OB Questions PDF

**Which placental condition requires an elective cesarean section before labor begins?**\ A. Placenta previa\ B. Placental abruption\ C. Abruptio placenta\ D. Uterine atony\ **Answer**: A **Which fetal circulation feature bypasses pulmonary circulation?**\ A. Foramen ovale\ B. Ductus venosus\ C. Um...

**Which placental condition requires an elective cesarean section before labor begins?**\ A. Placenta previa\ B. Placental abruption\ C. Abruptio placenta\ D. Uterine atony\ **Answer**: A **Which fetal circulation feature bypasses pulmonary circulation?**\ A. Foramen ovale\ B. Ductus venosus\ C. Umbilical vein\ D. Umbilical artery\ **Answer**: A **Which is a sign of uterine rupture during labor?**\ A. Increased uterine tone between contractions\ B. Fetal bradycardia, loss of station, cessation of uterine contractions\ C. Prolonged variable decelerations\ D. Increased maternal blood pressure\ **Answer**: B **What is the most appropriate management for a Category III fetal heart rate tracing?**\ A. Administer magnesium sulfate and observe.\ B. Continue oxytocin augmentation.\ C. Initiate intrauterine resuscitation measures immediately.\ D. Perform scalp pH sampling.\ **Answer**: C **When is the highest risk of VTE?** Postpartum **Why should NSAIDs be avoided in late pregnancy?**\ A. They increase maternal blood pressure.\ B. They cause premature closure of the ductus arteriosus and fetal renal injury.\ C. They prolong uterine contractions.\ D. They inhibit maternal hemoglobin production.\ **Answer**: B **What is the significance of a sinusoidal fetal heart rate pattern?**\ A. Normal finding in preterm fetuses\ B. Associated with fetal well-being\ C. Indicates fetal anemia or acidemia\ D. Reflects maternal metabolic derangement\ **Answer**: C **Which medication is most appropriate for preeclampsia with severe features?**\ A. Oxytocin\ B. Magnesium sulfate\ C. Methergine\ D. Phenylephrine\ **Answer**: B **Which maternal cardiac condition requires careful titration of neuraxial anesthesia to maintain preload?**\ A. Aortic stenosis\ B. Pulmonary hypertension\ C. Mitral regurgitation\ D. Patent foramen ovale\ **Answer**: A 71. **What physiologic change makes maternal cardiac output dependent on heart rate during labor?**\ A. Decreased preload\ B. Reduced preload and stroke volume during uterine contractions\ C. Increased systemic vascular resistance\ D. Increased uterine vascular tone\ **Answer**: B 72. **What effect does magnesium sulfate have on neuromuscular blocking agents?**\ A. Reduces the onset time of succinylcholine\ B. Potentiates non-depolarizing neuromuscular blockers\ C. Decreases the duration of blockade\ D. Enhances metabolism of blocking agents\ **Answer**: B 73. **Which fetal circulation shunt primarily directs oxygenated blood from the umbilical vein to the systemic circulation?**\ A. Foramen ovale\ B. Ductus arteriosus\ C. Ductus venosus\ D. Umbilical artery\ **Answer**: C 74. **Which physiologic adaptation to pregnancy facilitates venous stasis in the lower extremities?**\ A. Increased blood viscosity\ B. Compression of the inferior vena cava by the gravid uterus\ C. Decreased plasma volume\ D. Enhanced peripheral vasodilation\ **Answer**: B 75. **What causes the greatest increase in cardiac output immediately postpartum?**\ A. Increased sympathetic tone\ B. Increased preload from uterine autotransfusion\ C. Increased uteroplacental blood flow\ D. Enhanced myocardial contractility\ **Answer**: B 76. **What condition is characterized by painless vaginal bleeding during the third trimester?**\ A. Placenta previa\ B. Placental abruption\ C. Uterine rupture\ D. Uterine tonicity\ **Answer**: A 77. **What is the most common side effect of adding intrathecal opioids to neuraxial anesthesia?**\ A. Pruritus\ B. Hypotension\ C. Respiratory depression\ D. Tachycardia\ **Answer**: A 78. **Which uterotonic drug is contraindicated in hypertensive patients due to its vasoconstrictive effects?