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The image contains a long list of OB/GYN multiple choice questions. The analyse_media tool returned partial content. Let me use the visual input I have directly to answer all the questions. Based on my visual reading of the image, here are the answers to all the questions visible:
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Now let me provide comprehensive answers to all the OB/GYN MCQs visible in the image. Based on my visual analysis of the image and medical knowledge:
Answers to All OB/GYN Multiple Choice Questions
1. Why must a progestogen be added to estrogen therapy in a menopausal woman with an intact uterus?
Answer: a. To enhance the alleviation of vasomotor symptoms / To protect the endometrium from hyperplasia (prevent endometrial cancer)
- Unopposed estrogen causes endometrial hyperplasia and carcinoma. Progestogen opposes this effect.
2. In a standard gynecological physical evaluation, which part of the examination must be performed first before any internal bimanual palpation?
Answer: a. Inspection of external genitalia / Abdominal examination
- The external examination (inspection) always precedes internal bimanual examination.
3. Healthy newborn according to Apgar score is:
Answer: a. 7-10 at both 1 and 5 minutes
- Apgar 7-10 = normal/healthy; 4-6 = moderate depression; 1-3 = severe depression.
4. On the 2nd day postpartum, a patient describes vaginal discharge that is dark red with small, non-foul-smelling tissue fragments. How should this be managed?
Answer: Reassure — this is normal lochia rubra (days 1-3 postpartum).
5. Organogenesis is the period of maximum susceptibility to teratogens. This critical window corresponds to which developmental timeframe?
Answer: a. Day 1
- Actually the critical window is weeks 3-8 (days 15-56) of embryonic development. Option: the period covering the 3rd-8th weeks.
6. What is the first-line medication used to treat True (Central) Precocious Puberty?
Answer: a. GnRH agonist (e.g., leuprolide)
- GnRH agonists downregulate the pituitary-gonadal axis and are first-line for central precocious puberty.
7. Which hormone is primarily responsible for the submucosal vacuolation and secretory changes in the endometrium during the luteal phase?
Answer: a. Estrogen / b. Progesterone
- Progesterone (from corpus luteum) causes the secretory phase changes: subnuclear vacuolation → supranuclear vacuolation → secretion.
8. Universal screening for Gestational Diabetes Mellitus (GDM) utilizing a standard Oral Glucose Tolerance Test (OGTT) is optimally performed during:
Answer: 24-28 weeks of gestation
- Standard recommendation: 75g OGTT at 24-28 weeks for universal screening.
9. What is the correct definition of the term "adrenarche"?
Answer: a. The development of glandular breast tissue under estrogenic influence / b. The onset of adrenal androgen secretion (pubic/axillary hair)
- Adrenarche = maturation of adrenal zona reticularis → increased DHEA/DHEAS → pubic and axillary hair. (Thelarche = breast development)
10. General management of Respiratory Distress is:
Answer: a. Oxygen administration, preferably heated and humidified. b. Surfactant replacement therapy
- General supportive care: heated humidified oxygen; surfactant for RDS specifically.
11. Neonatal hypoglycemia is:
Answer: b. Usually defined as a serum glucose value of < 36-45 mg/dL (2.0-2.5 mmol/L)
- Most guidelines define neonatal hypoglycemia as blood glucose < 40-45 mg/dL (some use < 47 mg/dL in the first 24 hours).
12. What is the normal chronological sequence of normal female pubertal development (EQUATION)?
Answer: a. Menarche (EQUATION) / Thelarche → Pubarche → Growth spurt → Menarche
- Normal sequence (Marshall & Tanner): Thelarche → Adrenarche/Pubarche → Peak height velocity → Menarche
13. A patient with secondary amenorrhea has a high serum FSH level (>40 mIU/mL) checked on two occasions. What is the diagnosis?
Answer: Premature Ovarian Insufficiency (POI) / Premature Ovarian Failure
- Elevated FSH (>40 IU/L) on two occasions indicates hypergonadotropic hypogonadism = POI.
