13.Name a sequence of newborn reanimation.

14.What should be an Oxygen concentration at ALV realization?

15.The indications for newborn intubation.

16.Features of a temperature regimen during reanimation and newborn intensive care.

17.When the umbilical cord must be cut at newborn asphyxia?

18.How long it is necessary to carry out newborn reanimation measures?

3.5.2.Self control tests.

1.In 20h10min the primigravida received the injection of 2,0ml of 2% Promedolum solution. In 21h40min the amniotic membranes ruptured and after 40 min she delivered the boy 3100gr and 51cm. At birth the child had the satisfactory heartbeat rate with severe breath suppression. The ALV started with the parallel injection of:

A.Sodium bicarbonate.

B.Refilling of the circulation blood volume.

C.Adrenalin.

D.Naloxone hydrochloride.

E.All from the above mentioned.

2.The newborn girl 3600 gr, 53 cm, was born in asphyxia of moderate grade. During the primary examination the diagnosis of Bellentain-Runge syndrome was done. The classical Bellentain-Runge syndrome included the following signs except:

A.The increased thickness of skull bones.

B.The greenish skin tone.

C.The “sauna” palms and feet.

D.The light expression of subcutaneous fat.

E.The wide sutures and fonticles.

3.The Primipara M., 21 years old, was admitted to the maternity house after the 4 hours from the contractions start. The contractions duration 30-35 sec every 3-4 minutes. The fetal position longitudinal, the fetal head is a small segment to pelvic introitus. The amniotic fluids are stable. During cardiomonitoring: as a response to uterine contractions the slower fetal heartbeat rate of the right form are registered, with the amplitude up to 40-50 beats/minute, with the calm beginning and more calm restoration of previous heartbeat rate, starting from the contraction peak and lasting for 30-40 sec after it finishes. Can you determine the fetal heartbeat type of deceleration?

A.Early decelerations.

B.Late decelerations.

C.Variable decelerations.

D.Prolonged decelerations.

E.Basal bradycardy.

4.The aged primipara P. is on prelabor preparation in pregnancy pathology department. During the stress contractile test during 10 minutes we fixed 4 uterine contractions with the duration of 40-45 sec. As a response to uterine contractions the fetal heartbeat rate accelerations were registered with the amplitude 15-20 beats/minute and duration of 20-25 sec. Can you determine the result of a contractile test?

A.Negative test.

B.Positive test.

C.Suspicious test.

D.Areactive test.

E.It can’t be interpreted.

5.According to the dopplerography results in woman with the high degree risk of the perinatal pathology development the physician issued a conclusion about the critical state of the fetal-placental bloodstream. The change of what dopplerography parameters help to issue such a conclusion?

A.The increase of the diastolic component.

B.The decrease of the diastolic component.

C.The decrease of vascular resistance indexes.

D.The increase of vascular resistance indexes.

E.The reverse diastolic bloodstream.

6.In pregnant women P., in 1st labor period with primary weakness of patrimonial activity and labor induction with Prostaglandins during cardio monitoring the late decelerations 55-60 sec duration were registered. During the examination of blood from the fetal presented part the decompensated acidosis was determined. The fetal blood Ph corresponds to such a condition:

A.Less than 7,20.

B.7,20 – 7,25.

C.7,25 – 7,50.

D.7,50 – 7,75.

E.More than 7,75.

7.The estimation of fetal reactivity by the non-stress test showed the absence of accelerations with the amplitude more than 15 beats/min with the duration more than 15 sec for the 20 minutes of observation. The reason can be all except:

A.Non-satisfactory fetal condition.

B.Fetal unencephalon.

C.The use of drugs.

D.The morpho-functional fetal non-maturity.

E.The CTG was written in pregnant lying on her sides.

8.The primigravida L., 17 years old, 31-32 weeks of gestation came to female advice anbulance. From the

anamnesis – smoker (20 cigarettes per day), in 7-8 weeks had the acute respiratory-virus infection with temperature up to 38,5 C. The uterine fundus height – 27 cm, abdominal circle – 80 cm. Ultrasound: fetal hypotrophy 2nd grade, symmetrical form. All except characterizes the symmetrical form of fetal hypotrophy:

A.Develops from the early gestational ages.