**\ A. Methylergonovine\ B. Misoprostol\ C. Carboprost tromethamine\ D. Oxytocin\ **Answer**: A 79. **Why is a combined spinal-epidural (CSE) technique often used for labor analgesia?**\ A. Eliminates the need for a test dose\ B. Provides rapid onset of analgesia with the option for continuous infusion\ C. Reduces the risk of hypotension compared to spinal anesthesia\ D. Requires lower doses of local anesthetics compared to epidural alone\ **Answer**: B 80. **Which maternal condition most commonly necessitates the use of general anesthesia during a cesarean section?**\ A. Elective cesarean delivery\ B. Severe coagulopathy\ C. Multiple gestations\ D. History of epidural placement\ **Answer**: B 81. **What is the most appropriate anesthetic technique for fetal distress during labor?**\ A. General anesthesia for immediate cesarean delivery\ B. Epidural anesthesia to facilitate vaginal delivery\ C. Neuraxial blockade for fetal monitoring\ D. Intravenous sedation to relax uterine tone\ **Answer**: A 82. **What is the safest time during pregnancy for non-obstetric surgery?**\ A. First trimester\ B. Second trimester\ C. Third trimester\ D. Postpartum period\ **Answer**: B 83. **Which placental condition involves fetal blood vessels crossing over the cervical os?**\ A. Placenta previa\ B. Placental abruption\ C. Vasa previa\ D. Placental accreta\ **Answer**: C 91. **What is the most likely explanation for fetal bradycardia after administration of spinal anesthesia during a cesarean section?**\ A. Decreased maternal cardiac output and uteroplacental perfusion\ B. Direct fetal exposure to local anesthetic\ C. Increased uterine tone from neuraxial blockade\ D. Maternal hyperventilation causing fetal hypoxia\ **Answer**: A 92. **Which uterine abnormality is associated with abnormal adherence or invasion of the placenta into the uterine wall?**\ A. Placenta previa\ B. Placenta accreta\ C. Placental abruption\ D. Vasa previa\ **Answer**: B 93. **Which intervention is most appropriate for a prolapsed umbilical cord?**\ A. Emergency cesarean delivery with maternal repositioning to relieve compression\ B. Administration of oxytocin to enhance contractions\ C. Use of uterotonic agents to stimulate uterine activity\ D. Epidural analgesia to facilitate vaginal delivery\ **Answer**: A 94. **Why is it important to avoid hypocapnia during laparoscopic surgery in pregnant patients?**\ A. It increases the risk of preterm labor.\ B. It reduces uteroplacental perfusion due to vasoconstriction.\ C. It enhances maternal oxygen consumption.\ D. It decreases fetal respiratory effort after delivery.\ **Answer**: B 95. **Which factor most increases the risk of developing aspiration pneumonitis during pregnancy?**\ A. Reduced gastric emptying and increased gastric acidity\ B. Increased functional residual capacity\ C. Hyperdynamic circulation during pregnancy\ D. Increased uterine blood flow\ **Answer**: A 96. **What is the significance of reduced albumin levels during pregnancy?**\ A. Decreased uterine perfusion\ B. Reduced drug binding, increasing free drug concentrations\ C. Enhanced renal clearance of protein-bound drugs\ D. Decreased oncotic pressure leading to increased fetal edema\ **Answer**: B 97. **Which is the primary concern with excessive uterine contractions during labor?**\ A. Increased risk of postpartum hemorrhage\ B. Reduced fetal oxygenation due to uteroplacental insufficiency\ C. Enhanced maternal blood pressure\ D. Increased maternal cardiac output\ **Answer**: B 98. **Which anesthetic drug can be used for rapid induction during an emergency cesarean section?**\ A. Propofol\ B. Ketamine\ C. Etomidate\ D. All of the above\ **Answer**: D 101. **What hematologic change during pregnancy helps compensate for estimated blood loss (EBL) during delivery?**\ A. Increased erythropoietin production\ B. Increased plasma volume\ C. Decreased clotting factor synthesis\ D. Increased antithrombin III levels\ **Answer**: B