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Question 1
Correct
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In normal physiological changes in pregnancy, all of the following are increased, EXCEPT:
Your Answer: Peripheral resistance
Explanation:The heart adapts to the increased cardiac demand that occurs during pregnancy in many ways:
Cardiac output increases throughout early pregnancy, and peaks in the third trimester, usually to 30-50% above baseline.
Oestrogen mediates this rise in cardiac output by increasing the pre-load and stroke volume, mainly via a higher overall blood volume (which increases by 40–50%).
The heart rate increases, but generally not above 100 beats/ minute.
Total systematic vascular resistance decreases by 20% secondary to the vasodilatory effect of progesterone. Overall, the systolic and diastolic blood pressure drops 10–15 mm Hg in the first trimester and then returns to the baseline in the second half of pregnancy.
All of these cardiovascular adaptations can lead to common complaints, such as palpitations, decreased exercise tolerance, and dizzinessA pregnant woman may experience an increase in the size of the kidneys and ureter due to the increased blood volume and vasculature.
Later in pregnancy, the woman might develop physiological hydronephrosis and hydroureteronephrosis, which are normal.
There is an increase in glomerular filtration rate associated with an increase in creatinine clearance, protein, albumin excretion, and urinary glucose excretion.
There is also an increase in sodium retention from the renal tube so oedema and water retention is a common sign in pregnant women -
This question is part of the following fields:
- Physiology
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Question 2
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 3
Correct
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If a sample of cervical mucus is taken on the 12th day of the menstrual cycle and examined under the microscope, what kind of findings would be observed?
Your Answer: A fern pattern characteristic of oestrogen
Explanation:Fern test looks for a specific fern like pattern of cervical mucus when observed under light microscope after the sample is dried. It occurs due to the presence of sodium chloride under oestrogen influence whereas progesterone opposes it.
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This question is part of the following fields:
- Physiology
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Question 4
Correct
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Question 5
Incorrect
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All of the following statements regarding human chorionic gonadotrophin are true except::
Your Answer: Is reversible for the maintenance of corpus luteum
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 6
Correct
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Question 7
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 8
Correct
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All the following are possible causes of polyhydramnios, EXCEPT:
Your Answer: IUGR
Explanation: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 9
Incorrect
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Regarding cardiac examination during pregnancy which of the following findings should be considered pathological
Your Answer:
Correct 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 10
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:
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 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:
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
Incorrect
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Regarding amniotic fluid volume:
Your Answer:
Correct 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 13
Incorrect
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A patient is about to undergo an elective C-section. She wants to know how long it will take for her wound to completely heal.
How much time does it take for healing by primary intention to reach full tensile strength?Your Answer:
Correct Answer: 12 weeks
Explanation:Wound healing typically undergoes different stages that include haemostasis, inflammation, proliferation and remodelling. The phases are often shortened when healing occurs by primary intention such as in a surgical wound. Remodelling, which is the major strengthening phase, takes about 3 weeks, while it takes a total of 12 weeks to reach maximum tensile strength.
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This question is part of the following fields:
- Physiology
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Question 14
Incorrect
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What is the primary form of haemoglobin in a 6 week old foetus?
Your Answer:
Correct 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 15
Incorrect
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During normal pregnancy, the renal glomerular filtrate rate (GFR) can increase as much as:
Your Answer:
Correct Answer: 50%
Explanation:Pregnancy involves remarkable orchestration of physiologic changes. The kidneys are central players in the evolving hormonal milieu of pregnancy, responding and contributing to the changes in the environment for the pregnant woman and foetus. The functional impact of pregnancy on kidney physiology is widespread, involving practically all aspects of kidney function. The glomerular filtration rate increases 50% with subsequent decrease in serum creatinine, urea, and uric acid values.
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This question is part of the following fields:
- Physiology
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Question 16
Incorrect
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What is the typical volume increase of a non-pregnant uterus to term uterus?
Your Answer:
Correct Answer: 10ml to 5000ml
Explanation:Uterine blood flow increases 40-fold to approximately 700 mL/min at term. The uterus is 50–60 g with a volume of approximately 10ml prior to pregnancy and 1000 – 1200 g with a volume of 5000ml by term.
