Premature Labor and PROM

 Premature Labor and PROM:

1. All of these drugs can be used as tocolytic to stop labor, EXCEPT:

A. Salbutamol ventolin

B. Diazepam (valium)

C. Calcium channel blocker

D. Indomethacin non steroidal anti inflammatory drugs

E. Ritodrine (β agonist).

2. In cases with premature rupture of membranes, all the following are

acceptable in the conservative management except:

A. Frequent vaginal examination to assess cervical dilatation

B. serial complete blood count to diagnose rising of WBC

C. Close monitoring of maternal vital signs

D. Ultrasound to assess fetal weight and amount of liquor

E. Monitoring of the fetus by doing cardiotocogram

3. Regarding Surfactant:

A. Is secreted by type I pneumocytes

B. Are glycoprotein.

C. After 38 weeks the ratio to sphingomyelins is 2:1.

D. Its secretion is suppressed by betamethzone.

E. Its deficiency leads to adult respiratory distress syndrome.

4. The following has a recognized relation with spontaneous preterm labor:

A. Fetus with anencephaly

B. Oligohydromnios

C. Maternal hypothyroidism

D. Bacterial Vaginosis

E. Transverse lie of the fetus

5. All the following are possible of premature labor, EXCEPT:

A. Multiple pregnancy

B. Polyhydramnios

C. Bicorrnuate utures

D. Anecephaly

E. Perinatel infection.

6. A positive nitrazine test is:

A. Strong evidence of rupture of the membranes.

B. Presumptive evidence of intact membranes.

C. An evidence of intact membranes.

D. Presumptive evidence of intact membranes.

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E. None of the above.

7. The most serious complication of preterm premature rupture of membrane

(PPROM) at 28 weeks:

A. Fetal compression anomaly.

B. Pulmonary hypoplasia.

C. Intrauterine infection.

D. Limb contraction.

E. Abruptio placenta.

8. The following are obstetrics causes for premature labor EXCEPT :

A. Multiple pregnancy

B. Multiparity

C. Premature preterm rupture of the membrane

D. Cervical incompetence

E. Uterine congenital anomalies

9. In the diagnosis of premature rupture of the membrane, all of the following are

true EXCEPT:

A. History of fluid loss per vagina

B. Visualization of amniotic fluid in the vagina by sterile speculum

C. Positive Nitrazine test

D. Positive fern test

E. Positive methyline blue test

10. Rupture of membranes is suspected with all of the followings EXCEPT:

A. Positive Nitrazine test.

B. Positive Fern test.

C. Pooling of amniotic fluid on speculum examination.

D. Observing amniotic fluid drain through the cervix during speculum

examination.

F. Contractions seen on the CTG.

11. All the followings are causes of preterm labor EXCEPT:

A. Multiparity.

B. Placenta previa.

C. Polyhydramnios.

12. The following are known causes of preterm labor EXCEPT:

A. Maternal hypoxia

B. Intrauterine fetal death

C. Polyhydramnios

D. Multiple pregnancy

E. Cervical incompetence

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13. Early signs of premature labor include all of following EXCEPT:

A. Increased vaginal discharge

B. Increased uterine contraction

C. Low back pain

D. Cervical dilatation to 4 cm

E. Worsening pelvic pressure

14. Rupture of membranes is suspected with all the following, EXCEPT :

A. +ve nitrazine test.

B. +ve fern test.

C. Pooling of amniotic fluid on speculum examination.

D. Contraction seen on the CTG.

E. Observing amniotic fluid draining through the cervix during speculum

examination.

