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FHEA Study Set – Questions & Verified Answers
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FHEA Study Set – Questions & Verified Answers
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FHEA Study Set – Questions & Verified AnswersFirst stage of labor is defined as lasting from the onset of:
AContractions until active cervical dilation occurs.
B Regular contractions with cervical change until complete dilation.
C Regular contractions with cervical change until transition.
D Cervical change until the delivery of the infant. Right Ans - Feedback
Correct answer: Regular contractions with cervical change until complete
dilation.
Childbirth occurs in three stages. The first stage of labor is usually the longest
and lasts from the time of onset of labor (i.e., regular contractions) until the
cervix is completely dilated to 10 cm. The second stage comprises the period
after the cervix is fully dilated until the baby is delivered. The third stage
involves the delivery of the placenta.
Dysfunctional uterine bleeding (DUB), secondary to ovarian dysfunction, is
abnormal uterine bleeding resulting from: (Select all that apply.)
Endometriosis.
Progesterone deficiency.
Sexually transmitted infections.
Congenital abnormalities in the uterine structure.
Estrogen excess. Right Ans - Correct answer:
Progesterone deficiency
Estrogen excess
Dysfunctional uterine bleeding (DUB) refers to irregular bleeding that occurs
in the absence of pelvic disease, general medical issues, or pregnancy. DUB
results from a disruption in the normal cyclic pattern of ovulatory stimulation
,to the endometrial lining. About 90% of DUB cases are anovulatory and
bleeding in these patients is unpredictable (heavy or light, short or prolonged,
frequent or random). As a result of cyclic disruption, patients have constant,
non-cycling estrogen levels along with progesterone deficiency (normally
released during the luteal phase) that stimulates endometrial growth.
The diagnosis of irritable bowel syndrome (IBS) is defined by Rome II criteria,
which includes the following symptoms except:
Abdominopelvic pain for 12 weeks (not necessarily consecutive) in the
preceding 12 months and symptoms relieved with defecation plus a history of
childhood sexual or physical abuse.
Abdominopelvic pain for 12 weeks (not necessarily consecutive) in the
preceding 12 months with a change in the frequency of bowel movements
(constipation or diarrhea) and symptoms relieved with defecation.
Abdominopelvic pain for 12 weeks (not consecutive) over the past 12 months
associated with an onset of a change in the frequency of bowel movements
(diarrhea or constipation) and a change in the form of stool (loose, watery,
with mucus, or pellet-like) and no history of bloody stools.
Abdominopelvic pain for 12 weeks (not consecutive) over the past 12 months
associated with an onset of a change in the frequen Right Ans - Correct
answer: Abdominopelvic pain for 12 weeks (not necessarily consecutive) in
the preceding 12 months and symptoms relieved with defecation plus a
history of childhood sexual or physical abuse.
The Rome II criteria for IBS include abdominal discomfort or pain lasting at
least 12 weeks, which need not be consecutive, in the preceding 12 months
that has 2 of the following 3 features: 1) relieved with defecation, and/or 2)
onset associated with a change in frequency of stool, and/or 3) onset
associated with a change in form (appearance) of stool. A history of childhood
sexual or physical abuse is not required for the diagnosis.
A 29-year-old well woman of Mediterranean ancestry presents for her first
healthcare visit in many years. She relocated to North America from Italy after
marrying a member of the Armed Forces. A routine CBC reveals the following
results:
,-Hgb=9.6 g/dL (12-14 g/dL) (96 g/L {120-140 g/L})
-Hct=30% (36-42%) (.30 proportion {.36-.40 proportion})
-MCV=66 fL (80-96 fL)
-RDW=12% (<15%) (.12 proportion) (<.15 proportion)
-RBC=5.9 million cells/mm3 (3.2-4.3 million cells/mm³)
These findings are most consistent with:
Acute blood loss.
Beta thalassemia minor.
Iron deficiency anemia.
Cooley's anemia. Right Ans - Feedback
Correct answer: Beta thalassemia minor.
The mean cell volume (MCV) of 66 fL indicates microcytic anemia (normal
MCV=80-96 fL). Iron deficiency anemia and thalassemia are the two most
common microcytic anemias encountered in primary care and represent the
leading differential diagnoses. Iron deficiency is most commonly a
consequence of slow, steady blood loss and resulting depletion of iron,
whereas thalassemia is a genetic disorder and not related to iron or any
micronutrient deficiency. The normal red blood cell distribution width (RDW)
indicates a stable anemia of long duration. Mediterranean ancestry is a risk
factor for thalassemia, and the fact that the patient is a 29-year-old well
woman suggests that this is a thalassemia minor form, with no impact on
health. Consideration should be given to providing genetic counseling prior to
pregnancy.
A 36-year-old woman presents with a 12-h history of anorexia, nausea, and
right lower quadrant abdominal pain. A white blood cell count with
differential demonstrates:
-Total WBC=16,500 cells/mm³
-Neutrophils=66%
-Bands=8%
-Lymphocytes=22%
, Expected physical examination findings include:
Murphy's sign.
A palpable left lower quadrant mass.
Periumbilical ecchymosis.
A positive obturator sign. Right Ans - Feedback
Correct answer: A positive obturator sign.
This constellation of clinical symptoms is highly suggestive of appendicitis.
The obturator and psoas signs are both consistent with pain during peritoneal
stretch in the region of the appendix and are closely associated with
appendicitis; the coincident abdominal pain, anorexia, and nausea strengthen
the diagnosis. Consequently, the white blood cell (WBC) count will likely
demonstrate an increase characterized by elevated neutrophils and bands;
this pattern is commonly referred to as the "left shift".
A 27-year-old G2 P1 had a C-section with her last delivery because of a
transverse lie. She relates that they told her that the baby "was stuck" in the
top part of her uterus and they had to "do an extra cut up there" to get him
out. She is interested in have a vaginal birth after cesarean section (VBAC)
with this pregnancy. You tell her that:
She is probably a candidate for a VBAC if the baby is less than 4000 g.
She may not be a candidate for a VBAC assuming the medical records confirm
her history.
As long as she does not require oxytocin, she should be able to have a VBAC.
As long as the fetus is not in a transverse lie, she should be able to have a
VBAC. Right Ans - Correct answer: She may not be a candidate for a VBAC
assuming the medical records confirm her history.
A trial of labor after previous cesarean delivery (TOLAC) can allow women
who desire a vaginal delivery the possibility of achieving this goal. Although
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