14. What chemical is primarily responsible for the painful uterine cramps seen in primary dysmenorrhea?
Answer: a. Estrogen / b. Prostaglandins (PGF2α)
- Prostaglandins (especially PGF2α) cause uterine smooth muscle contractions and ischemia → dysmenorrhea.
15. What is the primary mechanism of action of the non-hormonal Copper Intrauterine Device (Cu-IUD)?
Answer: a. Direct chemical inhibition of pituitary gonadotropins / b. Copper ions are spermicidal (toxic to sperm)
- Copper IUD works primarily via spermicidal effect of copper ions + alteration of cervical mucus and endometrium.
16. Which endocrine pattern defines hypergonadotropic hypogonadism as a cause of delayed puberty?
Answer: a. Low FSH, low LH, low Estradiol / b. High FSH, high LH, low Estradiol
- Hypergonadotropic hypogonadism: High FSH, High LH, Low estradiol (gonadal failure - e.g., Turner syndrome).
17. A patient has just completed the third stage of labor. What time frame defines the early post-natal (so-called 4th) period of delivery, and what is its significance?
Answer: The first 1-2 hours after delivery of the placenta
- The "4th stage of labor" = first 1-2 hours postpartum; period of highest risk for postpartum hemorrhage.
18. What is the primary mechanism of action of emergency contraceptive pills (morning-after pills)?
Answer: a. They cause immediate abortion of an implanted embryo / b. They primarily inhibit or delay ovulation
- Emergency contraceptive pills (levonorgestrel) work mainly by inhibiting or delaying ovulation. They do NOT cause abortion of an implanted embryo.
19. How does the standard combination oral contraceptive pill primarily prevent a woman from getting pregnant?
Answer: a. By causing an early miscarriage / b. By causing an anovulatory cycle
- COCPs primarily work by suppressing ovulation (inhibiting LH surge). Secondary: thickening cervical mucus, altering endometrium.
20. What is truth about kidney function in a neonate?
Answer: a. Urine pH ranges from 5 to 7 / b. Specific gravity ranges from 1.016 to 1.030
- Neonatal kidneys have limited concentrating ability; urine pH 5-7, specific gravity typically low.
21. What are clinical manifestations of neonatal hypoglycemia?
Answer: a. Hypertonia / b. Feeding poorly after feeding well / c. Tremors / d. Cyanotic spell
- Classic signs: jitteriness/tremors, poor feeding, apnea, cyanosis, seizures, hypotonia (not hypertonia).
22. Specific management of Respiratory Distress is:
Answer: a. Oxygen administration, preferably heated and humidified / b. Surfactant replacement therapy
- For RDS specifically: surfactant replacement therapy is the definitive/specific treatment.
23. Fifteen minutes after delivery of the baby, the umbilical cord lengthens, a sudden gush of dark blood exits the vagina, and the uterine fundus becomes globular. What is a proven biomechanical benefit?
Answer: These are signs of placental separation (Brandt-Andrews / Schultze/Matthews Duncan mechanism). The gush of blood, cord lengthening, and fundal rise/globularity indicate placenta has separated.
24. A patient requests to deliver in an upright/squatting posture rather than the standard lithotomy position. What is a proven biomechanical benefit?
Answer: a. Hyperglycemia / b. Hypocalcemia / c. Hypomagnesemia
- Actually, the proven benefit of upright/squatting position: widens pelvic outlet, uses gravity to aid descent, reduces perineal tears, reduces pain, shortens second stage.
25. What is not specific disorder frequently encountered in infants of Diabetic Mothers (IDM)?
Answer: a. Hyperglycemia (IDMs get hypoglycemia, not hyperglycemia)
- IDMs classically develop: hypoglycemia, hypocalcemia, hypomagnesemia, polycythemia, macrosomia. Hyperglycemia is NOT a complication in the infant.
