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Question 1
Incorrect
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The resting pulse in pregnancy is:
Your Answer: Decreased by 10 to 15 bpm
Correct Answer: Increased by 10 to 15 bpm
Explanation:During pregnancy cardiac output increases by 30 to 50%. As a result, the resting pulse speeds up from a normal of about 70 bpm to 80 or 90 bpm.
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This question is part of the following fields:
- Physiology
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Question 2
Incorrect
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Which of the following is suggestive of ovulation:
Your Answer: Basal body temperature drop at least 5°C in the second half of the cycle
Correct Answer: Regular cycle with dysmenorrhea
Explanation:Ovulation in the menstrual cycle usually occurs over 4 days. There is an increase in basal body temperature at the time of ovulation due to the effect of progesterone.
A high Day 21 progesterone level indicates ovulation and the release of an egg.
Dysmenorrhea is described as painful menstruation. The symptoms start at the time of ovulation and persist till menstruation.
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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
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 5
Correct
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Which of the following statements is true regarding renal blood flow in pregnancy?
Your Answer: Increases by approximately 50%
Explanation:Glomerular filtration rate (GFR) rises immediately after conception and increases by about 50 per cent overall, reaching its maximum at the end of the first trimester. GFR then falls by about 20 per cent in the third trimester, returning to pre-pregnancy levels within 12 weeks of delivery.
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This question is part of the following fields:
- Physiology
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Question 6
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.
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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 following are presumptive skin signs of pregnancy, except:
Your Answer: Maculo-papular rash
Explanation:Skin signs during pregnancy may include: dark spots on the breasts, nipples and inner thighs, melasma (chloasma), linea nigra, stretch marks, acne, spider telangiectasis and varicose veins.
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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 of the following factors are associated with umbilical cord prolapse, except?
Your 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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During normal pregnancy, a weight gain is anticipated. The average weight gain is approximately:
Your Answer: 5-10 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 10
Correct
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Maternal mortality rate is lowest in which age group?
Your Answer: 20 - 30
Explanation:The maternal mortality rate starts low and raises steeply after the age of 30 years. The lowest mortality rate recorded among women is between 19-30 years of age group.
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This question is part of the following fields:
- Physiology
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Question 11
Correct
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A sure sign of pregnancy is:
Your Answer: Auscultation of fetal heart
Explanation:Classifications of Pregnancy Signs:
Presumptive signs — possibility of pregnancy
Probable signs — most likelihood of indicating pregnancy
Positive signs — 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 12
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 13
Incorrect
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During wound healing collagen alignment along tension lines is part of which phase?
Your Answer: Proliferation
Correct Answer: Remodelling
Explanation:Realignment of collagen is part of the remodelling phase. Remodelling is usually underway by week 3. Maximum tensile wound strength is typically achieved by week 12.
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This question is part of the following fields:
- Physiology
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Question 14
Incorrect
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Lowered haemoglobin during normal pregnancy is a physiological finding which is mainly due to:
Your Answer: Decreased reticulocytosis
Correct Answer: Increased plasma volume
Explanation:During pregnancy, anaemia increases more than fourfold from the first to third trimester. It is a well established fact that there is a physiological drop in haemoglobin (Hb) in the mid trimester. This physiological drop is attributed to increase of plasma volume and hence decrease of blood viscosity lead to better circulation in placenta.
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This question is part of the following fields:
- Physiology
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Question 15
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: 8
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 16
Incorrect
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Maternal serum prolactin levels in pregnancy are highest:
Your Answer: During breast feeding
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 17
Correct
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What is the typical volume increase of a non-pregnant uterus to term uterus?
Your 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 18
Correct
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Which of the following statements is true regarding heart rate in pregnancy?
Your 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 19
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 20
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 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 21
Correct
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What form is 99% of body calcium found in?
Your Answer: Calcium Phosphate
Explanation:Calcium phosphate salts are the most abundant form of calcium in the body, making up 99%. The majority of these salts are stored in the skeleton in different forms, mostly, hydroxyapatite, a lattice-like crystal composed of calcium, phosphates and hydroxide. The remaining calcium can be found in the extracellular fluid, tissues and skeletal muscle.
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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 of the following statements regarding human chorionic gonadotrophin are true except::
Your Answer: It is produced by the placenta
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 23
Incorrect
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In the absence of any gross pelvic abnormality, cephalopelvic disproportion can be correctly diagnosed by?
Your Answer: X-ray pelvimetry
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 24
Incorrect
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During pregnancy, maternal oestrogen levels increase markedly. Most of this oestrogen is produced by the:
Your Answer: Ovaries
Correct 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-17ί 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 25
Correct
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Physiological changes in the reproductive system include:
Your 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 26
Correct
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Chief role of the mid-cycle LH surge is:
Your Answer: All are correct
Explanation:LH surge occurs around ovulation and it is this LH surge which results in completion of the 1st meiotic division and ovulation occurs. It enhances the production of androgens and also luteinizes the granulosa cells.
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This question is part of the following fields:
- Physiology
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Question 27
Correct
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Luteal phase deficiency is characterised by:
Your Answer: Has inadequate luteal progesterone production
Explanation:Luteal phase occurs after the ovulation. Luteal defect means that the luteal phase is shorter than 10 days and women will find it difficult to sustain the pregnancy. There is decreased progesterone, LH and FSH production in this case.
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This question is part of the following fields:
- Physiology
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Question 28
Incorrect
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Regarding electronic fetal monitoring, which one of the following statements is true?
Your Answer: Has high specificity & sensitivity
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 29
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 30
Incorrect
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Regarding blood volume in pregnancy which of the following statements is TRUE?
Your Answer:
Correct Answer: Blood volume slowly increases by 40-50%
Explanation:Maternal blood volume expands during pregnancy to allow adequate perfusion of vital organs, including the placenta and foetus, and to anticipate blood loss associated with delivery. The rapid expansion of blood volume begins at 6–8 weeks gestation and plateaus at 32–34 weeks gestation. While there is some increase in intracellular water, the most marked expansion occurs in extracellular fluid volume, especially circulating plasma volume. This expanded extracellular fluid volume accounts for between 8 and 10 kg of the average maternal weight gain during pregnancy. Overall, total body water increases from 6.5 to 8.5 L by the end of pregnancy.
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This question is part of the following fields:
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
