1. What is determined by the first Leopold maneuver in breech presentation?
A. position of fetus;
B. the lie and position of fetus;
C. presenting part of fetus;
D. *head of the fetus;
E. breech end of fetus.
2. What is the first moment of biomehanism of labor in breech presentations?
A. flexion of head;
B. *internal rotation of breech;
C. flexion of trunk;
D. internal rotation of shoulders and external rotation of trunk;
E. internal rotation of head.
3. What term of pregnancy is possible to conduct the prophylactic rotation of fetus on a head in breech presentations?
A. in 28-32 weeks;
B. *in 34-36 weeks;
C. in 36-38 weeks;
D. in 32-38 weeks;
E. without limitation of term.
4. What is contraindication for the external rotation of fetus in breech presentations?
A. early gestosis;
B. contracted pelvis I degree;
C. kidney disease of pregnant woman;
D. *scar on the uterus;
E. all of the above
5. Which aid is given in the labor at frank breech presentation?
A. classic manual aid;
B. *Tsovianov’ I manual aid;
C. caesarean section;
D. perineum protective maneuvers;
E. the Muller’ maneuver is used.
6. What the aim of the Tsovyanov’ manual aid at frank breech presentation consists in?
A. in providing of slow and gradual advancement of fetus;
B. in perineum protection from injures;
C. in the safe delivery of shoulders of fetus;
D. in the safe delivery of fetal head;
E. *in the saving of correct fetal attitude.
7. What is the aim of the classic manual aid?
A. perineum protective maneuvers from injures;
B. providing of slow and gradual advancement of fetus;
C. *delivery of the fetal arms and head;
D. delivery of fetal breech;
E. saving of correct fetal attitude.
8. How often the breech presentations are there?
A. in 10%
B. *in 3-4%
C. in 1-2%
D. in 12-14%
E. in 6-8%
9. To the reasons, which caused the breech presentations belong all, except for:
A. polyhydramnion
B. olighydramnion
C. anomalies of development of uterus
D. the decreased uterine tonus
E. *fetal hypoxia
10.By the third Leopold’ maneuver in breech presentations is palpated:
A. the posterior of fetus
B. *the breech of the fetus
C. head of the fetus
D. the level of uterine fundus
E. position of fetus
11.By the second Leopold’ maneuver in breech presentations is palpated:
A. fetal extremities
B. breech of fetus
C. head of fetus
D. legs and buttocks of the fetus
E. *position of fetus
12.At ІІ position of breech presentation the fetal heart is listened at:
A. on the left at the level of umbilicus
B. right side below than umbilicus
C. on the left below than umbilicus
D. on the left higher than umbilicus
E. *right side higher than umbilicus
13.At the internal obstetric examination the doctor palpates above the pelvic inlet only the breech of fetus. What is the type of breech presentation?
A. complete breech;
B. knee;
C. incomplete breech
D. *frank breech;
E. transversal.
14.During the labor at internal obstetric examination the doctor palpates above the pelvic inlet only one foot of the fetus. What is the type of breech presentation?
A. complete breech;
B. knee;
C. *incomplete footling
D. frank breech;
E. complete footling.
15.What is the circumference of breech with legs in frank breech presentation?
A. *32 cm
B. 34 cm
C. 36 cm
D. 38 cm
E. 40 cm
16.What is the circumference of breech in complete breech presentation?
A. 32 cm
B. *34 cm
C. 36 cm
D. 38 cm
E. 40 cm
17.What complications occur in the first stage of labor in breech presentation more frequent?
A. *early gash of amniotic fluid
B. preeclampsia
C. bleeding
D. arrested fetal shoulders
E. strong uterine contractions
18.Which cervical dilation indicates 6 cm contractile ring station above the symphysis?
A. 2 cm
B. 3 cm
C. 4 cm
D. *6 cm
E. 5 cm
19.What is the reason of the early gash of amniotic fluid in breech presentation?
