Медведєв Михайло ВолодимировичТестуванняFinal test - pathological obstetrics

Final test - pathological obstetrics

Медведєв Михайло Володимирович // 27 Марта 2022

Вопросов в тесте: 20

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Дякую за повідомлення, ми зв'яжемося з вами електронною поштою найближчим часом
Final test - pathological obstetrics

A pregnant 25 y. o. female came to prenatal care clinic with complains on leakage of amniotic fluid. Labor pain is absent. Third pregnancy, the past two ended with spontaneous abortion at term 22-24 weeks. Vaginal exam: short cervix, cervical canal passes 1 finger, amniotic membrane is absent, occipital presentation. Uterus is enlarged up to 20 weeks of pregnancy, painless. When it is nessesary to prevent a habitual abortion in this woman?

вопрос 1 из 20 //

Варианты ответа:

  1. Not later than 20 weeks of pregnancy
  2. In term of previous miscarriages
  3. Prior to pregnancy
  4. During the formation of placenta
  5. At 12-16 weeks of pregnancy
Final test - pathological obstetrics

In woman with term of pregnancy 41-42 weeks labor lasted 6 hours. Contractions for 25 seconds, each 5-6 minutes. Fetal heartbeat arrhythmic 100-160 beats per minute, with long and profound late decelerations, amniotic fluid is green. Cervix fully effaced and opened up to 4 cm, saggital suture of fetus is in transverse diameter of the pelvic inlet. What is further step of management?

вопрос 2 из 20 //

Варианты ответа:

  1. Obstetric forceps
  2. Vacuum extraction
  3. Cesarean section
  4. Hypoxia treatment
  5. Labor induction
Final test - pathological obstetrics

In the maternity hospital women 40 weeks of pregnancy. Amniotic membrane ruptued 14 hours ago. Fetal heartbeat is 140 b/min. Vaginal exam: cervix is 2 cm, 20% effacement, the dilation of cervical canal up to 2 cm. Fetus head above the pelvic inlet. Tactics?

вопрос 3 из 20 //

Варианты ответа:

  1. Labor stimulation
  2. Drug sleep
  3. Obstetrical forceps
  4. Wait until 24 hours post PROM, then labor induction
  5. Cesarean section
Final test - pathological obstetrics

A pregnant 27 years, pregnancy 39 weeks, delivered in a maternity department complaining of abdominal pain, bloody discharge from vagina. Pregnancy was with preeclampsia, but not medical treatment in hospital. State is moderate, pulse - 90 b / min, BP - 110/70 mm. Hg. Uterus tense, painful. Fetal heartbeat 100 b / min deaf. During ultrasound examination abruptio placenta was detected. What is the prevention of this complication?

вопрос 4 из 20 //

Варианты ответа:

  1. Estrogen
  2. Exclusion of physical activity
  3. Treatment of preeclampsia
  4. Glucocorticoids
  5. Tocopherol acetate
Final test - pathological obstetrics

Labor is impossible at:

вопрос 5 из 20 //

Варианты ответа:

  1. An posterior facial presentation
  2. An anterior occipital presentation
  3. A anterior brow presentation
  4. A posterior occipital presentation
Final test - pathological obstetrics

On the 10th day postpartum a puerperant woman complains of pain and heaviness in the left mammary gland. Body temperature is 38, 8oC, Ps- 94 bpm. The left mammary gland is edematic, the supero-external quadrant of skin is hyperemic. Fluctuation symptom is absent. The nipples discharge drops of milk when pressed. What is a doctor’s further tactics?

вопрос 6 из 20 //

Варианты ответа:

  1. Antibiotic therapy, immobilization and expression of breast milk
  2. Compress to both mammary glands
  3. Inhibition of lactation
  4. Physiotherapy
  5. Opening of the abscess and drainage of the mammary gland
Final test - pathological obstetrics

A 23-year-old primigravida at 39 weeks gestation has been admitted to the maternity ward with irregular contractions. The intensity of uterine contractions is not changing, the intervals between them stay long. Bimanual examination reveals that the cervix is centered, soft, up to 1,5 cm long. There is no cervical dilatation. What diagnosis should be made?

