IUGR
* 5.breech presentation
168
169. In case of the third degree pelvic contraction one of the following is indicated:
1. CS
2. Application of obstetrical forceps
3. Perforation of the head (craniotomy)
4. Perineotomy
5. Vacuum extraction of the fetus
*1.CS
169
170. Cephalo- pelvic disproportion can result from
1. large fetus
2. abnormal cephalic engagement (attitude)
3. placenta praevia
4. uterine scar
5. hydrocephaly
* 1.large fetus
* 2.abnormal cephalic engagement (attitude)
* 5.hydrocephaly
170
171. the most common signs of cephalo-pelvic disproportion include:
1. lack of fetus head movement after complete uterine cervix dilation
2. hypotonic dysfunction
3. positive or equivocal Vasten sign
4. difficulties of micturition
* 1.lack of fetus head movement after complete uterine cervix dilation
* 3.positive or equivocal Vasten sign
* 4.difficulties of micturition
171
172. Vasten sign should be assessed
1. at the onset of labor
2. after rupture of amniotic membrane
3. when uterine cervix dilation is 4 cm
4. when uterine dilation is complete or almost complete
5. when the fetal head is fixed to the small pelvis inlet
* 2.after rupture of amniotic membrane
* 4.when uterine dilation is complete or almost complete
* 5.when the fetal head is fixed to the small pelvis inlet
172
173. In case of immunological conflict between mother and fetus labor can be complicated with:
1. Preterm rupture of membranes
2. Uterine rupture
3. Bleeding in the third period of labor
4. Intranatal fetal death
5. Fetal hypoxia
* 4.intranatal fetal death
| * 5.fetal hypoxia
173
174. Fetal hypoxia can be diagnosed with the help of
1. auscultation 2. cardiotocography
3. zaling test
4. x-ray
* 1.auscultation
* 2.cardiotocography
* 3.Zaling test
174
175. Neonatal hemolytic disease is characterized by:
1. hyperbilirubinaemia
2. narrowed cranial sutures and fontanel
3. general oedema
4. paleness and/or jaundice
5. cardiovascular and respiratory disorders
* 1.hyperbilirubinaemia
* 3.general oedema
* 4.paleness and/or jaundice
* 5.cardiovascular and respiratory disorders
175
176. Basic resuscitation measures for infants born in asphyxia include:
1. Airways toilet
2. Intubation and artificial lung ventilation
3. Oxygenotherapy
4. Drugs injection
5. External cardiac massage
* 1.airways toilet
* 2.intubation and artificial lung ventilation
* 3.oxygenotherapy
4. Drugs injection
* 5.external cardiac massage
176
177. Neonatal haemolytic disease results from
1. AB0 system antigens sensitization
2. Intrauterine infection
3. Chronic fetal hypoxia in case of gestosis
4. Leucocytes antigens sensitization
5. Rhesus-antigenes sensitization
* 1.AB0 system antigens sensitization
| * 5.rhesus-antigenes sensitization
177
178. Fetal hemolytic disease is characterized by:
1. total bilirubin elevation
2. total protein decrease
3. haemoglobin reduction
4. erythroblastosis
5. increased in erythrocytes
* 1.total bilirubin elevation
* 2.total protein decrease
* 3.haemoglobin reduction
* 4.erythroblastosis
178
179. To assess the fetal state in rhesus-negative women you can use:
1. amniotic fluid evaluation
2. ultrasonography
3. cardiomonitoring
4. amnioscopy
5. colposcopy
* 1.amniotic fluid evaluation
* 2.ultrasonography
* 3.cardiomonitoring
* 4.amnioscopy
179
181. Infectiouse deseases of the newborns include:
1. Pyoderma
2. Folliculitis
3. Pemphigus
4. Omphalitis
5. Toxic erythema
* 1.pyoderma
* 2.folliculitis
* 3.pemphigus
* 4.omphalitis
180
182. the most common types of fetal birth injury include:
1. Dushenn-Erb paralysis
2. Fractured clavicle
3. Cephalohaematoma
4. Auditory nerve injury
5. Facial nerve palsy
* 1.Dushenn-Erb paralysis
* 2.fractured clavicle *3.cephalohaematoma
* 5.facial nerve palsy
181
183. The first stage of puerperal septic process according to Sazonov-Bartels classification includes:
1. Endometritis
2. Pelvic trombophlebitis
3. Parametritis
4. Lower extremities veins trombophlebitis
5. Puerperal ulcer
* 1.Endometritis
| * 5.puerperal ulcer
182
184. The second stage of puerperal septic process according to Sazonov-Bartels classification includes:
1. puerperal ulcer
2. parametritis
3. pelvic trombophlebitis
4. salpingoophoritis
5. pelvioperitonitis
* 2.parametritis
* 3.pelvic trombophlebitis
* 4.salpingoophoritis
* 5.pelvioperitonitis
183
185. The typical symptoms of serous mastitis include:
1. acute onset
2. manifestation on the 6-8 week of the puerperium
3. general malaise, headache
4. mammary gland engorgement and involvement in the process
5. pain in mammary gland
* 1.acute onset
* 3.general malaise, headache
* 4.mammary gland engorgement and involvement in the process
* 5.pain in mammary gland
184
