obgynmidterm.txt


After the release of an egg - the follicle is now called the:


Corpus luteum


The umbilical cord has:


One vein and two arteries


The egg's primary site for fertilization is in the uterus. True or false?
True False


False


Ovulation occurs due to a spike in what hormone?


Luteinizing hormone (LH)


The fall in levels of these hormones begin the sloughing of the endometrium. (Choose more than one answer)


Progesterone hormone (PH) Estrogen hormone (EH)


Most ectopic pregnancies symptoms occur in the second trimester. True or false?
True False


False


Endometritis is:


Inflammation of the lining of the uterus


Mittelschmerz is characterized by pain:


Midcycle in the menstrual period


Endometriosis is:


Ectopic growth of endometrial tissue


The foramen ovale is:


The area where the oxygenated blood flows through the atrial septum bypassing the right ventricle


Dysmenorrhea is:


Painful menstruation

The menstrual phase of the menstrual cycle is associated with which time frame?Days 1 - 5


Ectopic pregnancies can occur where? (You may choose more than one answer)


Fimbria Fallopian tube Ovary Intra abdominal
Endometriosis is most common in women who:Defer pregnancy


Pelvic Inflammatory Disease (PID) refers to the infection of: (You may choose more than one answer)


Cervix Ovaries Uterus Fallopian tubes


The inner layer of the uterus is called:


Endometrium


You are treating a 23-year-old woman who complains of diffuse abdominal pain, low-grade fever, and vaginal discharge. She walks with a shuffle, taking short, slow steps. This patient most likely has:


Pelvic inflammatory disease


You are treating a 30-year-old woman who is 6 weeks pregnant with her first child. She has severe abdominal pain centered in the left lower quadrant. She reports vaginal spotting that began an hour ago. The most serious condition that could explain this presentation is:


Ectopic pregnancy


The rebuilding of the endometrium for future implantation of the egg is during which phase?


Proliferation phase


Abdominal pain in a woman that presents 1 week after menstruation is typical of:


PID


The ovulation of the egg from the follicle occurs on approximately which day of the menstrual cycle?


Day 14


Which body systems are affected by pregnancy induced hypertension (PIH)? (You may choose more than one answer)


Hepatic system Renal system Respiratory system Cardiovascular system Central nervous system


The triad of signs for preeclampsia are:


Proteinuria Hypertension Weight gain and edema
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP nar001-1.jpg, P 84, R 20. If the patient begins to seize the paramedic would consider administration of:Magnesium sulfate


A fully dilated cervix is how many centimeters?


10


Match the correct OB patient to the statement.


Primigravida Pregnant for first timeGravida 2 Para 1 Has one child and is pregnantGravida 3 Para 2 Has 2 children and on her 3rd pregnancyGravida 2 Para 3 Currently pregnant, previously delivered tripletsGravida 4 Para 0 Has been pregnant 4 times, but no childrenMultipara Has delivered 2 or more children


The definition of cervical effacement is:


The thinning and shortening of the cervix


The primary causes of preterm labor (PTL) include: (You may choose more than one answer)


A. Preeclampsia Ruptured membranes C. Previous history of PTL Infection E. Smoking F. Fetal defects Score: 0.667/1


The primary problem associated with gestational diabetes for both mom and baby, which can especially cause problems during delivery is:


Fetus becomes larger than normal


Pregnancy induced hypertension (PIH) is usually occurs when during the pregnancy?


After the 20th week


As you are delivering an infant, you note that the cord is loosely wrapped around the infant's neck. You should:


Gently slip the cord over the infant?s head


The definition of cervical dilatation is:


The opening of the cervix


The ductus venosus is:


The area where the maternal blood mixes with the fetal blood near the liver


The effects of preeclampsia and pregnancy induced hypertencion (PIH) on the liver can lead to symptoms that can be misinterpreted as cardiac chest pain. True or false?
True False


True


The foramen ovale works because:


The right side (pulmonary) of the fetal heart has higher pressure than the left side (systemic)


The medication used by paramedics to assist in stopping uterine hemorrhage is:


Oxytocin


Match the obstetrical terms: (Some answers may be used more than once)


Antepartal Period before the birthGestation From fertilization to birthGravida Number of pregnanciesPara Number of viable birthsPostpartum Period after the birthPrenatal Period before the birthPerinatal Period around the birthPrimigravida Pregnant for first timeNullipara Has never deliveredPrimipara Gave birth onceMultipara 2 or more deliveriesGrand multipara 7 deliveries or morePostnatal Period after the birth


The placenta is a maternal organ. True or false?
True False


False


The medical history of a woman in her thirty-third week of gestation includes the use of magnesium sulfate and terbutaline. You expect her to have a history of:


Pre-term labor


The edema of the lower extremities during pregnancy is most often caused by:


The pressure of the fetus on the vena cava reducing the return of blood from the pelvis and legs


How many stages of labor are there?


