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Question 1
Correct
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In pregnancy, the following lung function value remains unchanged:
Your Answer: FEV1
Explanation:The biochemical and mechanical effects of progesterone and the enlarging uterus are responsible for some changes in lung function during pregnancy.
Progesterone increases the sensitivity of the respiratory centre to arterial carbon dioxide while also causing hyperaemia in the airway leading to nasal obstruction. As a result, minute ventilation and tidal volume increase by 50% to allow greater arterial oxygen saturation.
The enlarging uterus displaces the diaphragm upwards, and also limits the movement of the thoracic cage, thereby decreasing the functional residual capacity (FRC) and the expiratory reserve volume (ERV) by 20%.
Functional Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) remain unchanged in pregnancy.
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This question is part of the following fields:
- Physiology
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Question 2
Incorrect
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Which one of the following features indicates fetal asphyxia?
Your Answer: Deep type I deceleration in the 2nd stage of labour
Correct Answer: Type II (late) decelerations with tachycardia
Explanation:A type II deceleration is due to placental insufficiency which can result in fetal distress and asphyxia. The fetal heart rate is lowest at the start of the contraction and returns to normal after the contraction is complete.
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This question is part of the following fields:
- Physiology
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Question 3
Correct
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What is the normal pH value of an umbilical arterial sample of a new born term baby?
Your Answer: 7.2
Explanation:The normal range for a term baby is pH: 7.18 – 7.38, and preterm pH: 7.14 – 7.4. A pH below 7.1 therefore indicates acidosis.
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This question is part of the following fields:
- Physiology
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Question 4
Incorrect
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Spinnbarkheit is a term which means:
Your Answer: Thickening of the cervical mucous
Correct Answer: Threading of the cervical mucous
Explanation:Spinnability (or Spinnbarkeit), which measures the capacity of fluids to be drawn into threads, represents an indirect measurement of the adhesive and elastic properties of mucus.
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This question is part of the following fields:
- Physiology
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Question 5
Correct
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What is the primary form of haemoglobin in a 6 week old foetus?
Your Answer: Hb Gower 1
Explanation:HB gower 1 is the predominant embryonic haemoglobin when the foetus is 6 weeks old and is replaced by adult haemoglobin by the age of 5 months post natally.
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This question is part of the following fields:
- Physiology
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Question 6
Correct
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Question 7
Incorrect
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Which of the following statements is true regarding renal blood flow in pregnancy?
Your Answer: Increases by approximately 25%
Correct Answer: Increases by approximately 50%
Explanation:Glomerular filtration rate (GFR) rises immediately after conception and increases by about 50 per cent overall, reaching its maximum at the end of the first trimester. GFR then falls by about 20 per cent in the third trimester, returning to pre-pregnancy levels within 12 weeks of delivery.
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This question is part of the following fields:
- Physiology
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Question 8
Incorrect
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A 25 year old primigravida with a regular cycle had her last menstrual period on June 30th. Therefore the expected date of delivery (EDD) is approximately when the following year:
Your Answer: 7-Mar
Correct Answer: 7-Apr
Explanation:Expected date of delivery (EDD) is a calculated from the first day of the woman’s last menstrual period. If her periods are regular i.e., 28-day menstrual cycle, Naegele’s rule may be used. Naegele’s rule involves a simple calculation: add seven days to the first day of your LMP and then subtract three months. e.g. 30 June + 7 days = 7 July, minus 3 months = 7 April.
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This question is part of the following fields:
- Physiology
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Question 9
Incorrect
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Normally, pregnancy in 2nd trimester is characterized by all of the following, EXCEPT:
Your Answer: Decreased fasting plasma glucose
Correct Answer: Elevated fasting plasma glucose
Explanation:Elevated fasting plasma glucose means gestational diabetes mellitus and is not considered to be in the spectrum of a normal pregnancy. In normal pregnancy however, maternal tissues become progressively insensitive to insulin. This is believed to be caused partly by hormones from the placenta and partly by other obesity and pregnancy related factors that are not fully understood. Gestational diabetes mellitus (GDM) occurs in about 5% of pregnancies but figures vary considerably depending upon the criteria used and demographic characteristics of the population.