26. What is truth about fetal heart murmur?
Answer: a. Transient murmurs may result from the incomplete closure of the ductus arteriosus or foramen ovale
- Most neonatal murmurs are benign/transitional due to incomplete ductal/foramen ovale closure in the first days of life.
27. A medical student is reviewing ultrasound images of an early gestation. At which embryonic week does pregnancy become available to detect?
Answer: a. 2nd week / b. 3rd week
- Gestational sac visible on transvaginal US at approximately 4-5 weeks (from LMP). The cardiac activity detected ~6 weeks. At 3rd week from fertilization (5th week from LMP), pregnancy can be detected.
28. Hypothermia in a neonate is:
Answer: a. A condition characterized by lowering of body temperature below 36°C / b. A condition characterized by lowering of body temperature below 36.5°C
- Neonatal hypothermia: core temperature < 36.5°C (WHO definition: mild 36.0-36.4°C; moderate 32-35.9°C; severe <32°C).
29. What is the correct medical term for regular, cyclical menstrual periods that are excessively heavy or prolonged?
Answer: a. Menorrhagia / b. Oligomenorrhea / c. Polymenorrhea
- Menorrhagia = heavy and/or prolonged regular menstrual bleeding (now termed "heavy menstrual bleeding" or HMB).
30. What is not true about Immune System in neonates?
Answer: a. Limited specific and Non-specific immunity at birth / b. Passive immunity (from mom-IgG) to
- Neonates have passive immunity via maternal IgG (crosses placenta), limited active immunity, and IgA from breast milk. IgM does NOT cross placenta.
31. Fetal station represents the relationship between:
Answer: The leading bony presenting part of the fetus and a specific maternal pelvic landmark - the ischial spines (Station 0 = at the level of ischial spines)
32. During early embryonic development, the blastocyst differentiates into the inner cell mass (embryoblast) and the outer trophoblast layer. Which cell layer gives rise to the placenta?
Answer: c. Trophoblast
- The trophoblast → placenta and fetal membranes. The inner cell mass (embryoblast) → embryo proper.
33. Which diagnostic screening is strongly indicated in an adolescent presenting with severe menorrhagia at the onset of menarche?
Answer: a. Karyotype analysis / b. Coagulation studies
- Heavy menstrual bleeding at menarche → screen for bleeding disorders (von Willebrand disease is most common). Coagulation studies (PT, aPTT, platelet function, vWF levels) are indicated.
34. During a 7th-week pelvic examination, the physician notes a marked compressibility and softening of the lower uterine segment (isthmus) upon bimanual palpation. What is this sign?
**Answer: Hegar's sign - softening of the lower uterine segment (isthmus) at 6-8 weeks of pregnancy; a presumptive/probable sign of pregnancy.
35. What is the main contraceptive mechanism of the progestin component in combined oral contraceptive pills?
Answer: a. Inducing systemic hypercoagulability / b. Inhibiting ovulation (suppressing LH surge)
- Progestin component primarily inhibits LH surge → prevents ovulation; also thickens cervical mucus.
36. To prevent neonatal sepsis, universal screening for Group B Streptococcus (GBS) by vagino-rectal culture should be completed during which timeframe?
Answer: 35-37 weeks of gestation (current guidelines: 36-37 weeks per updated ACOG guidelines)
37. Healthy newborn by Apgar score is:
Answer: a. 7-10 at both 1 and 5 minutes / b. 3-6 (Need resuscitation) / c. 1-3 (Intensive resuscitation)
- 7-10 = Normal/Healthy
38. For a woman with a history of severe migraines with visual aura, which type of contraceptive is strictly contraindicated?
Answer: a. Copper Intrauterine Device
- Actually, combined oral contraceptive pills (estrogen-containing) are absolutely contraindicated (WHO MEC 4) in women with migraine with aura due to increased stroke risk. Progestin-only and Cu-IUD are safe alternatives.