3


Preterm labor is defined as labor occurring before:


37 weeks


The beginning of the expulsion stage of labor is when:


Cerivical dilatation is complete


The problem with a presenting umbilical cord is:


Fetal asphyxia


The only appropriate times to place a sterile gloved hand into the vaginal canal during delivery is: (You may choose more than one answer)


Presenting cord delivery Performing the Mauriceau maneuver


The following changes occur to the respiratory system due to the effects of pregnancy. (You may choose more than one answer)


Increased ventilatory rate Decreased tidal volume


Which of the following statements is true regarding the maternal response to injury and shock


The mother's body will treat the fetus as an unnecessary organ shunting blood away from the fetus when in shock


Painless vaginal bleeding during pregnancy is most likely related to:


Placenta previa


Edema associated with pregnancy induced hypertencion (PIH) and pre-eclampsia has three contributory factors. These three factors are: (Choose 3)


Increased hydrostatic pressure Inflammation Increased proteins


What modifications of the usual management of cardiac arrest should be made for a pregnant patient?


Perform cardiac compressions higher on the sternum


Preeclampsia will affect the fetus by:


Clotting occurs in the umbilical cord


A miscarriage is defined as termination of pregnancy occurring before what week?


20th


Braxton-Hicks contractions:


Are generally benign


Amniotic fluid embolism can occur anytime during pregnancy.
True False


False


The ductus arteriosus is:


The area where the blood bypasses the fetal pulmonary circulation by entering the fetal systemic circulation


Fetal heart tones can usually be auscultated by what week?


16 - 20 weeks


The following changes occur to the cardiac system due to the effects of pregnancy. (You may choose more than one answer)


Increased blood volume Increased HR Flat or negative T waves may be present in lead III during the 3rd trimester Increased cadiac output


Pregnancy causes a women to go to the bathroom frequently (more than normal). What can cause this to occur? You may choose more than 1 answer.


Increased fetal pressure on the bladder Increased blood volume


The following are changes that occur to the gastrointestinal system from the effects of pregnancy: (You may choose more than one answer)


Increased risk of aspiration Morning sickness and nausea caused by high serum levels of chorionic gonadotropin Indigestion and heartburn Constipation


Testing for pregnancy is done for most females with abdominal complaints in the emergency department. The emergency department will test the urine or blood for:


Human chorionic gonadotrophin (hCG)


Your patient is a 40-year-old female, gravida 6, para 5. She is complaining that this labor is unlike her others. She has sharp, constant abdominal pain and vaginal bleeding, and she feels like something is "tearing." She tells you that she feels like her contractions were very strong and then stopped. You suspect:


Uterine rupture


The best position in which to transport a pregnant patient with no traumatic injuries is:


Left lateral recumbent


After delivery of the infant, the mother continues to bleed briskly, losing approximately 1 L of blood. You should:


Encourage the mother to breast-feed the infant and massage the uterus


Supine hypotensive syndrome occurs when a pregnant female is lying supine and the fetus places pressure on the aorta.
True False


False


A fetal heart rate of 80 indicates:


Hypoxia


The number one cause of peripartum death is:


Uncontrolled hemorrhage


A pregnant patient can?t remember how many weeks she is into her pregnancy. On exam, you feel the fundus of the uterus at the level of the umbilicus, leading you to conclude that she has been pregnant for:


24 weeks


The beginning of the dilatation phase of labor is:


The onset of regular contractions


You have begun resuscitation efforts on a 29 week newborn. You have intubated the newborn with a 2.5 ET tube and established an IV in the right hand. Your partners are doing good BLS as you note gentle chest rise and a brachial pulse with compressions. You feel that the newborn is hypovolemic and are now going to try a fluid bolus. You would estimate the weight of this newborn to be about 2 kilograms. 1. How many ml/kg of fluid are you going to give? 2. How many milliliters (ml) total for this patient?