вопрос 7 из 20 //

Варианты ответа:

  1. Pregnancy I, 39 weeks, labor I, 1 period, the latent phase
  2. Pregnancy I, 39 weeks, pathological preliminary period
  3. Pregnancy I, 39 weeks, preliminary period
  4. Pregnancy I, 39 weeks, labor I, period 1, the active phase
  5. Pregnancy I, 39 weeks, birth I, 1 period, the acceleration phase
Final test - pathological obstetrics

Woman 29 years old, addressed to gynecologist office with complaints of pain below the stomach, blood discharge. Diagnosed 7-8 weeks of pregnancy. In anamnesis 1 artificial abortion in term 9 weeks. During the abortion was difficulty with cervical dilatation. Two pregnancies followed with late spontaneous abortion at 20-21 weeks. Rh - negative blood type without Rh-antibodies. What is the most possible cause of miscarriage in this case?

вопрос 8 из 20 //

Варианты ответа:

  1. Uterine leiomyoma
  2. Genetic Pathology
  3. Adreno-genital syndrome
  4. Rh-conflict
  5. Cervical insufficiency (incompetence)
Final test - pathological obstetrics

A leading point at a brow presentation is:

вопрос 9 из 20 //

Варианты ответа:

  1. The middle of sagittal suture
  2. Large fontanel
  3. Small fontanel
  4. A chin
  5. The middle of a frontal suture
Final test - pathological obstetrics

A pregnant woman at 30 weeks has had an attack of eclampsia at home. On admission to the maternity ward BP-150/100 mm Hg. Predicted fetal weight is 1500 g. There is edema of face and extremities. Urine potein is 0,66o/oo. Birth canal is not ready for delivery. An intensive complex therapy has been started. What is the correct tactics for the management of this case?

вопрос 10 из 20 //

Варианты ответа:

  1. Treat preeclampsia and achieve the delivery by way of conservative management
  2. Labor induction by intravenous oxytocin or prostaglandins
  3. Continue therapy and prolong pregnancy for 1-2 weeks
  4. Delivery by cesarean section
  5. Continue therapy and prolong pregnancy for 3-4 weeks
Final test - pathological obstetrics

A 26-year-old multipara at 40 weeks of gestation arrived at the maternity ward after the beginning of labor activity. 2 hours before, bursting of waters occurred. The fetus was in a longitudinal lie with cephalic presentation. Abdominal circumference was 100 cm, fundal height - 42 cm. Contractions occurred every 4-5 minutes and lasted 25 seconds each. Internal obstetric examination revealed cervical effacement, dilation up to 4 cm. Amniotic membranes were absent. Fetal head was pressed against the pelvic inlet. What complication arose in labor?

вопрос 11 из 20 //

Варианты ответа:

  1. PROM (premature rupture of membranes)
  2. Primary weakness of contractions
  3. Clinically narrow pelvis
  4. Secondary weakness of contractions
  5. Discoordinated labor
Final test - pathological obstetrics

A pregnant 25 y.o. delivered to the maternity ward. According to relatives at home there were three attacks of convulsions. No epilepsy in anamnesis. OBJECTIVE: unconscious. BP on the right hand is 190/120 mm Hg. The lower and upper extremities are edematous. Gestation term is 35 weeks. The most likely diagnosis?

вопрос 12 из 20 //

Варианты ответа:

  1. Hepatic coma
  2. Eclampsia
  3. Diabetic coma
  4. Acute renal failure
  5. Epilepsy
Final test - pathological obstetrics

A maternity patient breastfeeding for 1,5 weeks has attended a doctor. She considers the onset of her disease to be when proportional breast engorgement occurred. Mammary glands are painful. Body temperature is 36, 6oC. Expression of breast milk is hindered. The most likely diagnosis is:

вопрос 13 из 20 //

Варианты ответа:

  1. Gangrenous mastitis
  2. Suppurative mastitis
  3. Infiltrative mastitis
  4. Chronic cystic mastitis
  5. Lactostasis
Final test - pathological obstetrics

A 24-year-old primipara was hospitalised with complaints of discharge of the amniotic fluid. The uterus is tonic on palpation. The position of the fetus is longitudinal, it is pressed with the head to pelvic outlet. The heart rate of the fetus is rhythmic, 140 bpm, auscultated on the left below the navel. Internal examination: cervix of the uterus is 2,5 cm long, dense, the external os is closed, transparent amniotic waters are discharged. Point out the correct component of the diagnosis:

вопрос 14 из 20 //

Варианты ответа:

  1. Premature rupture of amniotic membanes
  2. Pathological preterm labour
  3. The end of the 1st stage of labour
  4. Early discharge of the amniotic waters
  5. The beginning of the 1st stage of labour
Final test - pathological obstetrics

A 30-year-old parturient woman was delivered to a maternity hospital with full-term pregnancy. She complains of severe lancinating pain in the uterus that started 1 hour ago, nausea, vomiting, cold sweat. Anamnesis states cesarean section 2 years ago. Uterine contractions stopped. Skin and mucous membranes are pale. Heart rate is 100/min, BP is 90/60 mm Hg. Uterus has no clear margins, is sharply painful. No heartbeat can be auscultated in the fetus. Moderate bloody discharge from the uterus can be observed. Uterus cervix is 4 cm open. Presenting part is not visible. The most likely diagnosis is:

вопрос 15 из 20 //

Варианты ответа:

  1. Threatened uterine rupture
  2. Uterine rupture
  3. Compression of inferior pudendal vein
  4. Premature detachment of normally positioned placenta
  5. Initial uterine rupture
Final test - pathological obstetrics

Patient 23 years old, entered in the gynecological department with complaints of pain below abdomen, abundant bloody discharge from vagina. Last menses 3 months ago. Bimanual examination: cervix length 2 cm, cervical canal passes 1 finger. The body of the uterus enlarged to 6 weeks of pregnancy, dence. What is the most likely diagnosis?

вопрос 16 из 20 //

Варианты ответа:

  1. Threatened abortion
  2. Incipient abortion
  3. Full abortion
  4. Incomplete abortion
  5. Abortion in progress
Final test - pathological obstetrics

A parturient woman is 27 year old, it was her second labour, delivery was at full-term, normal course. On the 3rd day of postpartum period body temperature is 36, 8oC, heart rate - 72/min, BP - 120/80 mm Hg.Mammary glands are moderately swollen, nipples are clean. Abdomen is soft and painless. Fundus of uterus is 3 fingers below the umbilicus. Lochia are bloody, moderate. What is the most probable diagnosis?

вопрос 17 из 20 //

Варианты ответа:

  1. Physiological course of postpartum period
  2. Lactostasis
  3. Remnants of placental tissue after labour
  4. Postpartum metroendometritis
  5. Subinvolution of uterus
Final test - pathological obstetrics

A puerperant is 32 years old, it's her first childbirth, term precipitate labor, the III period is unremarkable, the uterus is contracted, tight. Examination of the birth canal revealed a rupture in the left posterior vaginal wall that was sutured. Two hours later, the patient complained of a feeling of pressure on the anus, pain in the perineum, minor vaginal discharges, edema of the vulva. These clinical presentations are indicative most likely of:

вопрос 18 из 20 //

Варианты ответа:

  1. Hemorrhoids
  2. Hypotonic bleeding
  3. Uterine rupture
  4. Cervical rupture
  5. Vaginal hematoma
Final test - pathological obstetrics

A maternal fetal medicine specialist is consulted and performs an indepth sonogram. The sonogram indicates that the fetuses are both male, and the placenta appears to be diamniotic and monochorionic. Twin B is noted to have oligohydramnios and to be much smaller than twin A. In this clinical picture, all of the following are concerns for twin A except

вопрос 19 из 20 //

Варианты ответа:

  1. Polycythemia
  2. Hydramnios
  3. Hypervolemia
  4. Anemia
  5. Congestive heart failure
Final test - pathological obstetrics

Pregnant at 36 weeks of pregnancy defined by significant edema of the legs and the anterior abdominal wall, face. BP - 180/110, 175/90 mm Hg. From the internal organs no pathology were detected. In the urine protein 6 g / l, hyaline cylinders 1-2. Diagnosis?

вопрос 20 из 20 //

Варианты ответа:

  1. Severe preeclampsia
  2. Pyelonephritis
  3. Mild preeclampsia
  4. Edema of pregnant
  5. Hypertension