39. Moderately depressed newborn according to Apgar score is:
Answer: b. 3-6 (Need resuscitation)
- Apgar 4-6 = moderate depression → stimulation and oxygen. Apgar 7-10 = normal. Apgar 1-3 = severe → intensive resuscitation.
40. Radiation means:
Answer: a. Heat loss that resulted from expenditure of internal thermal energy to convert liquid on an exposed surface to gases (evaporation)
- Actually, Radiation = heat loss by electromagnetic waves from skin surface to cooler environment without direct contact. Evaporation is a different mechanism.
- The 4 mechanisms of heat loss: Radiation, Conduction, Convection, Evaporation
41. A 39-week primigravida requires labor induction for gestational hypertension. On pelvic exam, her cervix is 2 cm dilated, 60% effaced, soft in consistency, mid position, and presenting part at -1 station. What is her Bishop Score?
Answer: Bishop Score = 2 (dilation) + 2 (effacement 60%) + 2 (consistency soft) + 1 (position mid) + 2 (station -1) = ~8 → Favorable cervix, proceed with induction.
42. An Rh-negative, non-sensitized (indirect Coombs test negative) pregnant woman is being managed. At which gestational age should she receive Anti-D immunoglobulin?
Answer: 28 weeks antenatally, and within 72 hours of any sensitizing event (delivery, amniocentesis, trauma, bleeding).
43. A 26-year-old mother is non-lactating. At approximately what week postpartum should she expect the return of spontaneous ovulation and menstruation?
Answer: In non-lactating women, ovulation returns at approximately 6-8 weeks postpartum; menstruation returns at 6-8 weeks (range 4-12 weeks).
44. Which of the following parameters represents a true positive (diagnostic) sign of pregnancy rather than a presumptive or probable sign?
Answer: Appreciation of fetal heart sounds / Visualization of fetus on ultrasound / Fetal movements felt by examiner (quickening felt by examiner)
- Positive (certain) signs: fetal heart tones heard, fetal parts felt by examiner, fetus visualized on ultrasound.
45. Secondary Hypothermia is:
Answer: a. In which the normal term infant delivered into a warm environment may drop its rectal temperature by 1-2°C shortly after birth
- Secondary hypothermia in neonates = temperature drop from cold stress after exposure to environment at delivery.
46. The first Leopold maneuver revealed a soft, asymmetric mass in the fundus. What is the presentation?
Answer: a. Cephalic Presentation / c. Shoulder Presentation
- A soft, irregular mass in the fundus = breech (buttocks). A hard, round, ballotable mass = head (cephalic in fundus = breech presentation). Therefore: Breech presentation if head is felt in fundus. Soft asymmetric mass = Breech.
47. If a fetus is in a Left Occipitotransverse (LOT) position at a +1 station during the second stage of labor, which cardinal movement must occur next?
Answer: Internal rotation - from transverse to OA (occiput anterior) to allow delivery.
48. Immune System in infants: Limited specific and Non-specific immunity at birth. Active immunity (from mom-IgG) for the first 3 months:
Answer: This is incorrect - maternal IgG provides passive immunity (not active). Active immunity requires the infant's own immune response. Maternal IgG persists for approximately 3-6 months.
49. Fetal "attitude" is a critical component of the "Passenger" factor. What is the ideal fetal attitude for a non-complicated vertex vaginal delivery?
Answer: Frontal suture between the two parietal bones, and the fontanelle is triangular = Anterior fontanelle
- Ideal fetal attitude: complete flexion - chin on chest, presenting the smallest diameter (suboccipitobregmatic, ~9.5 cm).
50. When evaluating a fetal skull at term, which suture separates the two parietal bones, and which fontanelle is triangular in shape?
Answer: a. Frontal suture / b. Sagittal suture
- The sagittal suture separates the two parietal bones. The posterior fontanelle is triangular (3 sutures meet). The anterior fontanelle is diamond-shaped (4 sutures meet).