1. 10 2. 20


Please place in the correct order the resuscitation efforts of the inverted neonate resuscitation triagle those procedures that are used most frequently to those that are used least frequently:


1 - Always needed Warm, dry, stimulate2 - Needed less frequently Supplemental O23 - Administered when HR < 100 bpm PPV4 - Poor response to step 3 Intubate5 - Administered when HR < 60 bpm CPR6 - Last resort IV and medications


You have begun resuscitation efforts on a 39 week newborn. You have intubated the newborn with a #4 ET tube and established an IV in the right hand. Your partners are doing good BLS as you note gentle chest rise and a brachial pulse with compressions. You must now give the first dose of epi. You would estimate the weight of this newborn to be about 4.5 kilograms. 1. How many milligrams (mg) of epinephrine are you going to give? 2. How many milliliters (ml) is this?


1. 0.045 2. 0.45


You have just delivered a 28 week preterm newborn that had meconium stained amniotic fluid. You note that the newborn is limp with minimal gasping but no sounds. The newborn is cyanotic all over and you palpate a pulse of 90. What is the infants APGAR score?


Appearance 0Pulse 1Grimace 0Activity 0Respirations 1
True or false? You should change out the ET tube after each time you suction meconium from the trachea.True


You have delivered a term infant but note that the infant has an obvious deformity to their upper lip. You note that this is a cleft lip and now examine the infant further as the cleft lip may interfere with your attempts at airway control because:


The integrity of the airway may be compromised if the defect involves the hard palate


You have begun resuscitation efforts on a 29 week newborn. You have intubated the newborn with a 2.5 ET tube and established an IV in the right hand. Your partners are doing good BLS as you note gentle chest rise and a brachial pulse with compressions. You must now give the first dose of epi. You would estimate the weight of this newborn to be about 2 kilograms. 1. How many milligrams (mg) of epinephrine are you going to give. 2. How many milliliters (ml) of epinephrine will you give?


1. 0.02 2. 0.2


You have ended up doing CPR on a 34 week newborn despite your best efforts. What is the "events per minute" you should try to achieve?


120


You have begun resuscitation efforts on a 29 week newborn. You have intubated the newborn with a 2.5 ET tube and established an IV in the right hand. Your partners are doing good BLS as you note gentle chest rise and a brachial pulse with compressions. You must now give the first dose of epi. You would estimate the weight of this newborn to be?


1 - 2 kilograms


Normal respiratory rate for a newborn would be:


40 to 60


What kind of cyanosis is considered normal after the delivery of a newborn?


Acrocyanosis


A meconium aspirator:


Attaches to the ET tube converting it into a suction device


What is the neonatal ratio of compressions to ventilations for CPR?


3:1


You have just delivered a 40 week term newborn. The mother had prenatal care during the pregnancy. You note that the newborn is moving all extremities with loud crying especially as you dry them off. The newborn's extremities are cyanotic but the body is pink. You palpate a pulse of 145. What is the infants APGAR score?


Appearance 1Pulse 2Grimace 2Activity 2Respirations 2


Pierre-Robin syndrome in the newborn could cause problems for the paramedic when dealing with:


Intubating the newborn


The initial management for a neonate with bradycardia is to:


Begin positive-pressure ventilation


Match ways to prevent a newborn from losing heat after their delivery.


Conduction Place the infant on a warm surfaceConvection Turn off the ventilation system in the ambulanceEvaporation Dry the infant offRadiation Cover the infant with blankets


The single most common cause of respiratory distress and cyanosis in a newborn is:


Prematurity


The greatest risk factor for birth injuries is:


Uncontrolled explosive delivery


When referring to developmental size of a neonate such as the term "small for gestational age", this is based on what measurement of the neonate?


Weight


When the fetus is delivered - two things occur. The infant fills their lungs with air and we clamp the umbilical cord. This causes the following changes in the infants circulation: (You may choose more than one answer)


Pulmonary blood flow increases Left atrium pressure increases Pulmonary vascular resistance decreases


When newborns are hypothermic, the demand on the body to maintain temperature can cause:


Metabolic acidosis


Why is atropine not use in neonatal resuscitation?


Paradoxical affect could occur and/or delay to more meaningful care


Hypothermia has the following effect on a newborn:


Bradycardia

The middle layer of the myometrium is compsed of muscle arranged in what shape to aide in hemostasis?Figure 8


True or false? Premature rupture of membranes could cause infection in the mom and neonate.
True False


True


True or false? Treatment for uterine inversion may include using a gloved hand to push the inverted fundus back up into the cervical canal.
True False


True


What Sxs of preeclampsia would you look for that would deem contacting an MCEP for Magnesium Sulfate appropriate? You may choose more thatn 1 answer


Increased or hyper reflexive DTR Positive clonus finding severe headache


True or false? When doing CPR in neonatal resuscitation, the ratio of compressions to ventilations is 3:1, unless the child arrested due to a known cardiac condition, rather than a hypoxic event.
True False


True