Physiological Changes During pregnancy:

Physiological Changes During pregnancy: 

1. The following are presumptive skin signs of pregnancy except: A. Chloasma B. Maculo-papular rash C. Linea Nigra D. Stretch Marks C. Spider Telangiectases 

2. The resting pulse in pregnancy is: A. Decreased by 20 bpm. B. Decreased by 10 to 15bpm. C. Unchanged. D. Increased by 10 to 15 bpm. E. Increased by 20 bpm. 

3. Normally, pregnancy in 2ND trimester is characterized by all of the following EXCEPT: A. Elevated fasting plasma glucose. B. Decreased fasting plasma glucose. C. Elevated postprandial plasma insulin. D. Elevated postprandial plasma glucose. E. Elevated plasma triglycerides. 

4. All are CORRECT, EXCEPT, Pregnancy is associated with: A. Increase cardiac output B. Increase venous return C. Increase peripheral resistance D. Increase pulse rate E. Increase stroke volume 

5. During normal pregnancy: Which is true? A. Estradiol is the principal circulating estrogen B. The blood pressure increases in first and second trimester C. The tidal volume is reduced D. In The second half of pregnancy, amniotic fluid is mostly contributed fetal urine E. Maternal hydroureters should be taken always as a serious pelvic condition 

6. In normal pregnancy, all of the following are true EXCEPT: F. Glucosuria increases. G. Plasma aldosterone concentration falls. 

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H. Creatinine clearance is increased. I. Folate excretion is increased. J. The presence of less than 300mg of proteins in 24hours urine collection is considered normal 

7. In normal pregnancy, levels of all of the following hormones increases EXCEPT: A. Total thyroxine (T4) B. Parathyroid hormone (PTH) in the 2ND & 3RD trimesters. C. Free cortisol. D. Prolactin. G. Estradiol  

8. The increase in blood volume in normal pregnancy is made up of: A. Plasma only. B. Erythrocytes only. C. More plasma than erythroblasts. D. More Erythrocytes than plasma. E. All of the above. 

9. In the fetus, the most well oxygenated blood is allowed into the systemic circulation by the: A. Ductus arteriosus. B. Foramen ovale. C. Rt. Ventricle. D. Ligamentum teres. E. Ligamentum venosum  

10. Changes in the urinary tract system in pregnancy include: A. Increase the glomerular filtration rate (GFR). B. Decrease in renal plasma flow (RPF). C. Marked increase in both GFR & RPF when the patient is supine. D. Increase in the amount of dead space in the urinary tract. E. Increase in BUN & creatinine. 

11. Lowered Hemoglobin during normal pregnancy is a physiological finding. It's mainly due to: A. low iron stores in all women. B. Blood lost to the placenta C. Increased plasma volume. D. Increased cardiac output resulting in greater red cell destruction. E. Decreased reticulocytosis  

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12. The Maternal blood volume in normal pregnancy: A. remains stable. B. Decreases 10%. C. Increases 10% D. Increases up to 40% E. Decreases up to 40%. 

13. During pregnancy, maternal estrogen levels increases markedly. Most of this estrogen is produced by the: A. Ovaries. B. Adrenals. C. Testes. D. Placenta. E. Uterus. 

14. During normal pregnancy, the renal glomerular filtrate rate (GFR) can increase as much as: A. 10%. B. 25%. C. 50%. D. 75%. E. 100%. 

15. Fetal blood is returned to the umbilical arteries & the placenta through: A. Hypogastric arteries. B. Ductus venosus. C. Portal vein. D. Inferior vena cava. E. Foramen ovale. 

16. In normal physiological changes in pregnancy, all of the following are increased EXCEPT: A. Glomerular filtration rate. B. Stroke volume. C. Peripheral resistance. D. Plasma volume. E. White blood cells. 

17. Regarding Renal changes in pregnancy, all of the following are true EXCEPT: A. Blood flow is increased by 10%. B. Glomerular filtration rate is increased by 50%. C. Plasma urea will be reduced. D. Glycosuria could be normal. E. Mild hydronephrosis is normal. 

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18. Consequences of fluid retention, all of the following are CORRECT, EXCEPT: A. Hemoglobin concentration decreases. B. Hematocrit falls. C. Serum albumin falls. D. Stroke volume increases. E. Renal blood flow increases  

19. During Pregnancy, all of the following are CORRECT EXCEPT: A. There will be hyperplasia & hypertrophy of the uterine muscle. B. Estradiol will increase the columnar epithelial of the endocervix. C. Estrogen will increase the glandular duct. D. Progestin & HPL will decrease the number of glands. E. Prolactin will be antagonized by the effect of estrogen  

20. Regarding renal tract during pregnancy, the following are true EXCEPT: A. The ureters are dilated. B. The renal pelvis calyces are dilated. C. The right side is affected more then the left side. D. The primigravida shows more changes then multigravida. E. The bladder tone increases. 

21. As pregnancy advances, which of the following hematological changes occurs? A. Plasma volume increases proportionally more than red cell volume. B. Red cell volume increases proportionally more than plasma volume. C. Plasma volume increases & red cell volume remains constant. D. Red cell volume decreases & plasma volume remains constant. E. Neither plasma volume nor red blood cell volume changes. 

22. Which of the following would normally be expected to increase during pregnancy: A. Plasma creatinine. B. Thyroxin-binding globulin. C. Hematocrit. D. Core temperature. E. Hair growth. 