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This question is part of the following fields:
- Physiology
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Question 10
Correct
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We can detect the fetal heart beat by Sonography (transvaginal) at:
Your Answer: 6 weeks
Explanation:The earliest fetal heart rate detected transvaginally was at 6 weeks 0 days of gestation compared with 7 weeks 0 days transabdominally. The transvaginal Doppler method was also more successful in detecting the fetal heart rate in women with a retroverted uterus (p < or = 0.01).
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This question is part of the following fields:
- Physiology
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Question 11
Incorrect
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A 29-year-old gravida 6, para 5 woman at 36 weeks of gestation arrives in the ED via ambulance and precipitously delivers a male child. The child coughs and has a strong cry. He is very active. Acrocyanosis is noted. Heart rate is 98 bpm and breathing is strong. What is this child’s Apgar score?
Your Answer: 8
Correct Answer: 5
Explanation:The Apgar test scores appearance, pulse, grimace, activity, and respiration and is generally done at 1 and 5 minutes after birth but may be repeated if the child continues to score low (Table). This child’s score is as follows: Appearance, 1; Pulse, 1; Grimace, 2; Activity, 2; Respiration, 2 (APGAR score = 8). A score of 3 or less is generally regarded as critically low, 4 to 6 is fairly low, and 7 to 10 is generally normal. Contrary to common belief, the Apgar score is not used to decide if a neonate requires resuscitation. Decisions about resuscitation are based on emergency assessment of airway, breathing, and circulation.5,6
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This question is part of the following fields:
- Physiology
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Question 12
Correct
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The test used to diagnose ovulation on day 21 in a 28 days menstrual cycle is:
Your Answer: Progesterone
Explanation:After ovulation, the dominant follicle turns into a corpus luteum and begins to secrete progesterone. To confirm ovulation, serum progesterone or its metabolite in urine, can be measured. A single serum progesterone level >3 ng/ml in mid‐luteal phase has been used to retrospectively detect ovulation.
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This question is part of the following fields:
- Physiology
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Question 13
Correct
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A sure sign of pregnancy is:
Your Answer: Auscultation of fetal heart
Explanation:Classifications of Pregnancy Signs:
Presumptive signs — possibility of pregnancy
Probable signs — most likelihood of indicating pregnancy
Positive signs — confirmation of pregnancy
Auscultation of fetal heart is the only positive sign amongst the rest of the answers. -
This question is part of the following fields:
- Physiology
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Question 14
Correct
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Which of the following is/are needed by women in increased amounts during pregnancy?
Your Answer: All of the options given
Explanation:The nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome. Pregnancy is a state of increased requirement of macro and micronutrients, and malnourishment or inadequate dietary intake before and during pregnancy, can lead to adverse perinatal outcomes. Many nutritional interventions have been proposed for pregnant mothers. These include multiple micronutrients (MMN), iron/folate, balanced protein energy, calcium, zinc and folic acid supplementation.
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This question is part of the following fields:
- Physiology
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Question 15
Incorrect
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Which one of the following statements regarding fetal blood pH is correct?
Your Answer: Can only be measured postnatally
Correct Answer: Can be measured during labour
Explanation:A sample for fetal blood pH can be taken during the labour. The mother should be lying in a left lateral position.
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This question is part of the following fields:
- Physiology
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Question 16
Correct
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The resting pulse in pregnancy is:
Your Answer: Increased by 10 to 15 bpm
Explanation:During pregnancy cardiac output increases by 30 to 50%. As a result, the resting pulse speeds up from a normal of about 70 bpm to 80 or 90 bpm.
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This question is part of the following fields:
- Physiology
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Question 17
Correct
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Polyhydramnios is associated with which one of the following conditions?
