ANATOMY AND PHYSIOLOGICAL CHANGES DURING PREGNANCY

FEMALE BLADDER AND URETHRA

1. The tube allows urine to pass outside the body
A. Hilum
B. Urethra
C. Ureter
D. Spincter

2. The ureter and various blood vessels and lymphatic vessels of the kidney
pass through this opening of the inner of the kidney

A. Renal medulla

B. Hilum

C. Renal pelvis

D. Renal cortex
(www.myvmc.com/anatomy)

3. This muscle in bladder during contract micturition to prevent the follow of urine
to ureter
A. Bells muscle
B. Detrusor muscle
C. mercien’s
D. Inner sphincter of urethra
4. Circular muscles that help keep urine from leaking by closing tightly like a
rubber band around the opening of the bladder
A. Meatus
B. Glomerulus
C. Sphincter muscles
D. Rugae
(www.visiblebody.com/urinary)
5. The dome shaped top of the bladder is called the
A. Pelvis
B. Meatus
C. Trigone
D. Fundus
6. Folds in the lining of the bladder that disappear when the bladder is empty of
urine
A. Rugae
B. Renin
C. Sphincter
D. mucosa
(www.Healthline.com/bladder)

7. The triangular region of the bladder,which is delineated by 3 opening (2 ureter

and 1 urethral orifice) is called the
A. Nephron loop
B. Medulla
C. Cortex
D. Trigone
8. The epithelial layer that front the rugae in the bladder is form this cell
A. Cuboidal
B. Columnar
C. Squamous
D. Transition
(https://tranning.seen.urinary.gov)

9. Glamerulos filtraction rate increase during pregnancy because of

A. Urinary tract infection

B. Increase in blood volume
C. Pressure from the growing uterus
D. A rise in human chorionic gonadothropin hormone
10. During labour the mother is encouraged empty the bladder as to avoid

A. Urinary tract infection

B. Caput succedaneum
C. Rupture of membrane
D. Delay the decent presenting part
(www.open.edu)

URINARY DISORDERS/COMPLICATIONSIN RELATION TO PREGNANCY AND

OTHER RELATED SYDTEM:
CARDIOVASCULAR
1) Peningkatan output kardium pada hujung trimester kedua adalah akibat
daripada
A) Anxiety dan kesakitan
B) Peningkatan stroke volume dari kadar jantung
C) Peningkatan rintangan vascular sistemik dan tekanan darah
D) Peningkatan edaran pulmonary dan rintangan vascular pulmonary
2) Keadaan jantung ini pada ibu hamil yang mempradisposkan ibu berisiko tinggi
untuk bacterial endocarditis
A) Cardiomyopathy
B) Vuvular heart disease
C) Coronary heart disease
D) Congenital heart disease
3) Tujuan foramen ovale adalah untuk
A) Meningkatkan aliran darah fetal ke paru-paru
B) Membenarkan aliran darah fetal ke atrium kiri
C) Membenarkan aliran darah fetal ke ventrikel kanan
D) Meningkatkan kandungan oxygen pada darah fetal
4) A pregnant woman with cardiac disease is comfortable at rest,but on climbing
the stairs,she become dyspnoeic with chest pain.what NYHA classification
you assign her?
A) I
B) Ii
C) Iii
D) Iv
5) Which is the preferred intrapartum analgesia in most situations involving
maternal heart disease
A) Paracervical block
B) Intravenous analgesic
C) Continuous epidural analgesia
D) Spinal analgesia
6) Which of the following is a nearly universal characteristic of endocarditis
A) Fever
B) Sycope
C) Headache
D) Sceral petechiae
7) Which of the following antimicrobial combinations is recommended for
bacterial endocarditis prophylaxis?
A) Ampicillin plus gentamycin
B) Ampicillin plus doxycycline
C) Penicillin G plus doxycycline
D) Vancomycin plus clindamycin
8) What is the common cause of death in women with hypertrophic
cardiomyopathy?
A) Stroke
B) Arrhythmia
C) Aortic dissection
D) Vascular occlusion
9) Madam H with this cardiac lesion is advise that pregnancy is contraindicated
for her
A) Tetralogy fallot
 B) Aortic stenosis
C) Mitral regurgitation
D) Eisenmenger syndrome
10)The specific nursing interventionfor a mother with cardiac disease during
management of 3rd stage is
A) Encourage upright position
B) Monitoring blood pressure
C) Monitor oxygen concentration
D) Give injection Pitocin

RESPIRATORY
1. Changes in blood preassure is minimal during pregnancy due to
A. Increasing cardiac stroke volume
B. Dilatation of blood vessel in the heart
C. Increasing blood volume in cardiaovascular system
D. Decrease in systemic vascular resistance in the peripheral
2. Supine hypotension syndrome occur during the late pregnancy due to
A. Increase plasma volume
B. Sudden change of position
C. Increase peripheral resistance
D. Preassure of gravid uterus on inferior vena cava
3. Pregnancy is associated with marked changes in respiratory function because
of
A. Higher eostrogen level
B. High level of serum bicarbonate
C. Increase in the maternal metabolic rate
D. Physical impact of the enlarging uterus
4. Penutupan ductus arteriosus berlaku akibat daripada peningkatan
A. Cardiac output
B. Tekanan di atrium kiri
C. Konsentrasi aksigen
D. Rintangan periferi
5. Cardiac output meningkat semasa hamil akibat daripada peningkatan dalam
A. Oestrogen dan progesterone
B. Sel darah merah dan platlet
C. Kadar denyutan jantung dan stroke volume
D. Rintangan peripheral dan sistemik vascular
6. The effect of this physiological change is obvious when the increase of plasma
volume reaches its maximum level
A. Haemodilution
B. Vasodilation
C. Hypotension
D. Palpitation
7. Selepas kelahiran bayi, foramen ovale akan tertutup apabila
A. Ductus arteriosus tertutup
B. Konsentrasi oksigen bertambah
C. Tekanan di atrium kiri meningkat
D. Pengaliran darah perifera menurun
8. Expension of the rib cage in pregnancy due to increased the elasticity of the
ligament result in all of the following EXCEPT
A. Increase tidal volume
B. Breathing is more shallow
C. Air flow along branchial is improved
D. The diagphram rises upto the 4 cm
9. Which of the following may cause haemodynamic changes during pregnancy
i. Anemia
ii. Heart rate increase
iii. Stroke volume increase
iv. Decreaseplasma concentration
A. 1 and 2
B. 2 and 4
C. 1,2, and 3
D. all the above
 10. During pregnancy the flaring out of the lower ribs, causes the diapgram to rise
up. The changes are due to the effect of

