7/28/2019 Docter 1

1/20

Obstetric Haemorrhage Quiz

7/28/2019 Docter 1

2/20

1. Post Partum Haemorrhage

A Primary PPH - Loss of 500 ml or more within24 hours of a delivery

B Severe PPH - Loss of more than 2000ml C Secondary PPH - excessive bleeding within 2

wks of delivery

D Is prevented by Syntocinon E Is commonly seen following a twin delivery

T T F T T

7/28/2019 Docter 1

3/20

2. PPH protocol should be

commenced

A when the blood loss is about 500ml in an

otherwise healthy mother

B in the presence of continuous bleeding

C In a mother with significant heart disease

with a 500ml blood loss

D when the blood loss is about 1000ml E in the presence of clinical features of shock

F T T T T

7/28/2019 Docter 1

4/20

3. Called to the labour ward to help

resuscitate a bleeding mother

A if not busy you will run to the ward

B as soon as you see the patient you will run tothe phone to inform seniors

C while resuscitating the mother you will ask anurse to inform your consultant

D your first priority would be ABC ofresuscitation

E when she is stabilized you take her to OT

T F T T T

7/28/2019 Docter 1

5/20

4. In the management of a severe

haemorrhage

A Resuscitation should be the last

B Surgical intervention should be done after

initial resuscitation

C Ergometrine is useful

D Communication saves time

E Communication, resuscitation, monitoringand investigations & arresting the bleeding

should be done simultaneously

F T T T T

7/28/2019 Docter 1

6/20

A Rapid infusion with14G cannulae

B Both crystalloids & colloids should be given

C Blood should be given as early as possible

D There is no place for uncross matchedblood

E A pressurized bag is useful

T T T F T

5.Volume replacement in an

unexpected severe haemorrhage

7/28/2019 Docter 1

7/20

6. Following personnel should be called in

a major obstetric haemorrhage

A Experienced nurse & midwife

B Extra house officer/officers

C Obstetric SHO/Registrar/ SR D Anaesthetic MO/ Registrar/ SR

E JMO

T T T T F

7/28/2019 Docter 1

8/20

7.Following members of the staff should be

alerted in a severe obstetric haemorrhage

A Consultant Obstetrician

B Consultant Anaesthetist

C Consultant Haematologist D Staff of the blood bank

E Consultant Physician

T T T T F

7/28/2019 Docter 1

9/20

8.What should we do in a major

obstetric haemorrhage ?

A Give Oxygen by mask at 1015

litres/minute

B Intravenous access (14-gauge cannulae)

C Elevate the patients legs

D Give 10 Litres of crystalloids fast

E Transfuse blood as soon as possibleT T T F T

7/28/2019 Docter 1

10/20

9.Clinical features of a severe

obstetric haemorrhage are

A tachycardia

B normal blood pressure C pallor

D thirst

E reduced urine outputT F T T T

7/28/2019 Docter 1

11/20

10. Assessment of blood loss in a post

partum haemorrhage

A is difficult

B visual estimate is not very accurate C is guided by clinical signs & symptoms

D is a useless exercise

E should be taught to nursesT T T F T

7/28/2019 Docter 1

12/20

11. Therapeutic goals of management of a

massive blood loss are to achieve a

A haemoglobin > 14g/dl

B platelet count > 75,000/dl

C prothrombin time < 1.5 x mean control D activated partial thromboplastin time

< 1.5 x mean control

E MAP ( Mean Arterial Pressure ) of 65 to70mm Hg

F T T T T

7/28/2019 Docter 1

13/20

12. Recommended fluids for initial

resuscitation in a PPH include

A 5% Dextrose solution

B 0.9% NaCl C Hartmanns solution

D Tetrastarch

E HetastarchF T T T T

7/28/2019 Docter 1

14/20

13. Which Anaesthetic?

A Spinal Anaesthesia - major degree

posterior placenta praevia

B General Anaesthesia - placenta accreta

D Spinal anaesthesia - mild antepartum

haemorrhage

E General Anaesthesia severe PPH

F Spinal Anaesthesia - severe secondary PPH

T T T T F

7/28/2019 Docter 1

15/20

Drugs for Induction of Anaesthesia

in a PPH

A Thiopentone Sodium & Atracurium

B Thiopentone Sodium & Suxamethonium

C Etomidate & Suxamethonium D Ketamine & Suxamethonium

E Midazolam & Suxamethonium

F T T T T

7/28/2019 Docter 1

16/20

14. Blood transfusion in a major obs

haemorrhage

A Should always be with cross matched

blood

B Can give uncross matched group specific

blood

C Uncross matched O negative blood is given

D FFP is given as 15ml/Kg

E One unit of platelets will increase the

count by about 10,000

F T T T T

7/28/2019 Docter 1

17/20

15. Obstetric management of a severe

haemorrhage may consist of

1. Bi manual massage

2. Balloon tamponade 3. Uterine artery ligation

4. Aortic cross clamping

5. Caesarean HysterectomyT T T F T

7/28/2019 Docter 1

18/20

Following required to anaesthetize

a mother with a PPH?

A Two good working laryngoscopes

B IV access with large bore cannulae

C Mothers Consent D A good assistant

E Basic monitoring

T T F T T

7/28/2019 Docter 1

19/20

LSCS and an Anticipated PPH

A Inform Seniors beforehand

B Inform patient about possible ICU care

C Discuss with relatives D Cross match 6 units of blood

E Advice to transfuse 4 units of FFP in the

ward T T T T F

7/28/2019 Docter 1

20/20