Your Answer: Tracheo-oesophageal fistula
Explanation:Oesophageal atresia/TE fistula may be suspected prenatally with ultrasound findings of polyhydramnios, absence of fluid in the stomach, small sized abdomen, or the presence of a dilated proximal oesophageal pouch. An underlying disease is only found in 17 % of cases in mild polyhydramnios. In contrast, an underlying disease is detected in 91 % of cases in moderate to severe polyhydramnios. The literature lists the following potential aetiologies: fetal malformations and genetic anomalies (8–45 %), maternal diabetes mellitus (5–26 %), multiple pregnancies (8–10 %), fetal anaemia (1–11 %), other causes, e.g. viral infections, Bartter syndrome, neuromuscular disorders, maternal hypercalcemia. Viral infections which can lead to polyhydramnios include parvovirus B19, rubella, and cytomegalovirus. Other infections, e.g. toxoplasmosis and syphilis, can also cause polyhydramnios.
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This question is part of the following fields:
- Physiology
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Question 18
Correct
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A serum progesterone value less than 5ng/ml can exclude the diagnosis of viable pregnancy with a certainty of:
Your Answer: 100%
Explanation:Serum progesterone has been proposed as a useful test to distinguish a viable pregnancy from a miscarriage or ectopic pregnancy. Low progesterone values are associated with miscarriages and ectopic pregnancies, both considered non-viable pregnancies, and high progesterone concentrations with viable pregnancies. A single progesterone measurement for women in early pregnancy presenting with bleeding or pain and inconclusive ultrasound assessments can rule out a viable pregnancy. The probability of a non-viable pregnancy was raised from 62.9% to 96.8%.
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This question is part of the following fields:
- Physiology
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Question 19
Correct
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Regarding cardiac examination during pregnancy which of the following findings should be considered pathological
Your Answer: Diastolic murmur
Explanation:Diastolic murmurs should be considered pathological until proven otherwise. The following are common and typically benign findings in pregnancy: A third heart sound after mid-pregnancy. Systolic flow murmurs are common. Left axis deviation on ECG is common, Sagging ST segments and inversion or flattening of the T wave in lead III may also occur
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This question is part of the following fields:
- Physiology
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Question 20
Correct
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What is the most common cause of hypercalcaemia?
Your Answer: Primary hyperparathyroidism
Explanation:Primary hyperparathyroidism is the most common cause of hypercalcemia. It is usually caused by a tumour of the parathyroid gland. Symptoms are related to increased calcium levels which can cause kidney stones, abdominal groans, psychiatric overtones and bones disease such as osteoporosis,osteomalacia and arthritis.
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This question is part of the following fields:
- Physiology
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Question 21
Correct
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In the foetus, the most well oxygenated blood flows into which part of the heart:
Your Answer: Right atrium
Explanation:The placenta accepts the blue, unoxygenated blood from the foetus through blood vessels that leave the foetus through the umbilical cord (umbilical arteries, there are two of them). When blood goes through the placenta it picks up oxygen and becomes red. The red blood then returns to the foetus via the third vessel in the umbilical cord, the umbilical vein. The red blood that enters the foetus passes through the fetal liver and enters the right side of the heart.
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This question is part of the following fields:
- Physiology
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Question 22
Correct
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Which of the following would normally be expected to increase during pregnancy:
Your Answer: Thyroxin-binding globulin
Explanation:Thyroid function in pregnancy is altered in two ways; the circulating levels of the thyroid binding proteins are increased, resulting in an increase in the total circulating levels of thyroid hormones (but a slight fall in the free component).
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This question is part of the following fields:
- Physiology
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Question 23
Incorrect
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All of the following statements regarding human chorionic gonadotrophin are true except::
Your Answer: Reaches a peak concentration in maternal serum by 10 weeks gestation
Correct Answer: It's level doubles every 48 hours in ectopic pregnancy
Explanation:In normal pregnancy the levels of hCG doubles after every 48-72 hours but in case of ectopic pregnancy the levels of hCG are lower than the normal. It is produced by the placenta and its main role is nourishment of the egg after implantation. Its levels reached a peak at 8-10 weeks of pregnancy and after that the levels decreases for the remainder of pregnancy. In hydatiform mole and trophoblastic diseases its the main hormone for diagnosis of the disease because the levels are highly elevated.