15. In cases of premature rupture of membrane, all the following is acceptable in

conservative management, EXCEPT:

A. Serial CBC to diagnose rising WBC.

B. Closed monitoring of maternal vital signs.

C. Frequent vaginal examination to asses cervical dilation.

D. US to asses fetal weight and the amount of liquor.

E. Monitoring of fetus by doing cardiogram.

16. In cases with premature rupture of membranes, all the following are

acceptable in the conservative management except:

A. Frequent vaginal examination to assess cervical dilatation.

B. serial complete blood count to diagnose rising of WBC.

C. Close monitoring of maternal vital signs.

D. Ultrasound to assess fetal weight and amount of liquor.

E. Monitoring of the fetus by doing cardiotocogram.

17. A premature birth has been defined as:

A. Before 37 completed weeks' gestation.

B. Prior to the period of viability.

C. Weighing less than 1000 g.

D. Weighing more than 1000g but less than 2500g.

E. None of the above.

18. Preterm labor is defined as labor which starts:

A. Before 24 weeks of gestation.

B. Before 37 completed weeks.

C. Before the viability of the fetus.

D. When the fetus weighing < 1000 gm.

E. Prior to 40 weeks gestation.

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19. Premature rupture of membrane is most strictly defined as rupture at any time

prior to:

A. A stage of fetal viability.

B. The 2ND stage of labor.

C. The 32ND week of gestation.

D. The onset of labor.

E. The 38TH week of gestation.

20. Contraindications to tocolytic therapy includes the following EXCEPT:

A. Severe PET.

B. Severe antepartum hemorrhage.

C. IUGR.

D. Chorioamnionitis.

E. Preterm breech presentation.

21. Drugs used to inhibit preterm labor include:

A. Phenobarbitone.

B. Prostaglandins.

C. Ca channel inhibitors.

D. Anticholinergic drugs.

E. Dexamethasone.

22. Premature rupture of membrane is :

A. Rupture of membranes before the onset of labor.

B. Rupture of membranes before fetal lung maturity.

C. Rupture of membranes before term.

D. Rupture of membranes before 28 weeks gestation.

E. All the above.

23. All of these drugs can be used as tocolytic to stop labor, EXCEPT:

A. Salbutamol ventolin

B. Methotrexate

C. Calcium channel blocker

D. Indomethacin non steroidal anti inflammatory drugs Retodrine (_-

agonist)

24. The following are known contraindications to the usage of Tocolysis in

pregnancy EXCEPT:

A. Cardiac disease.

B. Severe hypertension.

C. Clinical chorioamnionitis.

D. Intrauterine death.

E. Thyroid disease.

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25. Dexamethasone is indicated in which of the following condition :

A.Premature labor to prevent neonatal respiratory distress syndrome

B. Ectopic pregnancy to enhance fetal lung maturity

C. Spontaneous rupture of membrane at 39 week

D.At 38 weeks severe abruption placenta

E. Threatened abortion

26. Complication of pregnancy that predispose to preterm labor includes all the

following EXCEPT :

A. polyhydramnios

B. Urinary tract infection

C. 25 years old primigravida.

D. Premature rupture of membranes

E. Multiple pregnancy

27. Which of the following complications is associated with ruptured appendix &

peritonitis ?

A. Fetal growth restriction

B. Oligohydromnios

C. Chorioamnionitis

D. Preterm birth

E. Placental abruption

28. Inhibition of prostaglandin synthesis are not generally used for tocolysis

because they:

A. Are effective

B. Produce marked hypertension

C. May cause premature closure of the fetal ductus arteriosus

D. Are too expensive

E. Are associated with lactic acidosis

29. In cases with premature rupture of membranes, all the following are

acceptable in the conservative management except:

A. Frequent vaginal examination to assess cervical dilatation.

B. serial complete blood count to diagnose rising of WBC.

C. Close monitoring of maternal vital signs.

D. Ultrasound to assess fetal weight and amount of liquor.

E. Monitoring of the fetus by doing cardiotocogram.

30. Retodrine is a b adrenergic receptor stimulator that is used to arrest preterm

labor. Which of the following is a major maternal risk of its use?

A. Hypertension.

B. Decreased plasma glucose.

C. Decreased serum potassium.

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D. Cardiac arrhythmias.

E. Asthma

32. Prostaglandin synthesis is inhibited by:

A. progesterone.

B. Indomethacin.

C. ACTH.

D. Prolactin-inhibiting factor.

E. Thyroid hormone.

33. Side effects of β sympathomimetics include all of the following, EXCEPT:

A. Tachycardia

B. Pulmonary oedema

C. Headache

D. Premature closure of ductus arteriosus

E. Palpitation