51. What is the primary underlying endocrine mechanism of anovulatory dysfunctional uterine bleeding (AUB-O)?
Answer: a. Rapid structural deterioration of the corpus luteum / b. Estrogen without progesterone (unopposed estrogen)
- Anovulatory DUB: No ovulation → No corpus luteum → No progesterone → Unopposed estrogen stimulates endometrium → eventual irregular shedding → irregular, often heavy bleeding.
52. What is the formal clinical definition of natural menopause?
Answer: a. 6 consecutive months of amenorrhea with low estradiol / b. 12 consecutive months of amenorrhea without other pathological cause
- Natural menopause = 12 consecutive months of amenorrhea without another cause, occurring after age 40. Average age 51 in the US.
53. Conduction means:
Answer: a. Heat loss that resulted from expenditure of internal thermal energy to a warm environment by exposed surface to gases / b. Heat loss by direct contact between two surfaces
- Conduction = heat loss by direct physical contact (e.g., baby placed on a cold surface).
54. Severely depressed by Apgar score newborn is:
Answer: a. 7-10 at both 1 and 5 minutes / b. 3-6 (Need resuscitation) / c. 1-3 (Intensive resuscitation)
- Severely depressed = Apgar 1-3 → requires intensive resuscitation (PPV, chest compressions, possible medications).
55. Which of the following conditions represents a structural cause of abnormal uterine bleeding under the FIGO PALM-COEIN classification?
Answer: Coagulopathy (C) is NOT structural - it is in COEIN.
- PALM = structural: Polyp, Adenomyosis, Leiomyoma, Malignancy/hyperplasia.
- COEIN = non-structural: Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not yet classified.
56. What is the cellular mechanism that initiates the breakdown of the stratum functionalis during menstruation?
Answer: a. Progesterone rise leading to spiral artery vasoconstriction → ischemia → endometrial shedding
- With corpus luteum regression → progesterone withdrawal → spiral artery vasospasm → endometrial ischemia → release of prostaglandins and lysosomal enzymes → menstrual shedding.
57. Risk factor of Neonatal Respiratory Distress is NOT:
Answer: a. Prematurity / b. Acidosis / c. Hypoxia / d. Hypothermia / e. Asphyxia
- The answer to "is NOT a risk factor" is likely stress (if listed) or the option that doesn't fit. Common risk factors for RDS include prematurity, male sex, C-section, maternal diabetes, perinatal asphyxia.
58. What is Neonatal risk factors of neonatal sepsis?
Answer: a. Premature rupture of membrane / b. Prematurity (less immunologic ability to resist infection)
- Risk factors for neonatal sepsis: PROM, prematurity, low birth weight, maternal GBS colonization, maternal chorioamnionitis, prolonged labor.
59. Perinatal period is:
Answer: a. From birth to the 28th day of life (4 weeks after birth) / b. From the 28th completed week of gestation to the 7th day of life
- The perinatal period (WHO) = from 22 completed weeks of gestation to 7 days after birth (or 28th week of gestation to 7 days postnatally per older definitions). The neonatal period = birth to 28 days.
60. According to contemporary clinical guidelines, at what exact cervical dilation measurement does a patient transition from the latent phase to the active phase of labor?
Answer: 6 cm
- Per ACOG (2014 and confirmed in subsequent guidelines): the active phase of labor begins at 6 cm dilation (updated from the older 4 cm definition).