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This question is part of the following fields:
- Physiology
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Question 24
Incorrect
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Which of the following causes of polyhydramnios is more common?
Your Answer: Hydrops fetalis
Correct Answer: Idiopathic
Explanation:Maternal disorders, such as diabetes, in-utero infections, drug usage, placental abnormalities and fetal conditions as congenital and chromosomal abnormalities, Rh iso-immunization, and multiple gestations, are generally associated with polyhydramnios. Congenital abnormalities such as duodenal, oesophageal, or intestinal atresia of the foetus are the most common malformations that typically cause gastro-intestinal obstruction and interfere with fetal swallowing and/or absorption resulting with polyhydramnios. However, in about 70% of cases, none of the aforementioned aetiologies are causes of polyhydramnios, and it is referred to as idiopathic or isolated.
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This question is part of the following fields:
- Physiology
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Question 25
Correct
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Which of the following pubertal events is NOT mediated by gonadal oestrogen production?
Your Answer: Pubic hair growth
Explanation:The role of androgens in the female includes acting as precursors for oestrogen production, anabolic effects, stimulation of axillary and pubic hair growth, sebum production, stimulation of bone formation, and stimulation of erythropoietin production in the kidneys.
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This question is part of the following fields:
- Physiology
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Question 26
Correct
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Which of the following factors is fetal nutrition dependant on?
Your Answer: All of the options given
Explanation:Fetal nutrition is dependant upon multiple factors such as maternal nutritional state, quality of maternal diet, malnutrition, anorexia nervosa, metabolic rate of the mother or whether they suffer from malabsorption syndrome or other related conditions.
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This question is part of the following fields:
- Physiology
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Question 27
Incorrect
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During the inflammatory phase of wound healing what is the predominant cell type found in the wound during days 3-4?
Your Answer: Polymorphonuclear Neutrophils (PMNs)
Correct Answer: Macrophages
Explanation:PMNs phagocytise debris and kill bacteria via free radicals (AKA respiratory burst). They also break down damaged tissue. PMNs typically undergo apoptosis after 48 hours. They are then engulfed and degraded by macrophages. Macrophages therefore become the predominant cell type in the wound on days 3-4.
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This question is part of the following fields:
- Physiology
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Question 28
Correct
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Ovulation may be indicated by all the following, EXCEPT:
Your Answer: Mid-cycle elevation in prolactin
Explanation:An elevation in serum PRL is associated with a variety of reproductive disorders, including amenorrhea, oligomenorrhea, anovulation and/or luteal phase defects with subsequent infertility.
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This question is part of the following fields:
- Physiology
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Question 29
Incorrect
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During normal pregnancy, a weight gain is anticipated. The average weight gain is approximately:
Your Answer: 15-20 kg
Correct Answer: 10-15 kg
Explanation:Institute of Medicine Weight Gain Recommendations for Pregnancy: Recommends a gestational weight gain of 16.8–24.5 kg (37–54 lb) for women of normal weight, 14.1–22.7 kg (31–50 lb) for overweight women, and 11.3–19.1 kg (25–42 lb) for obese women.
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This question is part of the following fields:
- Physiology
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Question 30
Incorrect
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In the earliest phase of wound healing platelets are held together by what?
Your Answer: PGE1
Correct Answer: Fibrin
Explanation:The 1st stage of wound healing is haemostasis. Even in incised wounds a small haematoma forms. Here the clotting cascade is activated by tissue factor and endothelial cells resulting in activation of platelets. This results in platelet aggregation and the laying down of a fibrin mesh that is cross linked and holds the platelets in place.
Wound healing is typically divided into phases:
1. Haemostasis Phase
2. Inflammatory phase
3. Proliferation phase
4. Remodelling phase -
This question is part of the following fields:
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