A. the large presenting part
B. *absence of the girdle of contact
C. lost tonus of lower segment
D. the abnormal tonus of uterus
E. arrested fetal shoulders
20.During the labor in breech presentation all complications are possible, except for:
A. fetal hypoxia
B. *deflexed presentation
C. early gash of amniotic fluid
D. weakness of uterine contractions
E. arrested fetal shoulders
21.What is the third moment of biomehanizm of labor in breech presentation?
A. flexion of head;
B. internal rotation of breech;
C. flexion of trunk;
D. *internal rotation of shoulders and external rotation of trunk;
E. internal rotation of head.
22.What is the last moment of biomehanizm of labor in breech presentation?
A. *flexion of head;
B. internal rotation of breech;
C. flexion of trunk;
D. internal rotation of head.
E. internal rotation of shoulders and external rotation of trunk;
23.In relation to labor in frank breech presentation all assertions are correct, except for:
A. the legs of fetus lies along a trunk
B. the fetal arms are crossed on a chest
C. circumference of the fetal thorax together with arms and legs is more than head
D. *labor in frank breech presentation is more favourable, than in cephalic
E. manual aid by Tsov’yanov is given
24.All of the below are indications for cesarean section in breech presentation EXEPT:
A. *Probable fetal weight less 3000 g
B. Breech presentation of the first fetus in multiple pregnancy
C. Breech presentation and infertility
D. Foot link presentation
E. Probable fetal weight more 3700g
25.What is the aim of the Moriso-Leuvret maneuver?
A. the delivery of the fetal breech
B. the more rapid rotation of fetus
C. *maneuver helps to flex of the fetal head
D. delivery of the fetal shoulders
E. acceleration of labor of fetus
26.What is the first moment of classic manual aid?
A. the transferring of the anterior arm in the areas of sacrum
B. *delivery of posterior arm
C. delivery of anterior arm
D. delivery of head of fetus
E. delivery of breech
27.What is the feature of the first moment of classic manual aid?
A. an obstetrician always delivers the anterior arm of fetus
B. *an obstetrician always delivers the posterior arm of fetus
C. an obstetrician delivers the head of fetus, flexing it
D. an obstetrician delivers the head of fetus, deflexing it
E. an obstetrician helps for labor of breech
28.What is the feature of the IV moment of classic manual aid?
A. an obstetrician always delivers the posterior arm of fetus
B. an obstetrician always delivers the anterior arm of fetus
C. *an obstetrician delivers the head of fetus, flexing it
D. an obstetrician delivers the head of fetus, deflexing it
E. an obstetrician helps for labor of breech
29.What the purpose of the manual aid by Tsovianov’II method in footling presentation consists in?
A. in perineum protective maneuvers from injuring;
B. in providing of slow and gradual advancement of fetus;
C. in delivery of shoulders of fetus;
D. *to transform the footling presentation to the incomplete breech;
E. in saving of correct fetal attitude.
30.Which type of presentation appear as a result of correct applying of the Tsov”yanov’ method in footling presentation?
A. *incomplete breech
B. frank
C. incomplete footling
D. complete footling
E. complete breech
31.Which method of delivery in breech presentations is the best for minimizing of the infant mortality?
A. *cesarean section
B. obstetric forceps
C. Tsovyanov’method
D. classic manual aid
E. breech extraction
32.What the type of presentation is if the fetal buttocks are palpable:
A. *Frank breech presentation;
B. Complete breech;
C. Incomplete breech presentation;
D. Footling ;
E. Kneeling presentation.
33.What the estimated weight of the fetus in breech presentation in which fetus considered to be large?
A. 2500 g;
B. 3000 g;
C. *3700 g and more;
D. 4000 g.
E. 3800 g
34.What type of the manual aids need the patients with a footling presentation?
A. Manual aid by Tsovyanov I;
B. *Manual aid by Tsovyanov II;
C. Classic manual aid;
D. Breech extraction.
E. All of the above
35.What type of the manual aids need the patients with a frank breech presentation?