186. Infiltrative form of mastitis:
1. Results from serous mastitis in 2-3 weeks
2. Can be diagnosed in case of fluctuation in the mammary gland tissue
3. Is characterized only by local symptoms
4. Is an indication for surgical treatment
5. Often results from inadequate therapy of serous mastitis
*5.often results from inadequate therapy of serous mastitis
185
187. Lactation supression is indicated in:
1. mastitis gangrenosa
2. relapsing forms of mastitis
3. infiltrative form of mastitis
4. mammary gland abscess
5. rapid progression of mastitis
* 1.mastitis gangrenosa
* 2.relapsing forms of mastitis
* 4.mammary gland abscess
* 5.rapid progression of mastitis
186
188. the most adequate medication for lactation supression is:
1. spironolactone
2. monobromated camphor
3. parlodel
4. synaestrol
5. progesterone
*3.parlodel
187
189. The term “puerperal ulcer” can be used for contaminated:
1. perineum wounds
2. uterine cervix injuries
3. vaginal injuries
4. laparotomy wounds
5. nipple cracks
* 1.perineum wounds
* 2.uterine cervix injuries
* 3.vaginal injuries
188
190. Mini-abortion:
1. Can be performed in the out-patient unit
2. Can be performed in case of less than 3 weeks delay of menstruation
3. Can be performed after cervical channel dilation with Hegar dilator ¹8
4. Is performed with curette ¹2
5. isn’t associated with any complications
* 1.can be performed in the out-patient unit
| * 2.can be performed in case of less than 3 weeks delay of menstruation
189
191. A doctor can refuse to perform an abortion in case of:
1. Cervical ectopy
2. Uterine fibroid
3. HIV-carrier
4. Gonococcus determined in cervical smear
5. Chronic infection of any localization
*4.gonococcus determined in cervical smear
190
192. Prolonged pregnancy is characterized by:
1. Duration above 280 days from the ovulation
2. Fetoplacental insufficiency detected
3. Immature baby birth
4. Polyhydramnios
5. Oligohydramnios
*1.duration above 280 days from the ovulation
191
193. To diagnose post term pregnancy one can use:
1. pregnancy age determination according to the anamnesis
2. oxytocin Smith test
3. ultrasound
4. colpocytology
* 1.pregnancy age determination according to the anamnesis
* 3.ultrasound
* 4.colpocytology
192
194. Classical post mature baby syndrome includes:
1. Palm and feet skin maceration
2. Vernix caseosa absence
3. Long nails
4. Cellular tissue oedema
5. Cranial sutures and fontanel narrowed
* 1.palm and feet skin maceration
* 2.vernix caseosa absence
* 3.long nails
4. Cellular tissue oedema
* 5.cranial sutures and fontanel narrowed
193
195. Post term delivery is characterized by:
1. untimely rupture of the amniotic membranes
2. cephalo-pelvc disproportion
3. precipitate labor
4. fetal hypoxia
5. maternal trauma
* 1.untimely rupture of the amniotic membranes
* 2.cephalo-pelvc disproportion
* 4.fetal hypoxia
* 5.maternal trauma
194
196. Glomerulonephritis in pregnancy
1. Is usually seen in acute forms
2. Is one of the etiological factors of placenta praevia
3. Is complicated with gestosis at early stages of gestation
4. Isn’t usually followed with IUGR
*3.is complicated with gestosis at early stages of gestation
195
197. Gestational pyelonephritis
1. is usually seen in the second part of pregnancy
2. is more common on the left side
3. is usually due to streptoccocus
4. Doesn’t affect erythropoesis
*1.is usually seen in the second part of pregnancy
196
198. A medication that is ungrounded and contraindicated for the treatment of threatened preterm termination of pregnancy:
1. dexamethasone
2. magnesium sulphate
3. gynipral (B-mymetics)
4. seduxen
5. ovidone
*5.ovidone
197
199. Resuscitation measures in case of amniotic fluid embolism include:
1. Artificial lung ventilation
2. Massive antibiotic therapy
3. DIC syndrome prevention
4. Pulmonary edema prevention
5. High doses of corticosteroids
* 1.artificial lung ventilation
2. Massive antibiotic therapy
* 3.DIC syndrome prevention
* 4.pulmonary edema prevention
* 5.high doses of corticosteroids
198
200. Pregnant women with diabetes can:
1. Have insulin therapy
2. Have preparations of sulfur group
3. Take biguanids (áèãóàíèäû)
4. Follow a diet with reduction in proteins
5. Follow a diet with reduction in fats and carbohydrates
* 1.have insulin therapy
| * 5.follow a diet with reduction in fats and carbohydrates
199
180. the most common forms of fetal hemolytic disease are:
1. Oedematic
2. Icteric
3. Anemic
4. Haemorrhagic
5. Convulsive
* 1.oedematic
* 2.icteric
* 3.anemic
200
60. In case of no signs of placental separation and absence of bleeding one should attempt to perform manual separation and removal of the placenta after:
1. 2 h
2. 1,5 h
3. 1 h
4. 30 m
5. 15
*4.30 m
