Question 1

Giving baby only breast milk (and no other liquid) until 6 months of age is called exclusive breast feeding. Of the following, which are the advantages of breast feeding over formula feeding?

Accepted Answer

All of the Above
The infant does not require any other food during the initial 6 months of age than breast milk for growth and development.
Advantage of breast feeding includes:
1. Easily digested and well absorbed
2. Protects against infection
3. Promotes emotional bonding
4. Aids in involution of uterus following delivery

Question 2

In breast-feeding, which of the following statements is a sign of poor attachment for suckling?

Accepted Answer

Baby's mouth is opened widely
Signs of good attachment by the infant to breast-feed is:
· Baby's chin is touching the breast
· Baby's mouth is open narrowly
· Baby's lower lip is turned outward
· More areola is seen above than below
· The whole body is fully supported
· Baby's body is close to the mother

Question 3

Postnatal care includes systemic examination of the mother and baby, and appropriate advice given to the mother during the postpartum period. Which of the following is a recommendation to the mother regarding her infant?

Accepted Answer

Immunization
Proper postnatal care is very important for the infant to avoid failure to thrive and becoming diseased. Recommended postpartum care is:
1. Monitoring of progress of the baby by a healthcare professional
2. Monitoring of weight and height
3. Immunizations

Question 4

A primigravida had a vaginal delivery 2 days ago. What is your advice to her?

Accepted Answer

All of the above
Advices after normal delivery:
1. High nutrition diet
2. Should not bear heavy weight
3. Plan birth spacing of at least 2 years
4. Barrier method for contraception for next 2 years
5. Exclusive breast feeding for first 6 months
6. Compliance with routine immunizations of the infant

Question 5

Any deviation from normal parameters of puerperium is called abnormal puerperium. Of the following, which are commonly associated with abnormal puerperium? (Choose all that apply)

Accepted Answer

Puerperal pyrexia and C. Retention of urine
Puerperium is the period following childbirth during which the reproductive organs return back approximately to the pre-pregnant state. Any deviation from normal parameters of puerperium is called abnormal puerperium. Complications of abnormal puerperium include:
1. Puerperal pyrexia
2. Puerperal sepsis
3. Subinvolution
4. Retention of urine
5. Urinary Tract Infection (UTI)
6. Breast engorgement

Question 6

A woman came in her sixth day of puerperium complains of foul-smelling vaginal discharge and a rise in temperature above normal. How will you manage her?

Accepted Answer

All of the above
This is a case of an infection of the genital tract; it is a complication of delivery termed as puerperal sepsis.
Management of puerperal sepsis can include:
1. Isolation of the patient
2. Adequate fluid and calorie intake
3. Correction of anemic condition
4. Reduction in temperature if high
5. Antibiotic administration
6. Paracetamol as antipyretic

Question 7

A 30 year-old, postpartum female had a home delivery seven days ago. Since delivery, she has developed not only a high fever and foul-smelling vaginal discharge, but also a rapid pulse, low blood pressure, and generalized abdominal pain. Which of the following is the probable diagnosis?

Accepted Answer

Puerperal sepsis
Puerperal pyrexia is defined as the presence of a fever in a woman, within six weeks of giving birth-which is greater than or equal to 100 degrees (Fahrenheit) or 38 degrees (Centigrade). Puerperal sespsis is a systemic infection of the genital tract that occurs as a complication of delivery.
Causes of puerperal sepsis can include:
1. Bacteria
2. Malnutrition and anemia
3. Delivery in unhygienic conditions
4. Vaginal examinations in unhygienic conditions
5. Infection during cesarean delivery

Question 8

A 26 years old had a normal vaginal delivery some days ago. She reports high fever and foul smelling vaginal discharge. Of the following, which is the probable be cause?

Accepted Answer

Puerperal sepsis
Puerperal sespsis is a systemic infection of the genital tract that occurs as a complication of delivery. If left untreated, it can be fatal.
Causes of puerperal sepsis can include:
1. Bacteria
2. Malnutrition and anemi
3. Delivery in unhygienic condition
4. Vaginal examinations in unhygienic condition
5. Infection during cesarean delivery

Question 9

A 23 years old female was diagnosed with peurpeural sepsis, but she is noncompliant with her antibiotic regimen. Of the following, which is a possible complication? (Choose all that apply)

Accepted Answer

Pelvic cellulitis and C. General peritonitis
Puerperal sespsis is a systemic infection of the genital tract that occurs as a complication of delivery. If left untreated, it can be fatal. Pelvic cellulitis is inflammation of the soft or connective tissue in the pelvis. General peritonitis is inflammation of the abdominal lining, and it can be fatal.