A. *Manual aid by Tsovyanov I.
B. Manual aid by Tsovyanov II;
C. Classic manual aid;
D. Breech extraction.
E. All of the above
36.All of the following are the indications to the cesarean section, except:
A. Breech presentation and the fetal weight 3800 g
B. Breech presentation and any degree of contracted pelvis
C. Breech presentation and uterine dysfunction
D. *Sinciput vertex presentation and probable fetal weight 3000g
E. Breech presentation and fetal distress
37.All of the following are the indications to the breech extraction, except:
A. *Breech presentation and the fetal weight 3800 g
B. Breech presentation and maternal preeclampsia severe degree
C. Breech presentation and uterine dysfunction
D. Breech presentation and maternal heart or respiratory diseases
E. Breech presentation and fetal distress
38.All of the following are the conditions to the breech extraction, except:
A. complete dilation of cervix
B. *intact amniotic membrane
C. the normal fetopelvic proportions
D. the rupture of membranes
E. adequate anesthesia.
39.The contraindication to the breech extraction is:
A. *fetopelvic disproportion
B. fetal hypoxia
C. the rupture of membranes
D. breech presentation and maternal preeclampsia
E. breech presentation and uterine dysfunction
40.What is the presentation when the fetal neck is extended and the back and occiput are in contact?
A. Vertexanterior
B. *Face
C. Brow
D. Sinciput
E. Vertexposterior
41.What is the presentation when the fetal head is partially deflexed and a large anterior fontanel is presenting?
A. Occipital
B. Face
C. Brow
D. *Sinciput vertex
E. Vertexposterior
42.What is the circumference of the large segment of the fetal head in the face posterior presentation?
A. 34 cm.
B. 36 cm
C. *32 cm
D. 38 cm
E. 41 cm
43.Spontaneous vaginal delivery is possible in all types of presentations EXCEPT ?
A. OccipitalAnterior
B. Face
C. Vertex
D. Occipital Posterior
E. *Brow
44.During which cardinal movement of labor is the face linear of the fetal head is located in oblique diameter of the pelvic inlet?
A. Internal rotation
B. *Extension
C. External rotation
D. Expulsion
E. Flexion
45.The base of the os hyoideus is brought into contact with the inferior margin of the symphysis during which cardinal movement of labor in fase presentation ?
A. Extension
B. Expulsion
C. Descent
D. *Flexion
E. Internal rotation of the fetal head
46.Cesarean section is performed in all below situations EXCEPT ?
A. *Sinciput vertex presentation
B. Face auterior presentation
C. Brow presentation
D. Oblique lie
E. Transverselie
47.What is the presentation when the fetal head is extended and a chin is presenting?
A. VertexAnterior
B. *Face
C. Brow
D. Sinciput
E. Vertexposterior
48.What is the first moment in the biomechanism of labor in the face presentation?
A. Fetal head flexion
B. Additional flexion of the fetal head
C. Internal rotation of the fetal head
D. *Fetal head extension
E. External rotation of the fetal head and external rotation of the fetal body
49.What is the circumference of the large segment of the fetal head in the brow presentation?
A. 32 cm.
B. 34 cm
C. 36 cm
D. 28 cm
E. *39-41 cm
50.In which plane of true pelvis internal rotation of the fetal head in the occipital presentation is finished?
A. Pelvic inlet
B. *Pelvic outlet
C. Plane of the greatest diameter
D. Plane of the least diameter
E. Correct answer is absent
Situational Tasks
1. 30-years-old woman, primapara at 34 weeks of gestation arrives in active labor. Uterine contractions occur every 3-4 minutes. Per vaginum: the uterine cervix dilatation is 6 cm. The amniotic sac is intact. Fetal buttocks are presented. Management of labor?
