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Icm 1214: Reproductive Health I Question Paper
Icm 1214: Reproductive Health I
Course:Diploma In Clinical Medicine
Institution: Jomo Kenyatta University Of Agriculture And Technology question papers
Exam Year:2012
JOMO KENYATTA UNIVERSITY OF AGRICULTURE AND TECHNOLOGY
University Examinations 2012/2013
SEMESTER I EXAMINATIONS FOR THE DIPLOMA IN CLINICAL MEDICINE
ICM 1214: REPRODUCTIVE HEALTH I
DATE: AUGUST 2012 TIME: 2 HOURS
INSTRUCTIONS: ANSWER ALL QUESTIONS BY ASSIGNING TRUE OR FALSE AGAINST EACH CHOICE PROVIDED
SECTION A
1. Levels of hCG that are too low for gestational age suggest which of the following possibilities.
a. Ectopic pregnancy
b. Missed abortion
c. Earlier gestational age
d. Hydatidiform mole
e. All of the above
2. The following statements describe the physiologic changes of Kidneys during pregnancy.
a. Size decreases
b. Hydronephrosis is a possibility
c. Hydroureters are always pathological
d. Size of Kidneys increases
e. Glomerular filtration rate increases
3. Hyperemesis gravidarum
a. Is a form of nausea and vomiting causing weight loss and dehydration.
b. Is associated with ketonemia
c. Does not cause electrolyte imbalance
d. Must lead to pregnancy termination
e. Should be treated with antibiotics
4. Currently the causes of direct maternal death include:
a. Haemorrhage
b. Sepsis
c. Hypertensive disorders
d. Pulmonary embolism
e. Obstructed labour
5. The following tests should be done antenatally.
a. VDRL
b. Hepatitis A antigen
c. Haemoglobin level estimation
d. Urinalysis
e. HIV
6. Initial antenatal care visit should be
a. Three months after conception
b. Soon after missed menstruation
c. Done in the third trimester if the woman is well.
d. Vaginal examination to confirm pregnancy
c. Delayed up to the second month
7. A trial of labour should be
a. Stopped when the presenting part descends into the maternal pelvis
b. Offered to mothers with borderline pelvis
c. Offered to women with two previous scars
d. Stopped when there is no progress
e. Augmented with syntocinon in all patients
8. During the normal labour
a. Fetal heart rate should be assessed every four hours.
b. Fetal heart rate should be assessed every hour
c. Maternal vital signs should be checked every four hours
d. Delayed second stage should be managed by vacuum extraction
e. Episiotomy should routinely be done.
9. After newborn delivery
a. Apgar score of 7 and above needs no active resuscitation.
b. Brandt-Andrews method is used to deliver the body and legs.
c. Suction of nosetrils is all that is needed if the Apgar score is 7 or less.
d. Anal patency is confirmed by passing a thermometer through the anus.
e. Drying of the skin and provision of warmth is optional
10. In obstructed labour
a. Fetal distress occurs
b. Moulding and caput occurs
c. Should be managed by syntocinon
d. Maternal dehydration occurs.
e. Should be managed by caesarean section.
11. Weight gain in pregnancy can be caused by the following:
a. Hyperemeris granvidarum
b. Polyhydramnios
c. Increased dietary intake
d. Fluid retention
e. Oligohydramnios
12. Uterine rupture can be caused by
a. Fetal microsomia
b. Previous myomectomy
c. Fetal macrosomia
d. Malpresentations
e. Excessive syntocinon
13. The following are parameters of biophysical profile except
a. Breathing movements
b. Fetal tone
c. Fetal position
d. Fetal heart rate
e. Amniotic fluid volume
14. Characteristics of normal labour are:
a. Regular uterine contractions
b. Cervical dilatation and effacement
c. Any uterine contraction
d. Fetal descent
e. All of the above
15. Midline episiotomy compared with a mediolateral one is associated with
a. Less blood loss
b. More pain
c. Subsequent dyspareunia
d. Increased chance of 4th degree tear
e. Heals with bad scars
16. Nutrition during pregnancy
a. Carbohydrate intake should be increased.
b. Protein intake should be increased
c. Vegetables and fruits help prevent constipation.
d. Fat intake should be increased
e. Fat intake should be reduced
17. Ptyalism is
a. Compulsive ingestion of non-food substances
b. Excessive salivation
c. Nausea and vomiting in the morning
d. Associated with dehydration
e. Associated with hyperemesis gravidarum
18. The Placental separation is indicated by:
a. Gush of blood
b. Descent of umbilical cord
c. Increased fungal height
d. uterine contractions
e. Lower abdominal pain
19. Predisposing factors to malpresentation include:
a. Congenital abnormalities
b. Immaturity
c. Post datism
d. Uterine abnormalities
e. Short umbilical cord
20. Trial of labour in breech presentation.
a. Is safe in one previous scar
b. Safe if estimated fetal weight is 2500 – 3000 g
c. Unsafe in gynaecoid pelvis
d. Unsafe in android pelvis
e. Footling breech is a contraindication.
21. In Premature rupture of membranes at 37 weeks
a. Caesarean section should be done
b. Induction of labour with syntocinon
c. Conservative management with bed rest
d. Allow patient home to come back in active labour
e. Delivery is advised.
22. Pre-eclampsia is associated with
a. Facial edema
b. High blood pressure
c. increased urinary output
d. Kidney failure
e. Permanent vision loss.
23. Late pregnancy bleeding
a. Should be managed with emergency caesarean section.
b. Can be caused by abortion
c. Placenta abruptio can be the cause
d. Placenta praevia should be ruled out by careful digital examination
e. Delivery should be done
24. Features that are charted in a partogram include:
a. Colour of amnionic fluid
b. Fetal presentation
c. Uterine contractions and their strength
d. Fetal heart rate
e. Cervical dilatation
25. Malaria in pregnancy.
a. Is severe in premigravida than multigravida women.
b. Can present with only anaemia
c. Treat with sulphur based anti malarial is recommended.
d. Can cause congenital abnormalities
e. Can cause intrauterine growth restriction.
26. HIV in pregnancy
a. High CD4 count is associated with increased transmission to the baby
b. Low viral load is associated with increased transmission rate
c. ARTs can reduce transmission
d. Mother should be discouraged to breast feed
e. Premature rupture of membranes increases transmission rate.
27. Precipitate labour
a. May result from low resistance of the birth canal.
b. Can cause postpartum haemorrhage
c. Is protraction of labour
d. Only occurs if the baby is small
e. All of the above
28. In compound presentation
a. Both breech and vertex present
b. A limb prolapses beside the presenting part
c. Emergency caesarean section is a must
d. Vaginal delivery is possible
e. Umbilical cord presents
29. Anaemia in pregnancy
a. Can be caused by malaria
b. Haemodilution may be the only cause
c. Nutritional deficiency is never a cause
d. Should be managed with transfusion
e. Stool examination may reveal the cause
30. During early labour the fetal heart rate should be checked
a. Four hourly
b. Every 5 minutes
c. Every 30 minutes
d. Every hour
e. Six hourly
SECTION B: ANSWER ALL
1. Discuss the anatomical and physiological changes in the urinary system during pregnancy.
(8 marks)
2. Outline the minor complaints during pregnancy and give their remedies. (8 marks)
3. Discuss the management of postpartum haemorrhage. (8 marks)
4. Describe the clinical presentation of obstructed labour. (8 marks)
5. Outline the measures used to prevent mother to child transmission of HIV. (8 marks)
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