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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
Which of the following are causes of postpartum haemorrhage?
A
Vaginal or vulval lacerations
B
Retained placenta
C
Uterine atony
D
Coagulapathy
Question 1 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 2
At what stage of gestation would you expect a nulliparous women to begin to feel fetal movements?
A
10-12 weeks
B
22-24 weeks
C
14-16 weeks
D
18-20 weeks
Question 2 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 3
By James Heilman, MD

Which sign is present on this pregnant abdomen?

A
Striae gravidarum
B
Stria albicans
C
Linea nigra
Question 3 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 4
Which of the following are recognised causes of intrauterine growth restriction (IUGR)?
A
Diabetes
B
Hypertension
C
Hypercholesterolaemia
D
Alcohol
E
Pre-eclampsia
F
Smoking
Question 4 Explanation: 
IUGR can occur for a large number of reasons. Smoking accounts for around 30-40% of IUGR cases.
Question 5
Which period of gestation does the 1st trimester represent?
A
1-11 weeks
B
1-10 weeks
C
1-12 weeks
D
1-13 weeks
Question 5 Explanation: 
The first trimester refers to the first 12 weeks of pregnancy.
Question 6
At 22 weeks gestation where would you expect to find the uterine fundus?
A
Symphysis pubis
B
Umbilicus
C
Xiphisternum
D
Halfway between umbilicus and xiphisternum
Question 7
Which of the following is a prostaglandin commonly used in induction of labour?
A
Atenolol
B
Labetalol
C
Misoprostol
Question 7 Explanation: 
Misoprostol is inserted vaginally and causes effacement of the cervix in addition to uterine contraction.
Question 8
Which period of gestation does the 3rd trimester represent?
A
30-41 weeks
B
28-40 weeks
C
29-40 weeks
D
27-39 weeks
Question 8 Explanation: 
The third trimester starts at 29 weeks and ends at 40 weeks.
Question 9
At 12 weeks gestation where would you expect to feel the uterine fundus?
A
Symphysis pubis
B
Halfway between umbilicus and xiphisternum
C
Umbilicus
D
Xiphisternum
Question 10
At 36 weeks gestation where would you expect to find the uterine fundus?
A
Xiphisternum
B
Halfway between umbilicus and xiphisternum
C
Umbilicus
D
Symphysis pubis
Question 11
What is the most common cause of postpartum haemorrhage?
A
Uterine atony
B
Retained placenta
C
Uterine rupture
D
Vulval or vaginal lacerations
Question 11 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 12
Which of the following methods is the correct way to calculate the estimated date of delivery (EDD)?
A
First day of last menstrual period (LMP) + 8 months and 1 week
B
First day of LMP + 9 months and 1 week
C
Last day of LMP + 8 months and 1 week
D
First day of LMP + 9 months
Question 12 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 13
Which of the following are risk factors for pre-eclampsia?
A
First pregnancy
B
Change of partner
C
Maternal age > 40
D
Obesity (BMI >35)
E
Family history of pre-eclampsia in mother or sisters
Question 14
Which period of gestation does the 2nd trimester represent?
A
10-20 weeks
B
14-29 weeks
C
15-30 weeks
D
13-28 weeks
Question 14 Explanation: 
The second trimester begins at 13 weeks and ends at 28 weeks.
Question 15
Which of the following is thought to be a cause of hyperemesis gravidarum?
A
Over eating
B
High levels of circulating HCG
C
Psychological issues
D
Underlying infection
Question 15 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 16
At 28 weeks gestation where would you expect to feel the uterine fundus?
A
Umbilicus
B
Halfway between xiphisternum and umbilicus
C
Xiphisternum
D
Symphysis pubis
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