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Question 1
Correct
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Which one of the following statements regarding fetal blood pH is correct?
Your 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 2
Correct
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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-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 3
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 4
Incorrect
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Which of the following factors is fetal nutrition dependant on?
Your Answer: Placental exchange
Correct 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 5
Incorrect
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Which of the following statements is true regarding heart rate in pregnancy?
Your Answer: Heart rate decreases by 15 beats per minute
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 6
Incorrect
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What is the typical volume increase of a non-pregnant uterus to term uterus?
Your Answer: 1000ml to 5000ml
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 7
Correct
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What kind of biochemical changes occur during the follicular phase of menstrual cycle?
Your Answer: Endometrial gland proliferation
Explanation:During follicular phase, there is an increase in gonadotrophin hormones and a proliferation of the endometrium occurs. The duration of the cycle depends upon the overall length of the menstrual cycle. The progesterone levels are increased in the luteal phase and not in follicular phase.
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This question is part of the following fields:
- Physiology
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Question 8
Incorrect
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All of the following factors are associated with umbilical cord prolapse, except?
Your Answer: Footing breech presentation
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 9
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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Question 10
Incorrect
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During normal pregnancy, a weight gain is anticipated. The average weight gain is approximately:
Your Answer: 20-30 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 11
Correct
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Excessive increased level of β-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 12
Correct
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Which one of the following features indicates fetal asphyxia?
Your 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 13
Correct
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During wound healing the clotting cascade is activated. Which of the following activates the extrinsic pathway?
Your 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 14
Incorrect
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The test used to diagnose ovulation on day 21 in a 28 days menstrual cycle is:
Your Answer: LH
Correct 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 15
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 16
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 17
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 18
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 19
Correct
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In the earliest phase of wound healing platelets are held together by what?
Your 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 20
Incorrect
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In the absence of any gross pelvic abnormality, cephalopelvic disproportion can be correctly diagnosed by?
Your Answer:
Correct Answer: Trial of labour
Explanation:Cephalo-pelvic disproportion exists when the capacity of the pelvis is inadequate to allow the foetus to negotiate the birth canal. This may be due to a small pelvis, a nongynecoid pelvic formation, a large foetus, an unfavourable orientation of the foetus, or a combination of these factors. Diagnosis of CPD may be made when there is failure to progress, but not all cases of prolonged labour are the result of CPD. Use of ultrasound to measure the size of the foetus in the womb is controversial, as these methods are often inaccurate and may lead to unnecessary caesarean section; a trial of labour is often recommended even if size of the foetus is estimated to be large.
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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 is the normal pH value of an umbilical arterial sample of a new born term baby?
Your Answer:
Correct 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 22
Incorrect
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All the following are possible causes of polyhydramnios, EXCEPT:
Your Answer:
Correct 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 23
Incorrect
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In normal physiological changes in pregnancy, all of the following are increased, EXCEPT:
Your Answer:
Correct 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 24
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 25
Incorrect
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The expected date of delivery of a human pregnancy can be calculated as:
Your Answer:
Correct 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 26
Incorrect
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Spinnbarkheit is a term which means:
Your Answer:
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 27
Incorrect
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Regarding heart rate in pregnancy which of the following statements is true?
Your Answer:
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 28
Incorrect
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Changes in the urinary tract system in pregnancy include:
Your Answer:
Correct 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.
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This question is part of the following fields:
- Physiology
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Question 29
Incorrect
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Which of the following causes of polyhydramnios is more common?
Your Answer:
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 30
Incorrect
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We can detect the fetal heart beat by Sonography (transvaginal) at:
Your Answer:
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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SESSION STATS - PERFORMANCE PER SPECIALTY