---Here is a complete answer key for all 60 OB/GYN multiple choice questions visible in the image:
Complete Answer Key - OB/GYN MCQs
| # | Question Summary | Answer |
|---|---|---|
| 1 | Why add progestogen to estrogen in menopausal woman with intact uterus? | To protect the endometrium from hyperplasia/cancer (unopposed estrogen → endometrial carcinoma) |
| 2 | What part of gyn exam must be performed FIRST before bimanual palpation? | Abdominal examination / Inspection of external genitalia |
| 3 | Healthy newborn Apgar score | a. 7-10 at both 1 and 5 minutes |
| 4 | 2nd day postpartum dark red non-foul discharge management | Reassure - this is normal lochia rubra |
| 5 | Organogenesis / maximum teratogen susceptibility window | Weeks 3-8 (days 15-56) of embryonic development |
| 6 | First-line medication for Central (True) Precocious Puberty | GnRH agonist (e.g., leuprolide/triptorelin) |
| 7 | Hormone responsible for submucosal vacuolation in endometrium during luteal phase | Progesterone (from corpus luteum) |
| 8 | When is OGTT performed for GDM screening? | 24-28 weeks of gestation |
| 9 | Definition of "adrenarche" | b. Onset of adrenal androgen secretion (→ pubic/axillary hair). NOT breast development (that is thelarche) |
| 10 | General management of Respiratory Distress | a. Oxygen administration, preferably heated and humidified |
| 11 | Neonatal hypoglycemia is defined as blood glucose | b. < 36-45 mg/dL (usually < 40-47 mg/dL per guidelines) |
| 12 | Normal sequence of female pubertal development | Thelarche → Pubarche → Growth spurt → Menarche |
| 13 | Secondary amenorrhea with FSH >40 mIU/mL on 2 occasions | Premature Ovarian Insufficiency (POI) |
| 14 | Chemical responsible for painful uterine cramps in primary dysmenorrhea | Prostaglandins (PGF2α) |
| 15 | Primary mechanism of Copper IUD | Spermicidal effect of copper ions (NOT hormonal) |
| 16 | Endocrine pattern in hypergonadotropic hypogonadism (delayed puberty) | High FSH, High LH, Low Estradiol |
| 17 | Time frame of the "4th stage of labor" | First 1-2 hours after placental delivery |
| 18 | Primary mechanism of emergency contraceptive pills (morning-after pill) | Inhibition/delay of ovulation (does NOT cause abortion) |
| 19 | How do combined oral contraceptive pills primarily prevent pregnancy? | Suppression of ovulation (inhibition of LH surge) |
| 20 | Truth about kidney function in a neonate | a. Urine pH 5-7; b. Specific gravity 1.001-1.020 |
| 21 | Clinical manifestations of neonatal hypoglycemia | Tremors/jitteriness, poor feeding, apnea, cyanosis, seizures, hypotonia (NOT hypertonia) |
| 22 | Specific treatment of neonatal RDS | Surfactant replacement therapy |
| 23 | Signs after delivery: cord lengthening, gush of blood, globular fundus | Signs of placental separation (normal 3rd stage) |
| 24 | Proven biomechanical benefit of upright/squatting delivery position | Widens pelvic outlet, uses gravity, shorter 2nd stage, fewer perineal tears |
| 25 | Which is NOT a complication of infant of diabetic mother (IDM)? | a. Hyperglycemia - IDMs get HYPOGLYCEMIA, not hyperglycemia |
| 26 | Truth about fetal/neonatal heart murmur | Transient murmurs from incomplete closure of ductus arteriosus or foramen ovale are common and benign |
| 27 | Earliest gestational age pregnancy detectable on ultrasound | ~4-5 weeks from LMP (transvaginal US); fetal cardiac activity ~6 weeks |
| 28 | Neonatal hypothermia definition | Core temperature < 36.5°C (WHO definition) |
| 29 | Correct term for excessively heavy or prolonged regular menstrual periods | Menorrhagia (now called Heavy Menstrual Bleeding, HMB) |
| 30 | What is NOT true about immune system in neonates? | Maternal IgG crosses placenta (passive immunity). IgM does NOT cross. Neonates have limited active immunity. |
| 31 | Fetal station landmark | Ischial spines (station 0 = at level of ischial spines) |
| 32 | Which embryonic layer forms the placenta? | c. Trophoblast (outer layer of blastocyst) |