B.Is characterized by the non-proportional development of fetal different organs.

C.Is often the marker of the fetal genetic pathology.

D.Is characterized by the proportional development of fetal different organs.

E.Is the symptom of the primary placental insufficiency.

9.The performance of the intrauterine fetal condition monitoring in pregnant A. showed following results: the nonstress test areactive, the deep decrease of the breathing and general fetal movements, the placental thickness 30 mm, maturity grade – III with severe calcinosis, the amount of amniotic fluid is very decreased, the AFTH – 9 mm. What parameter from the mentioned below is most valuable marker of the chronic fetal intrauterine hypoxia?

A.Fetal reactivity.

B.Breathing fetal movements.

C.Movement fetal activity.

D.Fetal tonus.

E.The amount of amniotic fluids.

10.The patient K., is at the maternity house due to the threat of the preterm labor. During the cardiotocography on the base of previous normocardy (152 beats/minute) the acceleration of the fetal heart rhythm was registered with the amplitude of 25 beats which lasts for 10 minutes. That is:

A.Acceleration.

B.Prolonged acceleration.

C.Early deceleration.

D.Basal tachycardy.

E.Basal bradycardy.

11.In pregnant K., at 38 weeks of gestation during screening cardiotocography the compensatory accelerations were determined. The pregnancy – 1st without any complications. What additional investigations can verified the genesis of such accelerations?

A.Ultrasound.

B.The placental lactogen blood concentration estimation.

C.The estriol blood concentration estimation.

D.The dopplerography of uterine-placental flow.

E.The fetal biophysical profile examination.

12.The patient K., is at the maternity house due to the threat of the preterm labor. During the cardiotocography on the base of previous normocardy (152 beats/minute) the acceleration of the fetal heart rhythm was registered with the amplitude of 25 beats which lasts for 10 minutes. That is:

A. Acceleration.

B. Prolonged acceleration.

C.Early deceleration.

D.Basal tachycardy.

E.Basal bradycardy.

13.In pregnant K., at 38 weeks of gestation during screening cardiotocography the compensatory accelerations were determined. The pregnancy – 1st without any complications. What additional investigations can verified the genesis of such accelerations?

A.Ultrasound.

B.The placental lactogen blood concentration estimation.

C.The estriol blood concentration estimation.

D.The dopplerography of uterine-placental flow.

E.The fetal biophysical profile examination.

14.The pregnant women K., was forward for the treatment in hospital. The analysis: Hb – 85 g/l, Er – 2.9, leucocytes – 6.9, ESR – 35 mm/hour. What type of hypoxia in fetus is possible?

A.Hemical.

B.Hypoxic.

C.Transplacental.

D.Kardiogenic.

E.Hypovolemic.

15.The pregnant women G., was admitted to the observation department with the diagnosis: Pregnancy 2nd, 30-31 weeks. Antenatal uterine death. The intrauterine fetal death is characterized by all, exept:

A.The uterine growth stop.

B.The estriol level increase.

C.The disappearance of heartbeats and fetal movements.

D.The deep decrease of placental lactogen.

E.The alpha-fetoprotein level increase.

16.In pregnant P., based on the complex clinico-paraclinical examination, the chronic intrauterine fetal hypoxia was diagnosed.. For the medicamental therapy of fetal hypoxia we can use:

A.Spasmolytics.

B.Tocolytics.

C.Antioxydants.

D.Antiagregants.

E.All of the above mentioned groups.

17.The pregnant T. was admitted to the hospital after 1,5 hour from the patrimonial activity start in 32-33 weeks of gestation. During monitoring: the contractions 6-7 during 10 minutes, their duration 45-50 sec, the fetal heartbeat rate 110-120 beats/min, the late decelerations amplitude up to 30 beats/min during 30-50 sec are registered. The best effect for the acute intranatal hypoxia treatment in that case will be done by the administering of:

A.Antiagregants.

B.Beta-adrenomimetics.

C.Antioxidants.

D.The group B vitamins.

E.The 40% glucose solution.

