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Question 1
Correct
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During wound healing collagen alignment along tension lines is part of which phase?
Your Answer: Remodelling
Explanation:Realignment of collagen is part of the remodelling phase. Remodelling is usually underway by week 3. Maximum tensile wound strength is typically achieved by week 12.
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This question is part of the following fields:
- Physiology
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Question 2
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 3
Incorrect
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Which of the following causes of polyhydramnios is more common?
Your Answer: Diabetes
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 4
Correct
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The maternal blood volume in normal pregnancy:
Your Answer: Increases up to 40%
Explanation:Changes in the cardiovascular system in pregnancy are profound and begin early in pregnancy, such that by eight weeks’ gestation, the cardiac output has already increased by 20%. The primary event is probably peripheral vasodilatation. This is mediated by endothelium-dependent factors, including nitric oxide synthesis, upregulated by oestradiol and possibly vasodilatory prostaglandins (PGI2). Peripheral vasodilation leads to a 25–30% fall in systemic vascular resistance, and to compensate for this, cardiac output increases by around 40% during pregnancy.
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This question is part of the following fields:
- Physiology
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Question 5
Correct
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Regarding amniotic fluid volume:
Your Answer: Maybe predicted by ultrasound
Explanation:Amniotic fluid can be measured with the help of ultrasound to gauge the amniotic fluid index. The normal value ranges between 8-18.
Amniocentesis is a procedure by which amniotic fluid is removed. In rhesus disease, it appears yellow due to raised bilirubin levels. -
This question is part of the following fields:
- Physiology
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Question 6
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: 9
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 7
Incorrect
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Maternal serum prolactin levels in pregnancy are highest:
Your Answer: At the end of gestation just before delivery of the infant
Correct Answer: On the 3rd to 4th day postpartum
Explanation:Prolactin is necessary for the secretion of milk by the cells of the alveoli. The level of prolactin in the blood increases markedly during pregnancy, and stimulates the growth and development of the mammary tissue, in preparation for the production of milk. However, milk is not secreted then, because progesterone and oestrogen, the hormones of pregnancy, block this action of prolactin. After delivery, levels of progesterone and oestrogen fall rapidly, prolactin is no longer blocked, and milk secretion begins.
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This question is part of the following fields:
- Physiology
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Question 8
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 9
Correct
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Lowered haemoglobin during normal pregnancy is a physiological finding which is mainly due to:
Your Answer: Increased plasma volume
Explanation:During pregnancy, anaemia increases more than fourfold from the first to third trimester. It is a well established fact that there is a physiological drop in haemoglobin (Hb) in the mid trimester. This physiological drop is attributed to increase of plasma volume and hence decrease of blood viscosity lead to better circulation in placenta.
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This question is part of the following fields:
- Physiology
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Question 10
Correct
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Pregnancy is associated with all of the following, EXCEPT:
Your Answer: Increased peripheral resistance
Explanation:A variety of changes in the cardiovascular system occur during normal pregnancy, including increases in cardiac output, arterial compliance, extracellular fluid volume and decreases in blood pressure (BP) and total peripheral resistance.
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This question is part of the following fields:
- Physiology
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Question 11
Correct
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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: Macrophages
Explanation:Wound healing is initiated when inflammation begins. Macrophages predominate after neutrophils and peak 3-4 days after inflammation begins. They destroy and phagocytose the organism and debris using enzymes. The next step is the resolution of inflammation and healing of the wound.
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This question is part of the following fields:
- Physiology
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Question 12
Correct
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Which of the following is probably responsible for physiologic hyperventilation during pregnancy?
Your Answer: Increased progesterone production
Explanation:Progesterone gradually increases during the course of pregnancy, from 25 ng⋅mL−1 at 6 weeks’ to 150 ng⋅mL−1 at 37 weeks’ gestation. Progesterone acts as trigger of the primary respiratory centre by increasing the sensitivity of the respiratory centre to carbon dioxide, as indicated by the steeper slope of the ventilation curve in response to alveolar carbon dioxide changes. Progesterone alters the smooth muscle tone of the airways resulting in a bronchodilator effect. It also mediates hyperaemia and oedema of mucosal surfaces, causing nasal congestion.
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This question is part of the following fields:
- Physiology
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Question 13
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 14
Incorrect
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All of the following factors are associated with umbilical cord prolapse, except?
Your Answer: Cephalo pelvic disproportion
Correct Answer: Anencephaly
Explanation:Anencephaly means the missing of a particular portion of the scalp and brain tissue. The other factors listed are associated with umbilical cord prolapse like multiparity, twin birth, polyhydramnios, premature delivery, long umbilical cord or breech presentation.
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This question is part of the following fields:
- Physiology
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Question 15
Correct
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Which of the following statements is true regarding heart rate in pregnancy?
Your Answer: Heart rate increases by 15 beats per minute
Explanation:During the first 12 weeks of pregnancy, cardiac output increases by about 30-50%. To maintain this increase, systemic vascular resistance decreases by 20-30%, while stroke volume and the heart rate increase by 25-30% and 15 beats per minute respectively.
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This question is part of the following fields:
- Physiology
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Question 16
Incorrect
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Regarding cardiac examination during pregnancy which of the following findings should be considered pathological?
