Pytania na egzamin z angielskiego:
1. What was your most stressful case during your training In a hospital?
During my training in a hospital the most stressful case was the assistance during childbirth when the child was stillborn. Although the woman felt labour pains all the time, she knew that her new born child will be dead. I didn’t know how to behave in this kind of situation and how to help this woman.
2. There are 3 patients in the waiting room of an obstetric clinic. Describe their symptoms/what’s wrong with them?
First woman is pregnant for 10 weeks. She has strong nausea and vomiting, she hasn’t eaten for 10 hours, she is dehydrated and weakened (uncontrolled vomiting in pregnancy).
Second woman is ten days past EDD and she doesn’t have any symptoms of delivery (overdue pregnancy).
Third woman is 32 weeks pregnant with twins. She has outflow of amniotic fluid (PROM, premature labour)
3. What are the first symptoms of pregnancy? Describe them.
The first symptoms of pregnancy are:
- amenorhea
- increased breast size- woman has increased and aching breast
- rise in basal body temperature- the temperature measured in vagina is 37 and more Celsius degree
- vomiting- from 6 to 12 weeks of pregnancy, they can appear in the morning or nausea and vomiting in the evening
4. How do you calculate EDD?
There are four methods of calculate EDD:
- Naegele’s rule- from the first day of last menstrual period we subtracting three months, one year and adding seven days;
- Conception day- if the woman know exactly when she got pregnant we can calculate EDD subtracting 3 months, one year and 7 days from this date;
- An increase in basal body temperature- first day of increased temperature is the first day of conception, from this day we subtracting 3 months and 7 days and one year,
- First foetal movements- primigravidate - 20th week and multipara in about 18th week.
5. What are the types of miscarriage?
Induced - the pregnancy is terminated artificially.
Spontaneous - when the miscarriage occurs naturally
Threatened - there is bleeding and sometimes pelvic pain but the cervix is closed
Complete - the uterus has completely emptied itself.
Incomplete - products of the pregnancy still present in the uterus.
Missed – when the embryo has died.
Septic - the miscarriage has been complicated by infection.
Recurrent or habitual - three or more consecutive miscarriages.
Early - miscarriage in the first few weeks of the pregnancy.
Late - miscarriage after the first few weeks.
6. What is the management of an ectopic pregnancy?
An ectopic pregnancy is a medical emergency, and, if not treated properly, can lead to the death of the woman. An ultrasound showing a gestational sac with fetal heart in the fallopian tube is clear evidence of ectopic pregnancy. Surgeons use laparoscopy or laparotomy to remove only the pregnancy (salpingostomy) or remove the affected tube with the pregnancy (salpingectomy).
7. Give examples of 3-5 congenital infections and briefly describe one of them?
Rubella
Toxplasma gonidii
Human Immunodeficiency Virus
Chlamydia trachomatis
Cytomegalovirus - is the most common cause of intra- uterine infection. Most infants who are symptomatic at birth (hepatosplenomegaly, jaundice and microcephaly) and another 10% of infants with asymptomatic infection at birth develop late complications such as intellectual disability.
8. What are the obstetric procedures used for prenatal diagnosis?
· Ultrasound detection
o 7 weeks to confirm pregnancy dates
o 11-13 to identify higher risks of Downs syndrome
o 18 weeks to check for any abnormal development;
· Maternal serum screening during the 2nd trimester to identify neural tube defect, Down syndrome, or trisomy 18.
9. Give examples of 3-5 chromosomal abnormalities and briefly describe one of them?
Prader-Willi syndrome (deletion on chromosome 15)
Cri-du-chat (cat cry) syndrome (deletion on chromosome 5)
Wolf-Hirschhorn syndrome (deletion on chromosome 4)
Down syndrome is an example of a trisomy of chromosome 21. Children with Down syndrome have varying degrees of mental retardation, characteristic facial features and, often, heart defects and other problems. The risk of Down syndrome and other trisomies increases with maternal age.
10. What are the main duties of a mid-wife?
Midwives are autonomous practitioners who are specialists in a low-risk pregnancy, childbirth, and the postpartum stage. They generally strive to help women have a healthy pregnancy and natural birth experience. They refer women to obstetricians when a woman requires care beyond their area of expertise.
11. What are the types of HT-definition?
· primary (or essential) hypertension - by definition, essential hypertension has no identifiable cause,
· secondary hypertension - it is caused by a preexisting medical condition such as congestive heart failure, kidney failure, liver failure, or damage to the endocrine (hormone) system;
· pregnancy-induced hypertension (PIH) - is defined as the hypertension in a pregnant woman after 20 weeks gestation.
12. How can you define IUGR?
IUGR – intra uterine growth restriction. It means that fetus does not grow properly. The growth is slower. Baby is small for gestational age.
13. Give examples/describe placental pathologies?
· PLACENTA PREVIA - the placenta implanted over the cervical os.
· PLACENTA ACCRETA - invasion of chorionic villi has occurred superficially into myometrium
· PLACENTA INCRETA - the placental villi have invaded deeply into the myometrial wall
· PLACENTA PERCRETA - when the placenta penetrates the entire myometrium to the uterine serosa.
14. What are the types of delivery?
· Labor - consists of regular, frequent, uterine contractions which lead to progressive dilatation of the cervix with birth of newborn infants
· Induction - labour can be induced by rupturing the membrane, by gel or pessaries containing prostaglandins or by oxytocin;
· Episiotomy - this is an incision made through the perineum and the vaginal wall,
· Forceps - two large spoin are inserted into the vagina to grip the baby's head and speed up delivery,
· Ventouse - is a gentler alternative to forceps, it used plastic or metal cup;
· Caesarean section - if a normal delivery is considered impossible or too dangerous;
15. What are the fetal injuries associated with the delivery?
Fetal injuries associated with cesarean section (ob. 1% of all c.s.)
· Skin laceration
· Cephalhematoma
· Clavicle fracture
· Brachial plexus injury
· Skull fracture
· Facial nerve palsy
Fetal injuries associated with vaginal delivery
· Connected with shoulder dystocia
· Brachial plexus injury (Erb’s type, Klumpke’s type)
· Humerus fracture
· Associated with ventous extraction
· chignon
· cephalhematoma
· Associated with forceps use
· Facial bruising
· Temporary or permanent marks on the baby’s head
· Nerve damage - which may be temporary or permanent
· Skull fractures
16. What are the types of contraception offered to women?
· intrauterine contraceptive devices - is a birth control device placed in the uterus, also known as an IUD or a coil;
· hormonal contraception eg. oral pill, contraceptive injection, contraceptive patch;
· barrier contraception eg. Condom, Cervical cap, Diaphragm pessary
· spermicides eg. chemical pessaries, creams or foams
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