Women's health and pelvic floor

40 Gulf Prometric Physiotherapist (DHA, DOH, MOH, SCFHS, QCHP) practice questions on Women's health and pelvic floor, part of Special Populations. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

1. Question 1 · Medium

   During a curl-up, a postnatal woman shows a ridge or doming along the midline. What is the best modification?

   1. AIncrease the load by adding hand weights
   2. BStop the curl-up and train deep abdominal control
   3. CAdd more crunches to strengthen the wall
   4. DIgnore the ridge because it is normal

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   Answer: B · Stop the curl-up and train deep abdominal control

   Doming shows that intra-abdominal pressure is pushing on a weak linea alba. Loading trunk flexion should wait until the deep abdominal muscles control pressure and tension.

   • A: Added weight increases pressure.
   • C: More crunches increase the strain.
   • D: Doming signals a problem.

   Remember this

   Midline doming means avoid crunches and train deep abdominal control.

2. Question 2 · Medium

   A 34-year-old woman in Doha leaks urine when she coughs and lifts her child. What is the first-line management?

   1. AAnticholinergic medication
   2. BSupervised pelvic floor muscle training
   3. CSurgery at once
   4. DReducing fluid intake to below 500 mL a day

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   Answer: B · Supervised pelvic floor muscle training

   Leakage with effort is typical of stress incontinence from weak sphincter and pelvic support. Pelvic floor training is the first-line treatment. Anticholinergics treat urgency.

   • A: Anticholinergics treat urge symptoms.
   • C: Surgery is not first-line.
   • D: Severe fluid restriction is harmful.

   Remember this

   First-line treatment for stress incontinence is pelvic floor muscle training.

3. Question 3 · Medium

   What is the usual guidance for returning to running after a vaginal birth?

   1. ANot before about 12 weeks, after a pelvic floor check
   2. BOn the day after the delivery to regain fitness
   3. CNever, since running is unsafe after any birth
   4. DWithin the first week, once bleeding has settled

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   Answer: A · Not before about 12 weeks, after a pelvic floor check

   Postnatal guidance suggests gradual return, with running no earlier than about three months and only if the pelvic floor, abdominal wall and loading tests are satisfactory.

   • B: Immediately is too soon.
   • C: A permanent ban is not advised.
   • D: One week is too soon.

   Remember this

   Delay running until about 12 weeks and check pelvic floor function first.

4. Question 4 · Medium

   What is a commonly supported pelvic floor muscle training regimen for stress incontinence?

   1. ATwo contractions a day for one week only
   2. B8 to 12 contractions held 6 to 8 seconds, three times daily, for 3 months
   3. CMaximal holds of 5 minutes, once a month, for a year
   4. DOne contraction, once a week, for several months

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   Answer: B · 8 to 12 contractions held 6 to 8 seconds, three times daily, for 3 months

   Strengthening needs a sufficient dose, repeated near maximal contractions with holds, daily practice and a training period of at least three months.

   • A: Two a day for a week is too little.
   • C: A monthly hold is too little.
   • D: One a week is too little.

   Remember this

   Pelvic floor training needs repeated holds, daily, for at least 3 months.

5. Question 5 · Medium

   A woman has a sudden strong urge to void. Which strategy is part of urge suppression training?

   1. AStop, do quick pelvic floor contractions and wait for the urge to pass
   2. BRush to the toilet immediately to avoid leaking
   3. CStrain to empty the bladder completely each time
   4. DDrink a large glass of water at once

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   Answer: A · Stop, do quick pelvic floor contractions and wait for the urge to pass

   Quick pelvic floor contractions reflexly inhibit detrusor activity. Staying calm and delaying until the urge fades helps retrain the bladder.

   • B: Rushing reinforces urgency.
   • C: Straining is unhelpful and can harm the pelvic floor.
   • D: Extra fluid increases the urge.

   Remember this

   Urge suppression uses calm quick pelvic floor contractions, then waiting.

6. Question 6 · Hard

   A woman reports leakage with sneezing and also a frequent urge to void. What is the first-line management?

   1. AAn antimuscarinic drug alone, without any exercise
   2. BSupervised pelvic floor training with bladder training
   3. CImmediate sling surgery for the stress component
   4. DA vaginal pessary as the only treatment offered

   Answer and explanation in LearnFree account

7. Question 7 · Medium

   How is exercise intensity monitored in healthy pregnancy?

   1. ABy working at maximal exertion each time
   2. BBy skipping all monitoring during exercise
   3. CA fixed maximum heart rate of 220 beats a minute
   4. DPerceived exertion of about 13 to 14, or the talk test

   Answer and explanation in LearnFree account

8. Question 8 · Medium

   On the Oxford scale for pelvic floor strength, grade 3 is:

   1. AA moderate contraction with some lift
   2. BNo contraction
   3. CA strong contraction with firm squeeze and lift
   4. DA flicker

   Answer and explanation in LearnFree account

9. Question 9 · Hard

   Twelve weeks after delivery a woman has an inter-recti distance of 3.5 cm at the umbilicus, with poor tension of the linea alba on head-lift. What should the therapist do first?

   1. APrescribe an abdominal binder in place of any exercise
   2. BTeach deep abdominal activation, then progress the load
   3. CReassure her that no treatment is needed at all
   4. DPrescribe full sit-ups from the start of treatment

   Answer and explanation in LearnFree account

10. Question 10 · Hard

    A sedentary woman at 12 weeks of an uncomplicated pregnancy wants to start exercise. What is the best advice?