A. Manual aid by Tsovianov II
B. *Cesarean section
C. Subtotal breech extraction
D. Classic manual aid
E. Total breech extraction
2. Woman with in-time pregnancy. Bears down during 40-45 seconds with intervals 1-2 minutes. The rupture of the membrane has occurred 10 minutes ago. Vaginal examination: fetal head is on the pelvic floor. Saggital suture is in anterior-posterior diameter of pelvic outlet. Amniotic sac is absent. What is the stage of labor?
A. Cervical
B. *Pelvic
C. Cranial
D. Early postpartum
E. Placental
3. Primapara. At vaginal examination: opening of cervix is 8 cm, sagittal suture in a transversal size of the
pelvic inlet, small fontanel is palpated as a leading point. For which type of presentation is it typical?
A. The brow presentation
B. The vertex presentation.
C. The face presentation
D. *The anterior occiput presentation.
E. The posterior occiput presentation
4. At pregnant 28 years with pregnancy 24 weeks transverse lie of the fetus is found. Head is on the left. Fetal heart rate is clear, 138 in 1 min. Pregnancy is first, passed without complications. Sizes of pelvis: 25-29-31-20 cm. What is the doctor’ tactic now?
A. To hospitalize and to perform the external obstetric version
B. *The supervision
C. To hospitalize in the term of pregnancy 38-39 weeks for performing the external obstetric version
D. To do the classic obstetric version of fetus
E. To appoint a corregate gymnastics
5. Primapara. At vaginal examination: opening of cervix is 8 cm, sagittal suture in a oblique size of the pelvic inlet, the large fontanel is palpated as a leading point. For which type of presentation is it typical?
A. The brow presentation
B. *The sinciput vertex presentation.
C. The face presentation
D. The anterior occiput presentation.
E. The posterior occiput presentation
6. Postpartum patient. A girl was born by mass 3800 g. In pressing above the symphysis umbulical cord doesn't change it lenght. How do you called this sign of placenta separation?
A. Positive Shreder sign
B. Positive Alfelda sign
C. PositiveVasten sign
D. Positive Chukalov-Kustner sign
E. *Negative Chukalov-Kustner sign
7. A woman 28 years admitted to female dispensary with complaints about the delay of menstruation during 5 days. At vaginal examination: uterine cervix of conical shape, without pathology. The body of uterus is insignificantly increased, dense, mobile. The uterine adnexa are unpainful, not enlarged. Excretions mucous. What methods of examination for determination of pregnancy will be most effective?
A. *Test on pregnancy
B. Ultrasonic examination
C. Bimanual examination
D. X- ray examination
E. Biological method
8. In time of the vaginal examination of a pregnant women cervix is effaced, dilatation is 5 cm, the fetal head is in the pelvic inlet. A sagittal suture is in the right oblique size, a small fontanel is left close to a sacral bone. Determine the position and the variety of the fetus.
A. *The 2nd position, the posterior variety
B. The 1st position, the anterior variety
C. The 1st position, the posterior variety
D. The 2nd position, the anterior variety
E. The high-riding sagittal suture
9. Pregnant D. admitted to the maternity hospital with pregnancy at term and regular uterine contractions during 6 hours. This pregnancy is first. Pelvic sizes: 25-26-31-20 cm. Fetal heart rate 136 in 1 min. What is the doctor’ conclusion about the pelvic sizes?
A. Normal pelvis
B. The true conjugate decreased
C. The external conjugate decreased
D. *Distantia cristarum decreased
E. Distantia spinarum decreased
10.The doctor is measuring the patient’ pelvic size between the anterior spines of the os ileum. Which size is measuring by the doctor?
A. Distantia cristnarum
B. *Distantia spinarum
C. Distantia trochanterica
D. Conjugata externa
E. Conjugata vera
11.The last menstrual period in patient was 22.12. 2011 What is the exposed term of labor on the Negele’ formula?
A. 15.09.12
B. 29.08.12
C. *29.09.12
D. 22.09.12
E. 22.10.12
12.The pregnant C. was admitted in the pathology’pregnancy department. Pregnancy ІІ, 39 weeks. Circumference of abdomen – 110 cm, height of the uterine fundus – 36 cm. The fetal lie is longitudinal, cephalic presentation. What is the exposed fetal weight by Volskov’ method?