Question 10

Puerperal sespsis is a systemic infection of the genital tract that occurs as a complication of delivery. Of the following, which is proper management for puerperal sepsis? (Choose all that apply)

Accepted Answer

Fluid and electrolyte balance and B - Respiratory support
Puerperal sespsis is a systemic infection of the genital tract that occurs as a complication of delivery. Treatment includes antibiotic administration. Left untreated, puerperal sepsis can be fatal. Complications include pelvic cellulitis, generalized sepsis (blood), and brain damage (due to high fever).
Management of puerperal sepsis can include:
1. Fluid and electrolyte balance
2. Respiratory support
3. Circulatory support
4. Control of infection

Question 11

Which of the following is a breast complication that commonly occurs during puerperium in an otherwise healthy mother? (Choose all that apply)

Accepted Answer

Breast engorgement and D - Mastalgia
Puerperium is the period following childbirth during which the reproductive organs revert back approximately to the pre-pregnant state. The following are breast complications associated with the puerperium:
1. Breast engorgement
2. Mastalgia
3. Cracked and retracted nipple
4. Lactation failure

Question 12

A patient who had a vaginal delivery 4 days ago (and has been unable to drain her breasts due to distraction) has now developed breast pain. Which of the following is the most likely diagnosis?

Accepted Answer

Breast engorgement
During the peurperium period, a postpartum woman's breasts often feel "full"; this is partly due to extra blood and lymph fluids in the breast tissue. Engorgement of the breast often occurs in postpartum women a few days following delivery. This is usually due to lack of sufficient draining of the breasts-and may occur if nursing is not performed often enough (or thoroughly) enough to drain the breasts. The engorgement can result in breast pain and fever.

Question 13

A postpartum woman is experiencing engorged breasts. Of the following, which is a possible management for her?

Accepted Answer

all of the above
During the peurperium period, a postpartum woman's breasts often feel "full"; this is partly due to extra blood and lymph fluids in the breast tissue. Engorgement of the breast often occurs in postpartum women a few days following delivery. This is usually due to lack of sufficient draining of the breasts-and may occur if nursing is not performed often enough (or thoroughly) enough to drain the breasts. The engorgement can result in breast pain and fever.
Management of breast engorgement can include:
1. Supporting the breasts with brassiere
2. Analgesics
3. Breast pump use
4. Breast feeding

Question 14

When the involution of the uterus is impaired, it is called uterine subinvolution. Of the following, which is a probable delivery cause of uterine subinvolution?

Accepted Answer

Cesarean section
When the involution of the uterus is impaired, it is called uterine subinvolution.The involution state in the puerperium is assessed by looking at the fundal height (and consistency of the uterine fundus) plus the character and amount of lochia.
Causes of subinvolution include:
1. Grand multiparity
2. Overdistension of uterus
3. Maternal ill health
4. Cesarean section
5. Uterine prolapse
6. Uterine sepsis

Question 15

When the involution of the uterus is impaired, it is called uterine subinvolution. Which of the following is a possible management of subinvolution?

Accepted Answer

All of the above
When the involution of the uterus is impaired, it is called subinvolution of the uterus. Care providers may kneed the uterus to stimulate it back into the desired "grapefruit" position.
Management of subinvolution can include:
1. Improved nutrition
2. Treatment of anemia
3. Antibiotics (in endometritus)
4. Exploration of cause
Causes of subinvolution include:
1. Grand multiparity
2. Overdistension of uterus
3. Maternal ill health
4. Cesarean section
5. Uterine prolapse
6. Uterine sepsis

Question 16

A 30 year old female delivered a baby a few days ago, and has developed malaise, fever and breast pain. Of the following, which is the probable management?

Accepted Answer

Breast support
This is a case of mastalgia (breast pain). Management of mastalgia includes:
1. Breast support
2. Exploration of cause
3. Breast-feeding or expression of milk (if due to breast engorgement)

Question 17

The inappropriate secretion of milk (unrelated to the normal milk production of breast-feeding) is called _________.

Accepted Answer

Galactorrhea
The inappropriate secretion of milk (unrelated to normal milk production of breast-feeding) is called galactorrhea.
Causes of galactorrhea can be:
1. Excess production of prolactin
2. Pituitary tumor
3. Renal disease
4. Hyperthyroidism

Question 18

A 28 years old female delivered normally but has failed to feed her baby, and now fails to produce milk. Which of the following can be a probable cause?

Accepted Answer

All of the above
This is a case of lactation failure. Causes of lactation failure can include:
1. Infrequent suckling
2. Painful breasts
3. Anxiety and depression
4. Reluctance or apprehension to nursing
5. Diuretics
6. Endogenous suppression of the prolactin
7. Disinterest in the infant

Question 19

A 20 year old woman with amenorrhea for 10 weeks presents with excessive nausea and vomiting in the morning. What is your probable diagnosis?

Accepted Answer

Hyperemesis gravidarum
Hyperemesis gravidarum is a severe type of vomiting in pregnanc; it has a deleterious effect on the overall health of the pregnant woman.
Causes of hyperemesis gravidarum include:
1. Multiple pregnancy
2. Family history
3. Hypoglycemia
4. Unplanned pregnancy

Question 20

Preeclampsia is a systemic disorder of unknown etiology. Which of the following is a maternal complication of preeclampsia?

Accepted Answer

All of the above
Preeclampsia is a systemic disorder of unknown etiology. It is characterized by development of hypertension in a previously normotensive patient, and can lead to the development of eclampsia.
Maternal complications of preeclampsia include:
1. Eclampsia
2. Oliguria
3. Heart failure
4. Shock
5. Sepsis

Quiz 6: The Postpartum-Period