Fabella samplex

I. Multiple Choice 1. Patient is G2P1 (1001), her LMP was Nov. 12, 2006, today is April 28, 2007. Her AOG a. 23 4/7 wks b. 23 3/7 wks c. 23 6/7 wks d. 23 5/7 wks 2. Her EDC a. Aug. 19, 2007 b. Sept. 19, 2007 c. Jul. 19, 2007 d. Oct. 19, 2007 3. How is the pathophysiology of preeclampsia? a. vasodilatation b. vasospasm c. hemodilution d. hypervolemia 4. Considered abnormal 24 hour urinary protein for the diagnosis of severe preeclampsia? a. >300mg/24 hrs b. >2g/24 hrs c. 1 g/24 hrs d. >4g/24 hrs 5. Considered abnormal 24 hour urinary protein for the diagnosis of mild preeclampsia? a. >300mg/24 hrs b. >2g/24 hrs c. 1 g/24 hrs d. >4g/24 hrs

c. obstetric conjugate d. bi-ischial diameter 12. Is the diameter measured from the lower margin of the symphysis pubis to the promontory of the sacrum a. diagonal conjugate b. transverse diameter c. obstetric conjugate d. bi-ischial diameter 13. Second dose of tetanus toxoid should be given a. 1st week after 1 dose b. 8th week after 1 dose c. 4th week after 1 dose d. 9th week after 1 dose 14. At 34 weeks AOG, patient is advised to follow-up for prenatal check-up a. after 2 weeks b. after 4 weeks c. after 3 weeks d. after 1 week 15. Mechanical stretching of the cervix and lower uterine segment the enhances uterine activity a. cervical effacement b. Ferguson reflex c. cervical dilatation 16. Shortening of the cervical canal from a length of 2cm to a mere circular orifice with paper-thin edges a. cervical effacement b. Ferguson reflex c. cervical dilatation

6. What plasma magnesium level most often prevents seizure? a. 3-4mEq/L b. 4-7mEq/L c. 7-10mEq/L d. over 10mEq/L

17. The first stage of labor is characterized by a. cervical effacement and dilatation b. uterine preparedness for labor c. delivery of the fetus d. separation and expulsion

7. At what serum level of magnesium do patellar reflexes disappear? a. 6mEq/L b. 8mEq/L c. 10mEq/L d. 12mEq/L

18. The order of the stages of lochia beginning with early postpartum a. lochia rubra, serosa, alba b. lochia alba, rubra, serosa c. lochia alba, serosa, rubra d. lochia serosa, alba, rubra

8. Engagement of the fetal head occurs when the occiput reaches what station? a. -2 b. +2 c. 0 d. +4

19. Arrest of dilatation was defined by Friedman as no cervical change for what period of time? a. 1hr b. 2hr c. 3hr d. 4hr

9. Forceps used for low forceps delivery of a fetus with a molded head? a. Simpson b. Keilland c. Tucker-Mclane d. Pipers

20. Which of the following is characteristic of true labor? a. irregular contractions b. discomfort restricted to the lower abdomen c. cervical dilatation d. discomfort relieved by sedation

10. What is the median duration of the 2nd stage of labor in nulliparas and multiparas respectively? a. 2hr, 1 hr b. 2 hr, 30min c. 50 min, 50 min d. 50 min, 20 min 11. The shortest AP diameter through which the head must pass in descending through the pelvic inlet a. diagonal conjugate b. transverse diameter

II. True or False 1. Dystocia is the least common cause of primary CS. FALSE 2. 100gm OGTT is requested during the first visit in pregnant patients known to have diabetes. TRUE 3. Fetal heart tone monitoring for HIGH risk patient should be done every 30 mins. during the 1st stage of labor and every 15 mins. during the 2nd stage of labor. FALSE 4. Leopold maneuver 1 pertains to fetal pole or part the occupies the fundus. TRUE

5. Estrogen and progesterone are responsible for the increase in size of uterus during the early week of gestation. TRUE III. Identification 1. occurs when the biparietal diameter of the fetal head descends below the level of the pelvic inlet. ENGAGEMENT 2. how many gms is the loading dose of MgSO4 for PES. 4g 3. drug of choice in parenteral treatment of acute severe hypertension in a pregnant woman. HYDRALAZINE 4. perineal laceration involving the skin, anal sphincter, and rectal mucosa. 4TH DEGREE 5. discoloration of the vaginal mucosa during pregnancy. CHADWICK’S SIGN IV. Enumeration 1-6 (6) Indications for forceps delivery 1. heart disease 2. pulmonary edema 3. maternal exhaustion 4. neurologic conditions 5. prolonged 2nd stage of labor 6. effect of anesthesia 7-10 (4) Signs of placental separation 7. sudden gush of blood 8. elongation of the umbilical cord 9. Calkin’s sign – uterus becomes globular and firmer 10. uterus rises in the abdomen as detached placenta drops to the lower uterine segment and vagina 11-17 (7) Cardinal movements of labor (arrange accordingly) 11. engagement 12. descent 13. flexion 14. internal rotation 15. extension 16. external rotation 17. expulsion 18-20 (3) Parameters to check before giving magnesium sulfate. 18. DTRs 19. urine output 20. respiratory rate

2012 Identification >dose of dexamethasone: 6mg/IM q12 for 4 doses >dose of betamethasone: 12mg/IM q24 for 2 doses >dose of MgSO4: 4g >fundic height compatible with AOG: 18-32 weeks >relation of the long axis of the fetus to the long axis of the mother: LIE >normal AFI: 5-25 Enumeration >The three stages of Labor 1st: sufficient uterine contractions to bring about demonstrable cervical effacement and dilatation Up to full cervical dilatation 2nd: full cervical dilatation to expulsion of fetus 3rd: time from delivery of the infant to expulsion of the placenta

> Active Management of Labor 1. massage 2. oxytoxics 3. controlled cord traction and countertraction Correct Application of Forceps 1. sagittal sutures equidistant to the blades 2. posterior fontanel perpendicular to the shank 3. can’t insert a finger in the fenestration >EINC 1. immediate and thorough drying 2. early skin to skin contact 3. properly timed cord clumping 4. non-separation of the baby for early breastfeeding >Complications of hypothermia >benefits of thermoregulation >Name of the two clerk’s monitor