A. 3700 g
B. *3960 g
C. 4200 g
D. 2880 g
E. 3270 g
13.The neonatologist is measuring the sizes of the newborn head. The baby is at term, weight 3200 g. One of the fetal head size is 9.5 cm, circumference 32 cm. Which size is measured?
A. *Small obligue (suboccipitobregmatic)
B. Middle obligue (suboccipitofrontal)
C. Large obligue (occipitomental)
D. Biparietal
E. Bitemporal
14.The external conjugate of patient is 21 cm. Solovjov’s index 15cm. What is the average of the true conjugate?
A. 11 cm
B. 10 cm
C. *12 cm
D. 13 cm
E. 9 cm
15.The pregnant 24 years is admitted to the admitting office of the maternity hospital with pregnancy 38-39 weeks and regular uterine contractions. At the examination: body temperature is 38.5. In which department patient have to be admitted?
A. Pathology of pregnancy
B. Extragenital pathology
C. First obstetric department
D. *Second obstetric department
E. Admitting office
16.Pregnant A. admitted to the maternity hospital. The uterine fundus is palpated on the umbilical level. What is the doctor’ conclusion about the term of pregnancy?
A. 12 weeks of pregnancy
B. 20 weeks of pregnancy
C. *24 weeks of pregnancy
D. 28 weeks of pregnancy
E. 36 weeks of pregnancy
17.Patient N., II labor. The patient’ condition is satisfactory. Uterine contractions are active. On the left of umbilicus the head of fetus is palpated in uterus, presenting part is not determined. Heart rate is 150 in 1
min, is auscultated at the umbilical level. Your diagnosis?
A. *Transversal lie of fetus, I position.
B. Transversal presentation of fetus.
C. Breech presentation of fetus.
D. Transversal lie of fetus, II position.
E. Transversalposition.
18.Pregnant, 25 weeks of pregnancy. During the last 2 months complains of weakness, violation of taste, the promoted fragility of hair and nails. At laboratory examination: the rate of red blood cells 2,8x1012, Hb 98 g/l. To appoint medical treatment.
A. *Contained iron medicines
B. Vitamins
C. Transfusion of red blood cells mass
D. Medical diet
E. Immunocorrection
19.Pregnant D. admitted to the maternity hospital with pregnancy at term and regular uterine contractions during 6 hours. This pregnancy is first. Pelvic sizes: 25-28-32-18 cm. Fetal heart rate 136 in 1 min. What is the doctor’ conclusion about the pelvic sizes?
A. Normal pelvis
B. The true conjugate increased
C. *The external conjugate decreased
D. The internal conjugate is normal
E. Distantia spinarum decreased
20.In a maternity hall patient is delivered 6 hours ago. The head of the fetus is in the pelvic inlet. The fetal lie is longitudinal, the fetal back to the left. Fetal heart rate is clear, rhythmic, 136 in 1min. At vaginal examination: opening of cervix is 7 cm, sagittal suture in a right oblique size, small fontanel is below large one, located to the left near the sacrum. To define position and visus.
A. The first position, anterior visus.
B. The second position is and anterior visus.
C. *The first position, posterior visus.
D. The second position, posterior visus.
E. Occiput presentation, anterior visus.
21.The pregnant 26 years is admitted to the admitting office of the maternity hospital with pregnancy 40 weeks and regular uterine contractions. At the examination: body temperature is 36.5o. In anamnesis – tuberculosis. Which department the patient have to be admitted in?
A. Pathology of pregnancy
B. Extragenital pathology
C. First obstetric department
D. *Second obstetric department
E. Gynecological department
22.The pregnant 18 years is admitted to the admitting office of the maternity hospital with pregnancy 32 weeks. At the examination: body temperature is 36.6o, cough is present. In anamnesis – diabetes mellitus. In which department patient have to be admitted?