    1. ADo only static stretching and no aerobic exercise
    2. BBegin with 60 minutes of vigorous exercise each day
    3. CStart gradually, such as 15 minutes three times a week
    4. DDelay all activity until after the baby is delivered

    Answer and explanation in LearnFree account

11. Question 11 · Easy

    Kegel exercises mainly train which muscle group?

    1. AThe adductor muscles of the inner thigh
    2. BThe levator ani, a pelvic floor muscle
    3. CThe gluteus maximus of the buttock
    4. DThe rectus abdominis in the front wall

    Answer and explanation in LearnFree account

12. Question 12 · Hard

    At 34 weeks a woman in an exercise class has headache, visual disturbance and a blood pressure of 150/95. What should the physiotherapist do?

    1. AContinue the class at a lower intensity
    2. BStop exercise and arrange urgent obstetric assessment
    3. CGive a calming stretch routine and observe
    4. DAdvise rest at home and recheck next week

    Answer and explanation in LearnFree account

13. Question 13 · Easy

    After about 16 to 20 weeks of pregnancy, why should prolonged supine exercise be avoided?

    1. AThe position causes anaemia in the mother
    2. BThe position lowers the temperature of the fetus
    3. CThe uterus can compress the inferior vena cava
    4. DThe position raises the maternal blood glucose

    Answer and explanation in LearnFree account

14. Question 14 · Easy

    For uncomplicated pregnancy, how much moderate aerobic activity per week do guidelines recommend?

    1. AAt least 150 minutes
    2. B30 minutes
    3. CNone, rest is required
    4. D400 minutes of vigorous exercise

    Answer and explanation in LearnFree account

15. Question 15 · Medium

    Why should end-range stretching be done with caution in pregnancy?

    1. ABone density rises sharply
    2. BRelaxin increases ligament laxity
    3. CThe nervous system stops reacting
    4. DMuscles lose all elasticity

    Answer and explanation in LearnFree account

16. Question 16 · Easy

    Diastasis recti is:

    1. ASeparation of the rectus abdominis at the linea alba
    2. BA hernia through the inguinal canal
    3. CA tear of the pubic symphysis joint
    4. DWeakness of the gluteus medius muscle

    Answer and explanation in LearnFree account

17. Question 17 · Medium

    A pregnant woman of 30 weeks has been diagnosed with placenta praevia and bleeding. What is the advice on exercise?

    1. AContinue vigorous exercise as before the diagnosis
    2. BAvoid exercise and follow the obstetric plan
    3. CDo heavy lifting every day at home
    4. DStart high-impact aerobics for fitness

    Answer and explanation in LearnFree account

18. Question 18 · Medium

    A common clinical criterion for diastasis recti is an inter-recti distance greater than about:

    1. A10 cm
    2. B6 cm
    3. C2 cm
    4. D0.2 cm

    Answer and explanation in LearnFree account

19. Question 19 · Medium

    A woman at 28 weeks develops sudden calf pain and swelling during a walk. What is the safest action?

    1. AMassage the calf firmly to clear the swelling
    2. BStop and arrange urgent assessment for thrombosis
    3. CContinue walking to try to ease the pain
    4. DApply a deep stretch to the painful calf

    Answer and explanation in LearnFree account

20. Question 20 · Medium

    What fluid advice is appropriate for a woman with overactive bladder symptoms?

    1. AMaintain 1.5 to 2 litres a day and limit caffeine
    2. BAvoid plain water but drink plenty of tea
    3. CRestrict all fluids to avoid urgency
    4. DDrink about 5 litres a day to flush the bladder

    Answer and explanation in LearnFree account

21. Question 21 · Medium

    Three months after breast cancer surgery, a woman has a heavy, swollen arm with pitting oedema. Which treatment is first-line?

    1. AVigorous deep massage to push the fluid out of the arm
    2. BComplete decongestive therapy with compression and exercise
    3. CRegular hot packs to the arm to improve circulation
    4. DKeeping the arm rested in a sling to avoid any use

    Answer and explanation in LearnFree account

22. Question 22 · Medium

    After an uncomplicated vaginal birth, when can a woman usually begin gentle pelvic floor muscle exercises?

    1. ANot until three months, to let the tissues heal
    2. BWithin the first few days, as soon as it is comfortable
    3. COnly once all postnatal bleeding has stopped
    4. DOnly after the six-week postnatal check

    Answer and explanation in LearnFree account

23. Question 23 · Easy

    Which description fits stress urinary incontinence?

    1. ALeakage of urine on coughing, sneezing or lifting
    2. BLeakage that occurs only during sleep at night
    3. CContinuous dribbling from a bladder that never empties
    4. DLeakage preceded by a sudden, strong urge to void

    Answer and explanation in LearnFree account

24. Question 24 · Easy

    What is 'the knack' that is taught to women with stress urinary incontinence?

    1. AHolding the breath and bearing down before a lift
    2. BEmptying the bladder every 30 minutes to keep it small
    3. CContracting the pelvic floor just before and during a cough or sneeze
    4. DRelaxing the pelvic floor completely as the cough starts

    Answer and explanation in LearnFree account

25. Question 25 · Medium

    Which technique is used to assess the inter-recti distance in a postnatal woman?

    1. ASide-lying with the hips flexed to 90 degrees while the examiner palpates the pubic symphysis
    2. BStanding relaxed while the examiner measures the abdominal circumference
    3. CProne lying with both legs lifted while the examiner palpates the lumbar fascia
    4. DCrook-lying with head and shoulders lifted, palpating the linea alba around the umbilicus

    Answer and explanation in LearnFree account