18.Child at birth: pulse less than 100 beats/minute, the breathing with severe difficulties, the skin is pale, the muscles are atonic. The reanimation measures must start:

A.Urgently after the birth in delivery room.

B.After the newborn Apgar scale estimation on the 1st minute in delivery room.

C.After the newborn Apgar scale estimation on the 1st and 5th minutes in delivery room.

D.On the 30th minute after birth, if the Apgar points are less than 4.

E.Urgently after the admission the newborn to the intensive care unit.

19.For the decision making of newborn reanimation measures beginning and forward steps we use:

A.Apgar scale.

B.Estimation of breathing, heartbeat rate and skin color.

C.Muscle tonus and reflexes estimation.

D.Breathing and reflexes estimation.

E.Heartbeat rate and skin color estimation.

20.The newborn primary help in labor room includes all the measures except:

A.Decrease temperature avoidness.

B.The respiratory ways obstruction avoidness.

C.The tactile stimulation.

D.The newborn condition estimation.

E.The non-straight heart massage.

21.Immediately after birth the child was put under the source of warmer light, was clean with towel, the mucous suction from the mouth and nasal cavities was performed but the spontaneous breathing was absent. For the tactile stimulation we can use the following measures:

A.Light beating of the feet.

B.The dilation of anal sphincter.

C.The prelum of the chest.

D.The use of cold water.

E.The strong femur abduction to abdomen.

22.After the tactile stimulation the “gasping” breath is observed in newborn, the heartbeat rate is less than 100 beats/minute. The artificial lung ventilation started with the help of the mask and breathing sac. The frequency of the ALV must be:

A.10-20 breath/min.

B.15-25 breath/min.

C.20-40 breath/min.

D.40-60 breath/min.

E.60-80 breath/min.

23.In newborn after the beginning step of the ALV by 100% oxygen during 30 sec the heartbeat rate is 50 beats/min. The suitable doctor’s tactics:

A.Look for the start of spontaneous breathing.

B.Stop the ALV.

C.To supply the child with oxygen.

D.To start the tactile stimulation.

E. To start immediately the non-straight heart massage.

24.The child was born in the asphyxia of the severe grade. After the primary measures the ALV started and then the non-straight heart massage. During the non-straight heart massage in newborn the following main things are done except:

A.The pressing is done on the lower third of sternum.

B.The pressing depth is 1,5-2 cm.

C.The pressing rhythm is 80 per min.

D.The pressing frequency and depth are maintained on one level.

E.The fingers are in contact with sternum of newborn in pressing and without it.

25.The ALV with 100% oxygen and non-straight heart massage in newborn with asphyxia was unsuccessful and the medicine therapy started. The possible way of medicine injection is:

A.The umbilical vein.

B.The peripheral vein.

C.Trachea.

D.The right answer A and B.

E.All the answers are right.

26.After the ALV and non-straight heart massage during 60 sec, the heartbeat rate of newborn is 40 beats/min. The medicine therapy must be started from the injection of :

A.Sodium bicarbonate.

B.Refilling of the circulation blood volume.

C.Adrenalin.

D.Naloxone hydrochloride.

E.All from the above mentioned.

27.The main reason of fetal hypoxia development in postterm pregnancy is:

Structural changes in placenta

Gestosis

Oligoamnios

Anemia

Hydramnion

28.Areactive non-stress test is the indication for:

A.Stress test administration

B.Repeated non-stress test examination

C.Urgent beginning of therapy for the improvement of maternal-placental blood circulation

D.Delivery per pelvis naturalis

E.Caesarian section

3.6.Themes for the study research and scientific-research students work.

1.To perform the analysis of the children born in different grades of asphyxia rates and their reasons in the maternity house № 5.

2.To prepare the report about the specialties of the preterm newborn feeding.

3.To make the comparative study of sanitary-hygiene regimen in physiological and intensive care newborn departments.

4.To prepare the report about the long-term consequences of chronic hypoxia (acute hypoxia, asphyxia) influencing newborns for their mental and physical development.

5.To perform the analysis about morbidity and mortality rates in newborns from breech presentation.