A. Pathology of pregnancy
B. *Extragenital pathology
C. First obstetric department
D. Second obstetric department
E. Gynecological department
23.A woman 28 years visited the doctor of female dispensary with complaints about the delay of menstruation during 2 months. At vaginal examination: uterine cervix of conic shape, without pathology. The uterine body is enlarged to female fist. The uterine adnexa are unpainful, not enlarged. What is the gestational age of the pregnancy?
A. 16 weeks
B. 12 weeks
C. *8 weeks
D. 2 weeks
E. 4 weeks
24.Patient D, labor II, at term. The boy by mass 3200 g was born. The signs of separation of placenta are absent during 30 min, bleeding is absent. What must be done by doctor?
A. Extraction of placenta for the umbilical cord.
B. To apply method Abuladze.
C. To apply a method Krede.
D. Deleting of placenta for Genter.
E. *Manual separation of placenta.
25.Patient S., labor first, at term. Uterine contractions on 45-50 sec, every 2-3 min. Fetal heart rate is rhythmic, 144 bpm, a head is in the pelvic inlet. Vaginally: cervix is effaced, opening 7 cm, amniotic membrane is absent. What is period of labor?
A. *First.
B. Second.
C. Preliminary.
D. Finishing.
E. Third.
26.Pregnant 24 years, the first pregnancy, I labor. Regular uterine contractions. At vaginal examination: the cervical opening is 4 cm, an amniotic sac is whole, the fetal head is fixed in the pelvic inlet. Sagittal suture is in a transversal size, the small fontanel is in the center of pelvis to the left. What is the moment of the labor biomechanism?
A. The V moment of the labor biomechanism
B. The ІІ moment of the labor biomechanism
C. The ІІІ moment of the labor biomechanism
D. The IV moment of the labor biomechanism
E. *I moment of the labor biomechanism
27.In primapara entered department of pathology in 2 weeks after the supposed term of labor. Abdominal circumference 98 cm, diminished on 2 cm during the last week. From nipples at pressing milk is selected. Position of fetus is longitudinal, a head is in the pelvic inlet. Fetal heart rate is clear, rhythmic to 140 bpm. Diagnosis?
A. Pregnancy at term
B. Preterm pregnancy
C. *Postterm pregnancy
D. Retardation of the fetus
E. Multifetal pregnancy
28.Postpartum patient 25 years, at 7th day after labor. The patient’ condition is satisfactory, woman has no complaints. Temperature is 36,60С, pulse 76 in 1 min. Breasts are soft, nipples are unpainful. Uterus is dense, unpainful, fundus on 2 cm above the pubis. Lochia mucous, insignificant. What is the best doctor’ advice in relation to the hygiene of genitalia?
A. Cleanse of vagina by iodine
B. Cleanse of vagina by soap
C. Cleanse of vagina by vaginal tampons
D. *Cleanse of external genitalia by water with soap
E. Cleanse of external genitalia by alcohol
29.Patient F., 18 years. Labor I, at term. The body weight is 80 kg. What volume of blood lost is physiological for the patient?
A. To 500 ml.
B. To 600 ml.
C. To 300 ml.
D. To 200 ml.
E. *To 400 ml.
30.Postpartum patient is examined by the doctor of puerperal department. Uterine fundus is 8cm below the
umbilicus; lochia are bloody-serous; milk glands are enlarged, the milk from nipples is selected. For what time of puerperal period these changes are typical?
A. *4 day
B. 10 day
C. 9 day
D. 1 day
E. 12 day
31.Neonatologist at the examination of newborn girl on a 3rd day after labor exposed the bloody excretion from her vagina, heaping of milk glands up with the excretion of colostrum. Action of what hormones affects such changes at a girl?
A. *Maternal estrogens
B. Maternal prolactin
C. Maternal androgens
D. Maternal progesteron
E. The Gonadotropic hormones of girl
32.Primapara T., 19 years, I labor, II stage of labor. At vaginal examination: sagittal suture in the direct size of plane of pelvic outlet, small fontanel under a pubis, the fetal head is on the pelvic floor. What moment of perineal protective maneuvers is performed?
