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Question 1
Incorrect
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Which of the following causes of polyhydramnios is more common?
Your Answer: Twin pregnancy
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 2
Incorrect
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Regarding heart rate in pregnancy which of the following statements is true?
Your Answer: Heart rate increases by 25 beats per minute
Correct Answer: Heart rate increases by 15 beats per minute
Explanation:The following cardiovascular changes occur during pregnancy:
– Blood volume slowly increases by 40-50%
– Heart rate rises by 15 beats/min above baseline
– Stroke volume increases by 25-30%
– Cardiac output increases by approximately 30-50%
– Systemic vascular resistance (SVR) decreases by 20-30%
– Diastolic blood pressure consequently decreases between 12 and 26 weeks but increases again to pre-pregnancy levels by 36 weeks.
As most of the changes occur in the first 12 weeks of gestation cardiac problems are likely to present in early pregnancy -
This question is part of the following fields:
- Physiology
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Question 3
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 4
Correct
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Besides infertility, the most common symptoms of a luteal phase defect is:
Your Answer: Early abortion
Explanation:Luteal phase defect is an ovulatory disorder of considerable clinical importance that is implicated in infertility and recurrent spontaneous abortion.Ā
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This question is part of the following fields:
- Physiology
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Question 5
Incorrect
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Physiological changes in the reproductive system include:
Your Answer: Lower segment of the uterus will be formed in the 1st trimester
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 stretchāinduced myometrial hypertrophy. This ongoing process of stretchāinduced 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 lowāamplitude 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 6
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 7
Correct
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The expected date of delivery of a human pregnancy can be calculated as:
Your Answer: 40 weeks after last menstrual period
Explanation:Expected date of delivery/estimated due date (EDD) is a calculated date (i.e., an estimation), determined by counting forward 280 days (40 weeks) from the first day of the woman’s last menstrual period.
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This question is part of the following fields:
- Physiology
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Question 8
Correct
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The following ultrasonic measurements may be used to confirm or establish gestational age:
Your Answer: Crown rump length
Explanation:Fetal ultrasound scanning is considered an essential part of routine antenatal care with first trimester scans recommended for confirming viability, accurate estimation of gestational age and determining the number of foetuses. Fetal crown-rump length (CRL) is measured in early pregnancy primarily to determine the gestation age (GA) of a foetus and is most reliable between 9+0 to 13+6 weeksā gestation, but not beyond.
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This question is part of the following fields:
- Physiology
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Question 9
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 10
Correct
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Maternal serum prolactin levels in pregnancy are highest:
Your 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 11
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 ā 7.38, and preterm pH: 7.14 ā 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 12
Correct
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Which of the following increases during pregnancy?
Your Answer: Tidal Volume
Explanation:Ventilation begins to increase significantly at around 8 weeks of gestation, most likely in response to progesterone-related sensitization of the respiratory centre to carbon dioxide and the increased metabolic rate. Significant alterations occur in the mechanical aspects of ventilation during pregnancy. Minute ventilation (or the amount of air moved in and out of the lungs in 1 minute) is the product of tidal volume and respiratory rate and increases by approximately 30ā50 per cent with pregnancy. The increase is primarily a result of tidal volume, which increases by 40 per cent (from 500 to 700 mL), because the respiratory rate remains unchanged. The increase in minute ventilation is perceived by the pregnant woman as shortness of breath, which affects 60ā70 per cent of women. This physiological dyspnoea is usually mild and affects 50 per cent of women before 20 weeks gestation, but resolves immediately postpartum.
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This question is part of the following fields:
- Physiology
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Question 13
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 14
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 50ā60 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 15
Correct
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During normal pregnancy, the renal glomerular filtrate rate (GFR) can increase as much as:
Your 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.Ā
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This question is part of the following fields:
- Physiology
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Question 16
Correct
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A sure sign of pregnancy is:
Your Answer: Auscultation of fetal heart
Explanation:Classifications of Pregnancy Signs:
Presumptive signs ā possibility of pregnancy
Probable signs ā most likelihood of indicating pregnancy
Positive signs ā 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 17
Correct
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Excessive increased level of Ī²-HCG is expected in:
Your Answer: Twin pregnancy
Explanation:Human chorionic gonadotropin levels dynamically increase during early gestation and the levels are significantly greater in viable pregnancies than in ectopic gestation, biochemical pregnancy, or spontaneous abortions. Similarly, the hCG concentrations are significantly higher in multiple pregnancy as compared with singleton.
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This question is part of the following fields:
- Physiology
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Question 18
Correct
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In normal pregnancy, the value of Ī²-hCG doubles every:
Your 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 19
Correct
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Which one of the following factors will most likely increase the chances of ovulation in female?
Your Answer: LH surge
Explanation:Different changes can occur during the menstrual cycle including an increased body temperature at the time of ovulation, thinning of the cervical mucus and few other changes, but it is the LH surge which is the most important factor necessary for ovulation.
Mittelschmerz is characterised by recurrent midcycle pain which occurs around the time of ovulation. -
This question is part of the following fields:
- Physiology
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Question 20
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-17ĪÆ 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 21
Incorrect
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What percentage of haemoglobin is HbF by 6 months of age?
Your Answer: <2%
Correct Answer:
Explanation:HB gower 1 is the predominant embryonic haemoglobin when the foetus is 6 week old and is replaced by adult haemoglobin by the age of 5 months post natally. Only 2% of the haemoglobin is HbF.
Embryonic Haemoglobin:
Haemoglobin Gower 1 (HbE Gower-1)
Haemoglobin Gower 2 (HbE Gower-2)
Haemoglobin Portland I (HbE Portland-1)
Haemoglobin Portland II (HbE Portland-2)Fetal Haemoglobin (haemoglobin F, HbF)
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This question is part of the following fields:
- Physiology
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Question 22
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: 28-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, Naegeleās rule may be used. Naegeleās 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 23
Incorrect
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We can detect the fetal heart beat by Sonography (transvaginal) at:
Your Answer: 5 weeks
Correct 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 24
Correct
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Changes in the urinary tract system in pregnancy include:
Your Answer: Increase in the glomerular filtration rate (GFR)
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.Ā
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This question is part of the following fields:
- Physiology
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Question 25
Incorrect
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All of the following factors are associated with umbilical cord prolapse, except?
Your Answer: Multiparity
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 26
Correct
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Serum prolactin levels are greatest in which of the following conditions?
Your 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 27
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 28
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 midāluteal 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 29
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 30
Incorrect
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According to the UK food standards agency which of the following RDIs (recommended daily intake) is 3 times higher in pregnancy than the non-pregnant state?
Your Answer: Iron
Correct Answer: Folic Acid
Explanation:Folic Acid should be increased in diet of a pregnant women. Deficiency will lead to neural tube defects i.e. spina bifida.
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This question is part of the following fields:
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