Your Answer: Left axis deviation on ECG
Correct Answer: Diastolic murmur
Explanation:Diastolic murmurs occur in conditions such as mitral stenosis, tricuspid stenosis and even in carditis. They are always pathological during pregnancy. Systolic murmurs and left axis deviation may be normal during pregnancy due to an increase in the blood volume and load on the heart.
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This question is part of the following fields:
- Physiology
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Question 17
Correct
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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: 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 18
Correct
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During pregnancy, maternal oestrogen levels increase markedly. Most of this oestrogen is produced by the:
Your Answer: Placenta
Explanation:The placenta does not have all the necessary enzymes to make oestrogens from cholesterol, or even progesterone. Human trophoblast lack 17-hydroxylase and therefore cannot convert C21-steroids to C19-steroids, the immediate precursors of oestrogen. To bypass this deficit, dehydroisoandrosterone sulphate (DHA) from the fetal adrenal is converted to estradiol-17ί by trophoblasts. In its key location as a way station between mother and foetus, placenta can use precursors from either mother or foetus to circumvent its own deficiencies in enzyme activities.
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This question is part of the following fields:
- Physiology
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Question 19
Correct
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What is the typical weight of a non-pregnant premenopausal uterus?
Your Answer: 40g
Explanation:Uterine blood flow increases 40-fold to approximately 700 mL/min at term, with 80 per cent of the blood. The uterus is 50–60 g prior to pregnancy and 1000 g by term. The volume increases from 10 ml to 5000ml approx. It is around 40g at menopause.
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This question is part of the following fields:
- Physiology
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Question 20
Correct
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Immediate delivery of the foetus is recommended at which fetal scalp pH?
Your Answer: 7.18
Explanation:A pH value below than 7.18 indicates acidosis which can result in hypoxic brain injury. In order to prevent brain injury, immediate delivery of the foetus should be planned. The normal range for a term baby is pH: 7.18 – 7.38, preterm pH: 7.14 – 7.4.
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This question is part of the following fields:
- Physiology
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Question 21
Correct
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When does ovulation occur?
Your Answer: 36 hours after LH surge
Explanation:Ovulation occurs in the mid stage of the menstrual cycle, usually 36 hours after the LH surge. It is this LH surge which is necessary for the ovulation to occur.
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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 is suggestive of ovulation:
Your Answer: Regular cycle with dysmenorrhea
Explanation:Ovulation in the menstrual cycle usually occurs over 4 days. There is an increase in basal body temperature at the time of ovulation due to the effect of progesterone.
A high Day 21 progesterone level indicates ovulation and the release of an egg.
Dysmenorrhea is described as painful menstruation. The symptoms start at the time of ovulation and persist till menstruation.
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This question is part of the following fields:
- Physiology
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Question 23
Incorrect
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In the earliest phase of wound healing platelets are held together by what?
Your Answer: Fibroblasts
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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Question 24
Correct
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Which one of the following features best describes the role of prostaglandins?
Your Answer: Are involved in the onset of labour
Explanation:Prostaglandins are involved in the uterine contraction and cervical dilatation during labour. Higher prostaglandin concentrations can also lead to severe menstrual cramps.
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This question is part of the following fields:
- Physiology
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Question 25
Incorrect
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Serum prolactin levels are greatest in which of the following conditions?
Your Answer: Parturition
Correct Answer: Suckling
Explanation:Serum prolactin levels are increased during suckling. Some other conditions in which serum prolactin is increased consist of: prolactin secreting brain tumours, anti psychotic drugs and hypothyroidism. It can also be increased in pregnancy, nipple stimulation and stress.
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This question is part of the following fields:
- Physiology
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Question 26
Incorrect
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Regarding electronic fetal monitoring, which one of the following statements is true?
Your Answer: Has moderate sensitivity & specificity
Correct Answer: Has low specificity but high sensitivity
Explanation:There are different ways of monitoring fetal heart rate during pregnancy. It can be done by just auscultation or by electronic fetal heart rate monitoring which is done with the help of an ultrasound machine and has a low specificity but high sensitivity.
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This question is part of the following fields:
- Physiology
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Question 27
Correct
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The following are presumptive skin signs of pregnancy, except:
Your Answer: Maculo-papular rash
Explanation:Skin signs during pregnancy may include: dark spots on the breasts, nipples and inner thighs, melasma (chloasma), linea nigra, stretch marks, acne, spider telangiectasis and varicose veins.
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This question is part of the following fields:
- Physiology
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Question 28
Correct
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Regarding cardiac output in pregnancy which of the following statements is TRUE?
Your Answer: Cardiac output increases by approximately 40-50% during pregnancy
Explanation:In a non pregnant adult female the cardiac output is 4.5L/min, by the 20 week of pregnancy the cardiac output increases by 40% to 6.3L/min. During early stages of labour it increases further still by 17% to 7.3L/min.
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This question is part of the following fields:
- Physiology
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Question 29
Correct
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What form is 99% of body calcium found in?
Your Answer: Calcium Phosphate
Explanation:Calcium phosphate salts are the most abundant form of calcium in the body, making up 99%. The majority of these salts are stored in the skeleton in different forms, mostly, hydroxyapatite, a lattice-like crystal composed of calcium, phosphates and hydroxide. The remaining calcium can be found in the extracellular fluid, tissues and skeletal muscle.
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This question is part of the following fields:
- Physiology
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Question 30
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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SESSION STATS - PERFORMANCE PER SPECIALTY