A. The regulation of pushing
B. The delivery of the fetal head out of the pushing
C. Decreasing of perineal tension
D. *Prevention of preterm fetal head extension
E. The delivery of shoulders
33.At patient on the 5th day of postpartum period suddenly there was an increasing of the temperature. The body temperature is 38,5oС, mammary glands are normal, lactation is satisfied. Signs of perotoneal irritation are abcent. In pelvic examination purulent excretions from the uterus are present, uterus is soft in painfull in palpation. The uterus is increased, soft, painful in palpation.What is the most probable diagnosis?
A. *Endometritis
B. Mastitis
C. Lochiometra
D. Pelvioperitonitis
E. Peritonitis
34.The first delivery, II period. The fetal lie is longitudinal. The head presents, that it can't be determinate by external maneuvers. In internal examination: the uterine cervix is effaced, dilatation is full, membranes are absent. The sagittal suture is in a direct size, small fontanel is under the pubis. In the pushing the fetal head appears from a vulva. What area of pelvis a fetal head occupies?
A. Pelvic inlet
B. That is pressed to pelvic inlet plane
C. *The area of pelvic outlet
D. The area of wide part of a cavity of a small pelvis
E. The area of narrow part of a cavity of a small pelvis
35.Patient S., labor first, at term. Uterine contractions on 45-50 sec, after 2-3 min.. Fetal heart rate is rhythmic, 144 in 1 min, a head is in the pelvic inlet. Vaginally: cervix is effaced, dilating is full, amniotic membrane is absent. What is period of labor?
A. First.
B. *Second.
C. Preliminary.
D. Finishing.
E. Third.
36.Primapara N., 20 years, II pregnancy, I labor. The fetal lie is longitudinal, the fetal back is anteriorly. The fetal heart rate is clear, rhythmic. Vaginal examination: the cervix is effaced, opening is full, an amniotic sac is absent. Head of fetus in the plane of pelvic outlet. Sagittal suture is in a direct size, small fontanel
is under the pubis. What moment of the labor biomechanism at the anterior type of occipital presentation is ended?
A. The І moment of the labor biomechanism
B. *II moment of the labor biomechanism
C. The ІІІ moment of the labor biomechanism
D. The IV moment of the labor biomechanism
E. The V moment of the labor biomechanism
37.The patient is admitted to delivery department. In examination longitudinal lie, I position, posterior variety of the fetus is exposed. What is the leading point at the posterior type of occipital presentation?
A. Small fontanel
B. *The middle of sagittal suture
C. Large fontanel
D. Chin
E. Subtongue bone
38.Multipara 32 years. 30 minutes passed after delivery of the fetus. The signs of placental separation are negative. Bleeding began – blood lost is 450 ml. What must be done?
A. Uterine curettage.
B. Introduction of uterotonics.
C. To apply the method of Crede-Lazarevich.
D. Expecting tactic to 1 hour.
E. *Manual separation of placenta.
39.Postpartum patient, 22 years. On the 3rd day after the first labor complains on pains in milk glands, on its increasing, body T - 36,6o. What hormones do regulate the process of milk producing?
A. *Luteotropin, prolactin
B. Corticotropin, lyoteotropin
C. Tireotropin, prolactin
D. Follitropin, prolactin
E. Somatotropin, follitropin
40.Primapara, 20 years, I labor. Regular pushing. The fetal lie is longitudinal. The fetal heart rate is clear, rhythmic, 130 in 1 min. At vaginal examination sagittal suture in the direct size of pelvic outlet, small fontanel is under a pubis. The fetal head is extending. What moment of perineal protective maneuvers is performing now?