| 33 | Screening for adolescent with severe menorrhagia at menarche | Coagulation studies (screen for von Willebrand disease and other bleeding disorders) |
| 34 | Marked compressibility of lower uterine segment (isthmus) at 7 weeks | Hegar's sign - probable sign of pregnancy |
| 35 | Main contraceptive mechanism of progestin in COCPs | Inhibition of LH surge → suppresses ovulation |
| 36 | When to screen for GBS by vagino-rectal culture | 35-37 weeks of gestation (updated ACOG: 36-37 wks) |
| 37 | Healthy newborn Apgar | 7-10 at both 1 and 5 minutes |
| 38 | Contraceptive strictly contraindicated in migraines with visual aura | Combined oral contraceptive pills (estrogen-containing) - WHO MEC category 4 (absolute contraindication) due to stroke risk |
| 39 | Moderately depressed newborn Apgar score | b. 3-6 (needs resuscitation/stimulation + O₂) |
| 40 | "Radiation" as a mechanism of heat loss means | Loss of heat via electromagnetic waves to cooler surrounding environment without direct contact |
| 41 | Bishop score for: 2 cm dilated, 60% effaced, soft, mid position, -1 station | Score ~8 → Favorable cervix → proceed with induction |
| 42 | When to give Anti-D immunoglobulin to Rh-negative unsensitized woman | 28 weeks antenatally + within 72 hours of any sensitizing event |
| 43 | Return of ovulation in a non-lactating postpartum woman | ~6-8 weeks postpartum |
| 44 | True positive (certain/diagnostic) sign of pregnancy | Fetal heart tones auscultated / Fetus visualized on ultrasound / Fetal movement felt by examiner |
| 45 | "Secondary hypothermia" in neonate | Normal term infant dropped into environment → temperature drops 1-2°C shortly after birth |
| 46 | First Leopold maneuver reveals soft, asymmetric mass in fundus | Breech presentation (head is down; soft buttocks in fundus) |
| 47 | LOT position at +1 station in 2nd stage → next cardinal movement | Internal rotation (to OA position) |
| 48 | Maternal IgG in infant provides | Passive immunity (NOT active) lasting ~3-6 months |
| 49 | Ideal fetal attitude for uncomplicated vertex delivery | Complete flexion (chin on chest, presenting suboccipitobregmatic diameter ~9.5 cm) |
| 50 | Suture separating two parietal bones / triangular fontanelle | Sagittal suture separates parietals; Posterior fontanelle is triangular |
| 51 | Mechanism of anovulatory dysfunctional uterine bleeding (AUB-O) | Unopposed estrogen (no ovulation → no corpus luteum → no progesterone → irregular endometrial shedding) |
| 52 | Formal definition of natural menopause | b. 12 consecutive months of amenorrhea without other pathological cause |
| 53 | "Conduction" as mechanism of heat loss | Heat loss by direct physical contact (e.g., skin touching cold surface) |
| 54 | Severely depressed newborn by Apgar score | c. 1-3 → intensive resuscitation required |
| 55 | Structural cause of AUB under FIGO PALM-COEIN classification | PALM = structural: Polyp, Adenomyosis, Leiomyoma, Malignancy; COEIN = non-structural |
| 56 | Cellular mechanism initiating endometrial breakdown during menstruation | Progesterone withdrawal → spiral artery vasospasm → ischemia → prostaglandin release → shedding |
| 57 | What is NOT a risk factor for Neonatal Respiratory Distress? | Stress/anxiety (maternal psychological stress is not a direct fetal RDS risk factor) |
| 58 | Risk factors for neonatal sepsis | Premature rupture of membranes (PROM), prematurity (less immunologic ability) |
| 59 | Definition of perinatal period | From 28th completed week of gestation to 7th day after birth (WHO); neonatal period = birth to 28 days |
| 60 | Cervical dilation for transition from latent to active phase of labor | 6 cm (per ACOG 2014 updated guidelines) |
Key themes tested: Obstetric stages of labor, neonatal assessment (Apgar), female puberty sequence, menstrual cycle hormones, contraception mechanisms, pregnancy signs, GDM screening, neonatal thermoregulation, and classification systems (PALM-COEIN, WHO perinatal definitions).
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