Puerperium and Puerperal Sepsis

 Puerperium and Puerperal Sepsis:

1. Regarding Puerperium:

F. Refer to the first 6 months after delivery

G. The lochia usually persist for 7 weeks

H. The uterine fundus should not be palpable abdominally by 14 days after delivery

E. The incidence of post partum depression is 50%

F. Fever due to engorged breast occurs on the second day after delivery

2. The most common complication of breast feeding is:

A. Amenorrhea.

B. Pregnancy.

C. Excessive weight loss.

D. Puerperal mastitis.

E. Breast abscess.

3. Oxytocin in the Puerperium is associated with :

A. Involution of the uterus

B. Initiation of lactation

C. Resumption of menses

D. Sub-involution of the uterus

E. Post partum mastitis

4. Of the following, the greatest predisposing cause of puerperal infection is:

A. Retained placental tissue.

B. Iron deficiency

C. Coitus during late pregnancy

D. Poor nutrition

E. Maternal exhaustion

5. Which of the following is the most likely causes of a fever in a women on the second

day postpartum:

A. Pneumonia

B. Endometritis.

C. Mastitis

D. Cholycystitis

E. Thrombophlebitis

6. Postpartum, the deciduas becomes necrotic and is normally cast off within five to six

days as :

A. Decidual cast

B. Placental remnants

C. Lochia

D. Carunculae myrtiforms

E. None of the above

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7. A syndrome of amnenorrhea-glactorrhea developing postpartum is :

A. Ahumada del Castillo

B. Ciari-formmel

C. Budd-chiari

D. Sheehan's

E. Simmonds

8. What is the recurrence risk of postpartum depression ?

A. 5%.

B. 20%.

C. 70%.

D. 95%.

9. Immediately after delivery:

A. The uterine fundus is between the umbilicus & the symphysis pubis.

B. The uterus weighs about 500 gm.

C. The lochia is yellowish in color.

D. There is decreased venous return to the heart.

E. There is increased diuresis.

10. Infectious maternal (puerperal) morbidity is defined as:

A. Death of mother.

B. High rectal temperature in the first ten days in one occasion.

C. Postpartum hemorrhage.

D. On oral temperature of 38_ C or more on 2 separate occasions during the first

24 days postpartum.

E. On oral temperature of 38_ C or more on 2 separate occasions during the first

10 days postpartum.

11. The most common bacteria isolated from cases of puerperal infection is:

A. E.coli.

B. Anaerobic streptococcus.

C. Anaerobic staphylococcus.

D. Aerobic streptococcus.

E. Clostridium perfringens.

12. Immediately after the completion of a normal labor, the uterus should be :

A. Firm & contracted at the level of the umbilicus.

B. At the level of the symphysis pubis.

C. Immobile.

D. Atonic.

E. Boggy

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13. In the mother, suckling leads to which of the following response:

A. Decrease of Oxytocin.

B. Increase of Prolactin-inhibiting hormone.

C. Increase of hypothalamic dopamine.

D. Increase of hypophyseal Prolactin.

E. Increase of LH-releasing hormone.

14. After parturition, endometrium regenerates from the decidual:

A. Basal zone.

B. Compact zone.

C. Functional zone.

D. Parietal layer.

E. Spongy zone.

15. A routine postnatal check include all of the following EXCEPT:

A. Breast examination.

B. Pap smear.

C. Serum blood sugar 2 hr. p. p.

D. Bimanual vaginal examination.

E. Contraceptive counseling.

16. Risk factors of post partum Endometritis include all of the following, EXCEPT:

A. Prolonged labor

B. Prolonged rupture of membranes

C. Multiple vaginal exams

D. Prolonged monitoring with an intrauterine pressure catheter

E. Gestational diabetes.

17. Symptoms and signs of puerperal endometritis include all the following,

EXCEPT :

A. Malodorous vaginal discharge.

B. Lower abdominal pain.

C. Fever.

D. Involution of the uterus.

E. Uterine tenderness on palpation.

18.All the following methods inhibit lactation EXCEPT :

A. Restriction of fluid and diuretics

B. Tight breast binder and analgesics

C. estrogen hormone in large dose

D. Thyroxin hormone

E. Dopamine agonist

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19. Breast feeding :

A. Should be discontinued if breast infection is suspected

B. Should be started until 3 days postpartum

C. Should be replaced by bottle feeds if the patient had a caesarean section

D. Has a role in innvoulating of the fetus

E. Should not be supplemented with iron

20. In the mother suckling leads to which of the following responses?

A. Decrease Oxygen

B. Increase of prolactin-inhibiting factor

C. Increase of hypothalamic dopamine

D. Increase of hypothalamic Prolactin.

E. Increase of luteinizing hormone-releasing factor

21. Breast feeding accelerates the involution of the uterus through:

A. The increased level of prolactin.

B. The release of oxytocin.

C. The increased level of estrogen.

D. The decreased level of progesterone.

E. The decreased level of HPL.