A. Prevention of preterm fetal head extention
B. *Decreasing of perineal tension and regulation of pushing
C. The regulation of pushing
D. The delivery of shoulders
E. The delivery of the fetal head out of the pushing
41.Patient II, labor first, at term. The patient’ condition is satisfactory. The new-born is just delivered. The umbilical cord hangs down from a vagina and increses in its lenths. Bleeding is not present. Uterus is in normal tonus. How do you called this positive sign of placenta separation?
A. Dovshenko sign
B. *Alfelda sign
C. Shreder' sign
D. Kutsenko sign
E. Hehar sign
42.Postpartum patient, 26 years, after the third physiological labor, discharged out from hospital to home on a sixth day. What method of contraception to her is the best?
A. *Amenorrea due to lactation
B. Hormonal contraception
C. Mechanical contraception
D. The interrupted sexual intercourse
E. Barrier methods
43.Patient 30 years, labor at term. A girl with the Apgar score 8 was born. The umbilical vessels do not
pulsate, the cord is clammed. Bloody excretions from the vagina are absent. What period of labor this patient is found in?
A. Cervical
B. Pelvic
C. *Placental
D. Puerperal period
E. Preliminary period
44.Pregnant N., 25 years is delivered in the maternity department with complaints about periodic pains in lower part of abdomen and lumbal region during 7 hours. Amniotic fluid did not released. Fetal heart rate is 136 in 1min. Vaginal examination: the cervix is effaced, opening 10 cm, the amniotic membrane is whole. What is the doctor’ tactic?
A. *Amniotomy
B. Cesarean section
C. Stimulation of labor
D. Obstetric forceps
E. Conservative conducting of labor
45.Pregnant at term is admitted to the maternity home . Uterine contractions are not present. Position of the fetus is longitudinal, presentation is cephalic. Fetal heart rate 136 in 1 min, clear, rhythmic. Amniotic fluid are not released. What is the reason of prolonged pregnancy?
A. High level of oxytocin
B. High level of estrogens
C. Low level of progesteron
D. *Low level of oxytocin
E. High level of prostaglandins
46.Multipara 32 years. 10 minutes passed after fetus delivery. The signs of placenta separation are negative. Bleeding began – blood lost is 550 ml. What must to be done?
A. Expecting tactic.
B. Introduction of uterotonics.
C. To apply the method of Crede-Lazarevich.
D. *Manual separation of placenta.
E. Massage of uterus.
47.At patient on the 7th day of puerperal period suddenly there was a hallucinatory syndrome: patient is not oriented in space and time, does not recognize neighbors. The temperature of body rose to 38,5oС, purulent excretions from the uterus appeared. At vaginal examination: the uterus is increased, soft, painful at palpation, the uterine cervix freely skips 1 finger. What reason of psychical violations, that arose up at postpartum patient?
A. Psychical diseases in anamnesis
B. Negative emotional influence of labor on patient
C. Astenic-vegetative syndrome
D. *Puerperal infection
E. Manifestation of schizophrenia
48.Postpartum patient C. on 4th day after labor complains about the rise of body temperature, general weakness, pains in lower part of abdomen. Preterm rupture of amniotic fluid was happaned. 72 hours without amniotic fluid. Uterus is on 4 cm below umbilicus, soft. On ultrasound the signs of endometritis are found. What is the reason of complication?
A. *The protracted amniotic fluidless period.
B. Premature labor.
C. Hypotonic uterine contractions.
D. Epiziotomy.
E. The infection of organism
49.Patient in III stage of labor undergo the operation of manual separation of placenta. Which blood loss is indication for this operation?
A. 50 ml and more
B. 100ml and more
C. 150 ml and more
D. 200 ml and more
E. *More 250 ml
50.In the 30years old primapara intensive uterine contractions with an interval of 1-2 min, duration 50 sec have begun. In time of the fetal head delivery the patient complaints on severe pain in the perineum. The perineum is 5 cm, its skin become pale. What is it necessary to perform:
A. *Perineotomy
B. Episiotomy.
C. Protection of the perineum.
D. Vacuum - extraction of the fetus.
E. Waitingtactics.
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