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Obstetrics Quiz

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Put your knowledge to the test with this obstetrics quiz.

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Obstetrics quiz

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Question 1
At 22 weeks gestation where would you expect to find the uterine fundus?
A
Halfway between umbilicus and xiphisternum
B
Umbilicus
C
Xiphisternum
D
Symphysis pubis
Question 2
Which of the following are causes of postpartum haemorrhage?
A
Vaginal or vulval lacerations
B
Uterine atony
C
Retained placenta
D
Coagulapathy
Question 2 Explanation: 
All of the above are potential causes of PPH with uterine atony being the most common. Coagulopathy is a rare cause, accounting for around 1% of PPH.
Question 3
Which of the following are recognised causes of intrauterine growth restriction (IUGR)?
A
Diabetes
B
Pre-eclampsia
C
Smoking
D
Hypercholesterolaemia
E
Hypertension
F
Alcohol
Question 3 Explanation: 
IUGR can occur for a large number of reasons. Smoking accounts for around 30-40% of IUGR cases.
Question 4
Which period of gestation does the 3rd trimester represent?
A
30-41 weeks
B
27-39 weeks
C
28-40 weeks
D
29-40 weeks
Question 4 Explanation: 
The third trimester starts at 29 weeks and ends at 40 weeks.
Question 5
By James Heilman, MD

Which sign is present on this pregnant abdomen?

A
Stria albicans
B
Linea nigra
C
Striae gravidarum
Question 5 Explanation: 
Linea nigra can be seen on this image. This occurs in around 3/4 of pregnancies. It's described as a vertical line of increased pigmentation running down the centre of the pregnant abdomen. The increased pigmentation occurs over the linea alba which is stretched during pregnancy to accommodate the developing foetus.
Question 6
At 28 weeks gestation where would you expect to feel the uterine fundus?
A
Symphysis pubis
B
Umbilicus
C
Xiphisternum
D
Halfway between xiphisternum and umbilicus
Question 7
Which of the following is thought to be a cause of hyperemesis gravidarum?
A
High levels of circulating HCG
B
Underlying infection
C
Over eating
D
Psychological issues
Question 7 Explanation: 
Hyperemesis gravidarum is a severe form of morning sickness in which women suffer from excessive nausea and vomiting which prevents them from taking in adequate amounts of food and water. It is thought to be caused by high levels of circulating HCG. This is supported by the fact that it's more common in multiple pregnancy and also tends to only affect women during the first 12 weeks of pregnancy.
Question 8
Which of the following methods is the correct way to calculate the estimated date of delivery (EDD)?
A
First day of LMP + 9 months and 1 week
B
Last day of LMP + 8 months and 1 week
C
First day of LMP + 9 months
D
First day of last menstrual period (LMP) + 8 months and 1 week
Question 8 Explanation: 
The correct way to calculate the EDD is to add 9 months and 1 week onto the first day of the last normal menstrual period. This method may not be reliable if a woman is unsure about when her last menstrual period was. As a result ultrasound is used to more accurately date pregnancies.
Question 9
Which period of gestation does the 2nd trimester represent?
A
13-28 weeks
B
15-30 weeks
C
14-29 weeks
D
10-20 weeks
Question 9 Explanation: 
The second trimester begins at 13 weeks and ends at 28 weeks.
Question 10
At 36 weeks gestation where would you expect to find the uterine fundus?
A
Halfway between umbilicus and xiphisternum
B
Symphysis pubis
C
Umbilicus
D
Xiphisternum
Question 11
At what stage of gestation would you expect a nulliparous women to begin to feel fetal movements?
A
14-16 weeks
B
18-20 weeks
C
10-12 weeks
D
22-24 weeks
Question 11 Explanation: 
Most women will become aware of fetal movements around 18-20 weeks. However, if a woman has had previous pregnancies they often notice movements earlier (around 15-18 weeks).
Question 12
What is the most common cause of postpartum haemorrhage?
A
Vulval or vaginal lacerations
B
Retained placenta
C
Uterine atony
D
Uterine rupture
Question 12 Explanation: 
The most common cause of PPH is uterine atony, however, retained placenta and vaginal lacerations also account for a significant proportion of PPH. Uterine atony describes a state in which the uterus can no longer effectively contract. Because the uterus cannot contract the blood vessels which were supplying the placenta are not compressed and can, therefore, bleed profusely. A uterus can become atonic for a number of reasons such as prolonged labour, large baby, multiple pregnancy and retained placenta.
Question 13
Which period of gestation does the 1st trimester represent?
A
1-12 weeks
B
1-13 weeks
C
1-11 weeks
D
1-10 weeks
Question 13 Explanation: 
The first trimester refers to the first 12 weeks of pregnancy.
Question 14
Which of the following are risk factors for pre-eclampsia?
A
First pregnancy
B
Family history of pre-eclampsia in mother or sisters
C
Obesity (BMI >35)
D
Maternal age > 40
E
Change of partner
Question 15
Which of the following is a prostaglandin commonly used in induction of labour?
A
Labetalol
B
Atenolol
C
Misoprostol
Question 15 Explanation: 
Misoprostol is inserted vaginally and causes effacement of the cervix in addition to uterine contraction.
Question 16
At 12 weeks gestation where would you expect to feel the uterine fundus?
A
Xiphisternum
B
Halfway between umbilicus and xiphisternum
C
Symphysis pubis
D
Umbilicus
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