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Obstetrics written exams

A 28-year-old woman, G2P1 26 weeks gestation, comes to your clinic to do


her antenatal care and brings laboratory screening results. From complete
blood count find Hb 10. 0 g/dl, Ht 30 MCV 78, MCH 28 MCHC 30

1. What is your initial next management to this patient?


A. Check ferritin
B. Check serum iron
C. Check blood smear
D. Check red distribution width (RDW)
E. Give iron therapy directly for therapy and also for diagnosis

2. If anemic condition of this patient considered as a part of physiological


changes in pregnancy. What is the most common cause?:
A. Inadequate dietary intake
B. Increased cardiac output
C. Decreased blood volume
D. Increased plasma volume
E. Decreased red blood cell volume

3. If her blood smear findings show microcytic hypochromic, and the Ferritin
level is 11ug/L. What is the most likely diagnosis of this patient?
A. Thalassemia
B. Iron depletion
C. Hemolytic anemia
D. Iron deficiency anemia
E. Physiological anemia in pregnancy

19 years-old woman at 33 weeks gestation is referred with high blood


pressures of 190/100 and 3+ proteinuria. The patient complains severe
headache and blurred vision. She does not have any remarkable past medical
history.

4. What is the most likely diagnosis in this patient?


A. Mild preeclampsia
B. Severe preeclampsia
C. Impending Eclampsia
D. Gestational hypertension
E. Superimposed preeclampsia

5. What is the most appropriate management to this patient?


A. Deliver the baby immediately
B. Gives magnesium sulphate for 24 hours
C. Expectant management until 34 completed weeks
D. Gives lung maturation with dexamethasone for 2 days
E. Gives antioxidant to reduce stress oxidative occurred in this case
6. What anti-hypertensive drugs which not recommended for this patient,
considering the danger of renal failure and patent ductus arteriosus in the
newborn?
A. Atenolol
B. Captopril
C. Nifedipine
D. Hydralazine
E. Methyldopa

28 year old lady, G2P1, 26 weeks gestation, comes to your policlinic to have
information regarding to her current condition. Her previous pregnancy was
terminated at 32 weeks gestational age due to intrauterine fetal death. She
gave birth a female baby, 2500 g with maceration grade 2. She did antenatal
care at hospital, ultrasound examination was done twice, and no remarkable
abnormalities were found. She never had laboratory examination during her
previous pregnancy. Her mother has type 2 diabetes mellitus. BMI of the
patient is 32

7. The most possible cause of intrauterine fetal death of her previous


pregnancy was?
A. Infections
B. Diabetes mellitus
C. Congenital anomaly
D. Rhesus incompatibility
E. Fetal growth restriction

8. What was the possible mechanism of IUFD in her previous pregnancy?


A. Subchorionic bleeding
B. Intra-uterine infection
C. Sudden drop on fetal blood sugar
D. Severe placental detachment
E. Feto-placental insufficiency

She visits you at the clinic a week later with her laboratory result:
Hb 12,1 g/dL Ht 35 Leu 8100 Platelet 265.000 Erythrocyte 4 million MCV 86
MCH 34 MCHC 32
OGTT 93/165 HbA1C 5.6

9. What is the most appropriate management to this patient


A. Insulin injection
B. Regular exercise
C. Metformin
D. Diet management
E. Heparin injection