A. Relaxin and luteinizing

B. Oestrogen ang relaxin
C. Progesterone and relaxin
D. Relaxin and Hcg

GASTRO INTESTINAL
1. This hormone relaxes cardiac sphincter of the stomach that results in gastric
reflex during pregnency
A. Relaxin
B. Oestrogen
C. Progesteron
D. Prostaglandin
myles text books page 163
2. The effect of progesteron on gastro intestinal system is
A. Enlargement of the liver
B. Dilatation of the gall bladder
C. Reduce risk of obstetric cholestasis
D. Fasten the water absorption in the colon
myles text books page 163
3. Madam H experience heart burn at 30/52 gestation how would you advice her
A. Drink more milk
B. Sleep in lateral position
C. Take small frequency meals
D. Avoid bending heads downword
myles text books page 163

4. Changes in gastrointestinal tract during the second and third trimester of

pregnency
A. Increase of gall bladder volume
B. Decrease of gall bladder residual
C. Decrease of gall bladder volume
 D. Increase of gall bladder emptying rate
myles text books page 163

5. This is the changes within gastro intestinal system increased during pregnency
EXCEPT
A. Esophageal reflex
B. Stomach emptying time
C. Large intestine motility
D. Craving for food
myles text books page 163

6. Which of the following is a motor disorder of esophageal smooth muscle

A. Diaphragmatic hernia
B. Hiatal hernia
C. Reflux esophagitis
D. Achalasia
myles text books page 163

7. Which of the following complication in pregnency are increased in women with a

famale fetus?
A. Cholelithiasis
B. Hepatitis
C. Reflux esophagitis
D. Hyperemesis gravidarum

myles text books page 162

8. Which of the following is associated with normal pregnency

A. Decreased mucus secretion
B. Increased gastric secretion
C. Decreased gastric motility
D. Constriction of lower esophageal sphincter

myles text books page 163

9. What is the etiology of reflux esophagitis in pregnency
A. Constriction of upper esophageal sphincter
B. Relaxation of upper esophageal sphincter
C. Constriction of lower esophageal sphincter
D. Relaxation of lower esophageal sphincter
myles text books page 163
10. Which of the following complication is associated with ruptured appendix and
peritonitis

A. Fetal growth restriction

B. Oligohydramnios

C. Chorioamnnionitis

D. Preterm birth

myles text books page 163

ANDOCRINE
1. hCG produced by the :

A) Placental Syncytiotrophoblast

B) Placental Cytootrophoblast

C) Pituitary Gland

D) All the above

Myles P168

2. When hCG can be detected in maternal serum?

A) 20th day after ovulation

B) 8th day after ovulation

C) 1 month after ovulation

D) 8th day befor ovulation

Myles P168
3. Which hormone is produced by the corpus luteum and contributes to the process
of decidualization and to the vasodilatation of healthy pregnancy?

A) hCG

B) Oxytocin

C) Relaxin

D) Progestrone

Myles P168

4. Human Placental lactogen regulates maternal :

i) carbohydrate metabolism

ii) lipid metabolism

iii) protein metabolism

iv) fetal growth

A) i & ii

B) i, ii, iii

C) ii, iv

D) all the above

Myles P169

5. Placenta secretes over 20 different oestrogens into the maternal circulation but
the major ones are :

A) oestradiol

B) oestrone

C) oestriol

D) all the above

Myles P169
6. Prolactin is produced by the :

A) anterior lobe of the pituitary gland and by amniotic fluid

B) posterior pituitary gland

C) anterior and posterior pituitary glan

D) posterior pituitary gland and by amniotic fluid

Myles P169

7. The posterior pituitary gland produces two hormones :

A) vasopressin and prolactin

B) oxytocin and HPL

C) Oxytocin and hCG

D) vasopressin and oxytocin

Myles P169

8. The steep rise im hCG levels during the first trimester may results in :

A) a decrease production of thyroid hormones and thus incresed thyroid stimulating

hormone levels

B) an increased production of thyroid hormones and thus decreased thyroid

stimulating hormone levels

C) an increased production of thyroid hormones and thyroid stimulating hormone

levels

D) a decresed production of thyroid hormones and thyroid stimulating hormone

levels

Myles P170

9. Routine iodine supplementation is advised in parts of the world where the risk of
iodine deficiency is endemic and should commence :

A) after conception

B) before conception
C) after labour

D) Postpartum

Myles P170

10. Aldosterone secretion continues to respond to physiological stimuli such as

posture and varies according to salt intake. The increase in aldosterone promotes :

A) Glucose retention in the distal renal tubules

B) Glucose retention in the proximal renal tubules

C) Sodium retention in the proximal renal tubules

D) Sodium retention in the distal renal tubules

Myes P171