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This question is part of the following fields:
- Physiology
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Question 17
Incorrect
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Which of the following is/are needed by women in increased amounts during pregnancy?
Your Answer:
Correct 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 18
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:
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 19
Incorrect
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In normal pregnancy, the value of β-hCG doubles every:
Your Answer:
Correct Answer: 2 days
Explanation:During early pregnancy, hCG can be detected in the maternal serum as early as 6 to 8 days after fertilization. hCG levels are dynamically increased and doubled every 48 h in most normal pregnancies, and this pattern is similar in both in vivo or in vitro (IVF) conceptions.
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This question is part of the following fields:
- Physiology
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Question 20
Incorrect
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Regarding the renal tract during pregnancy, the following are true, EXCEPT:
Your Answer:
Correct Answer: The bladder tone increases
Explanation:Incontinence in women is typically related to dysfunction of the bladder or pelvic floor muscles, with such dysfunction often arising during pregnancy or childbirth, or at the time of menopause.
A pregnant woman may experience an increase in the size of the kidneys and ureter due to the increased blood volume and vasculature.
Later in pregnancy, the woman might develop physiological hydronephrosis and hydroureteronephrosis, which are normal.
There is an increase in glomerular filtration rate associated with an increase in creatinine clearance, protein, albumin excretion, and urinary glucose excretion.
There is also an increase in sodium retention from the renal tube so oedema and water retention is a common sign in pregnant women -
This question is part of the following fields:
- Physiology
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Question 21
Incorrect
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All of the following factors are associated with umbilical cord prolapse, except?
Your Answer:
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 22
Incorrect
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Which of the following statements is true regarding heart rate in pregnancy?
Your Answer:
Correct 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 23
Incorrect
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During normal pregnancy, a weight gain is anticipated. The average weight gain is approximately:
Your Answer:
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 24
Incorrect
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Regarding electronic fetal monitoring, which one of the following statements is true?
Your Answer:
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 25
Incorrect
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During wound healing the clotting cascade is activated. Which of the following activates the extrinsic pathway?
Your Answer:
Correct Answer: Tissue Factor
Explanation:The extrinsic pathway is activated by the tissue factor, which converts factor VII to VIIa which later on converts factors X and II to their activated form finally leading to the conversion of fibrinogen to fibrin fibres.
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This question is part of the following fields:
- Physiology
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Question 26
Incorrect
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Question 27
Incorrect
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Physiological changes in the reproductive system include:
Your Answer:
Correct Answer: The uterus 1st enlarges by hyperplasia then by hypertrophy
Explanation:Although uterine growth during the first few weeks of pregnancy is accomplished by increased numbers of smooth muscle cells (i.e. hyperplasia) and a smaller contribution from increased cell size (i.e. hypertrophy), the predominant growth of the uterus during pregnancy is by way of stretch‐induced myometrial hypertrophy. This ongoing process of stretch‐induced tissue remodelling and smooth muscle hypertrophy is accompanied by the lack of uterine contractions during most of gestation to accommodate the developing foetus (phase 0 of parturition). Phase 1 of parturition represents myometrial activation. The final stages of pregnancy are characterized by increases in spontaneous low‐amplitude contractions that gradually increase in frequency, rhythmicity and strength, normally culminating in labour and delivery of the foetus at term (phase 2 of parturition).
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This question is part of the following fields:
- Physiology
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Question 28
Incorrect
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What is the typical weight of a non-pregnant premenopausal uterus?
Your Answer:
Correct 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 29
Incorrect
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Maternal serum prolactin levels in pregnancy are highest:
Your Answer:
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 30
Incorrect
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Besides infertility, the most common symptoms of a luteal phase defect is:
Your Answer:
Correct Answer: Early abortion
Explanation:Luteal phase defect is an ovulatory disorder of considerable clinical importance that is implicated in infertility and recurrent spontaneous abortion.
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This question is part of the following fields:
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