23. The supine position is important during late pregnancy because it may cause all of the following EXCEPT: A. Complete occlusion of the inferior vena cave. B. A significant decrease in maternal ventilatory capacity. C. Hypotension & syncope. D. A significant reduction in renal blood flow & glomerular filtration. E. Augmentation of the cardiovascular effects due to high conduction  

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24. Which of the following is probably responsible for physiologic hyperventilation during pregnancy? A. Large fluctuations in plasma bicarbonate. B. Increased estrogen production. C. Increased progesterone production. D. Decreased functional residual volume. E. Decreased plasma PO2 

25. Normally the pregnant woman hyperventilates. This is compensated by: A. Increased tidal volume. B. Respiratory alkalosis. C. Decreased Pco2 of the blood. D. Decreased plasma bicarbonate. E. Decreased serum pH. 

26. The resting pulse in pregnancy is : A. Decreased by 30 beats /min. B. Decreased by 10-15 beats/min. C. Unchanged. D. Increase by 30 beats/min. E. Increased by 10-15 beats/min. 

27. After birth, all of the following vessels constrict EXCEPT: A. Ductus arteriosus. B. Umbilical arteries. C. Ductus venosus. D. Hepatic portal vein. E. Umbilical vein. 

28. Select the most correct statement about fetal & neonatal IgM: A. It is almost entirely maternal in origin. B. It is approximately 75% maternal & 25% fetal in origin. C. It is 50% maternal, 50% fetal in origin. D. It is 25% maternal, 75% fetal in origin. E. It is almost entirely fetal in origin  

29. Which one is true about the placenta: A. 10% maternal contribution only B. U.C covered with chorion C. U.C contain wharlton jell D. Placental lobes are the functional units. 

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30. Spinnbarkheit is a term which means : A. Crystallization of the cervical mucous. B. Thickening of the cervical mucous. C. Mucous secretion of the cervix. D. Threading of the cervical mucous. E. Thinning of the cervical mucous. 

31. Regarding Placental function: A. hCG is a glycoprotein composed of alpha & β subunits. It's secreted by cytotrophoblast. B. Human placenta lactogen enhances insulin action & improves glucose tolerance. C. Placental Corticotropin releasing hormone increases ACTH & cortisol & causes vasoconstriction of the feto-placental blood vessels. D. Estrogen is secreted by the feto-placental unit responsible for the growth of the myometrium & angiogenesis. E. Progesterone causes vasodilatation of blood vessels & contraction of uterine smooth muscle. 

32. Regarding placental anatomy: A. The decidua capsularis forms part of the placenta. B. The fetal side of the placenta is divided into 30-40 cotyledons. C. The intervillous space contains fetal blood. D. Anatomically the placenta id fully formed by 30 weeks. E. Fetal blood vessels develop in the mesenchymal core of the chorionic villi. 

33. Which of the following does NOT accurately describes the placenta in humans: A. 15-20 cm in diameter. B. 2-4 cm thick. C. Weighs about 1/6 of what the term infant does. D. Delivered from maternal & fetal tissue. E. Umbilical cord originates from the center of the placenta in all most of the cases. 

34. Maternal serum Prolactin levels in pregnancy are highest: A. At the end of gestation just before delivery of the infant. B. Just after the delivery of the infant. C. As the placenta is released. D. The 3RD to 4TH day postpartum. E. During breast feeding. 

35. All of the following causes Oligohydromnios EXCEPT: A. Renal agenesis B. Poor placental perfusion 

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C. Post term pregnancy D. Anencephaly E. Urinary obstruction 

36. Placental insufficiency is caused by all the following, EXCEPT: A. Smoking in pregnancy. B. Post maturity. C. Dietary insufficiency in pregnancy. D. Hypertensive disorder in pregnancy. 

37. All the following hormones are products of placental synthesis, EXCEPT : A. HCG. B. HPL. C. Prolactin. D. Progesterone. E. Estriol. 

38. We can detect the fetal heart beat by Sonography (Transvaginal) at: A. 5 weeks B. 6 weeks C. 7 weeks D. 8 weeks E. 9 weeks 

39. Pregnant lady with polyhydramnios, the cause could be: A. Fetus with oesophageal-atresia B. Fetus with polycystic kidney disease C. Fetal growth restriction D. Hyperprolactinaemia during pregnancy E. Patient is taking anti epileptic drugs 

40. Polyhydramnios is associated with the following condition A. Intrauterine growth restriction B. Fetal kidney agenesis C. Diabetes insipidus D. Tracheo-oesophageal fistula E. Hind water leakage 

41. All the following are possible causes of Polyhydramnios, EXCEPT: A. Diabetes B. Multiple pregnancy C. Fetus with hydrops fetalis D. Fetus with duodenal atresia or neural tube defect E. IUGR 

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42. Which of the following causes of polyhydramnios is more common: A. Twin pregnancy. B. Diabetes. C. Hydrops fetalis. D. Anencephaly. E. Idiopathic. 

43. Using your knowledge of normal maternal physiology, which of the following would employ if a 38 weeks’ pregnant patient become faint while lying supine on your examination table: A. Blood transfusion. B. Turning the patient on her side. C. Oxygen by face mask. D. I.V. saline solution. 

1. Skin changes during pregnancy should include: A. Chloasma. B. Striae. C. Palmer erythema. D. Vascular spiders. E. All of the above