Nokea
An inorganic risk factor to birth injuries includes
- A. Maternal short stature
- B. Prenatal oligohydramnios
- C. External cephalic version
- D. Fetal macrosomia
Correct Answer: D
Rationale: The correct answer is D: Fetal macrosomia. Fetal macrosomia, which refers to a baby being significantly larger than average, is an inorganic risk factor for birth injuries because it can lead to difficult delivery and increase the risk of birth trauma such as shoulder dystocia. Maternal short stature (A) is a biological risk factor, not inorganic. Prenatal oligohydramnios (B) refers to low levels of amniotic fluid and is a maternal condition, not an inorganic factor. External cephalic version (C) is a procedure to turn a breech baby and is not a risk factor for birth injuries.
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Precipitate labour is an unusually rapid labour
- A. That is concluded in less than three hours
- B. Where the external cervical os fails to dilate despite good uterine contractions
- C. That is concluded in more than three hours
- D. Where the external cervical os fails to dilate due to poor uterine contractions.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Precipitate labor is defined as unusually rapid labor.
2. Option A states that it is concluded in less than three hours, aligning with the definition.
3. Option B talks about cervical dilation, which is not a defining factor of precipitate labor.
4. Option C contradicts the definition as it mentions a duration longer than three hours.
5. Option D mentions poor uterine contractions, which are not characteristic of precipitate labor.
Summary:
Option A is correct because it aligns with the definition of precipitate labor being rapid, while the other options are incorrect as they do not accurately describe the characteristics of precipitate labor.
Ms. OReilly is a 69-year-old patient who is having a bowel resection for a malignant tumor of the right colon. She has several chronic medical conditions and takes numerous daily medications, including metoprolol 100 mg daily, warfarin 5 mg daily, vitamin E 200 units daily, and metformin 1000 mg bid. Which of the following regimens is the most appropriate approach to managing her medications preoperatively?
- A. All medications should be taken up to and including the morning of surgery
- B. The beta blocker may be taken up until the day of surgery, metformin should be held the day of surgery, and the remaining medications should be d/c’d 5–7 days before surgery
- C. Warfarin should be held 5 days before surgery; all other medications may be taken through the morning of surgery
- D. Metformin should be held if the morning blood sugar is < 200 mg/dL; all other medications except warfarin may be given the day of surgery
Correct Answer: B
Rationale: The correct answer is B. It is important to manage medications appropriately preoperatively to minimize complications. Metoprolol, a beta blocker, should be continued up until the day of surgery to prevent rebound hypertension or tachycardia. Metformin should be held on the day of surgery to avoid potential lactic acidosis due to its effects on kidney function. Warfarin should be discontinued 5-7 days before surgery to reduce the risk of bleeding. Vitamin E can increase bleeding risk and should be discontinued. Choice A is incorrect as not all medications should be taken until the morning of surgery. Choice C is incorrect as warfarin should be held earlier than 5 days before surgery. Choice D is incorrect as metformin should be held on the day of surgery, regardless of blood sugar levels, to prevent lactic acidosis.
The major causative organism of urinary tract infection during puerperium is:
- A. Staphylococcus pyogenes
- B. Anaerobic streptococci
- C. Clostridium welchii
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. During puerperium, the most common causative organism of urinary tract infection is E. coli. This is because E. coli is a normal flora in the gastrointestinal tract and can ascend to the urinary tract due to factors like hormonal changes, reduced bladder tone, and trauma during delivery. Staphylococcus pyogenes (Choice A), Anaerobic streptococci (Choice B), and Clostridium welchii (Choice C) are not typically associated with urinary tract infections during puerperium. Staphylococcus pyogenes is more commonly known for causing skin infections, Anaerobic streptococci are not commonly implicated in urinary tract infections, and Clostridium welchii is associated with gas gangrene, not urinary tract infections.
A characteristic of monozygotic twins is that
- A. They are always of the same sex
- B. They share a similar fingerprint pattern
- C. They have different blood groups
- D. Superfetation is a common finding
Correct Answer: A
Rationale: The correct answer is A: They are always of the same sex. This is because monozygotic twins, also known as identical twins, develop from a single fertilized egg that splits into two embryos. As a result, they share the same genetic material and are always of the same sex.
Choice B is incorrect because fingerprint patterns are not determined by genetics and can vary even between identical twins. Choice C is incorrect because monozygotic twins share the same blood type since they have the same genetic makeup. Choice D is incorrect as superfetation, the occurrence of multiple pregnancies in the same uterus but from different ovulations, is extremely rare and not a common finding in monozygotic twins.
Signs of obstructed labor per vaginally include
- A. Dry vagina, Oedema of the cervix, Caput succedaneum
- B. Plenty amniotic fluid, Hot/dry vagina, meconium stained liquor
- C. Meconium stained liquor, Hot/dry vagina, Diluted urine
- D. Caput succedaneum, Oedema of the cervix, plenty amniotic fluid
Correct Answer: A
Rationale: The correct answer is A because signs of obstructed labor include a dry vagina due to prolonged pressure, oedema of the cervix due to prolonged contractions, and caput succedaneum which is swelling of the baby's scalp from prolonged pressure.
Choice B is incorrect because plenty of amniotic fluid is not a sign of obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Meconium-stained liquor can be a sign of fetal distress, but not specifically obstructed labor.
Choice C is incorrect because meconium-stained liquor is a sign of fetal distress, not necessarily obstructed labor. A hot/dry vagina is not a typical sign of obstructed labor. Diluted urine is not a typical sign of obstructed labor.
Choice D is incorrect because while caput succedaneum is a sign of obstructed labor, oedema of the cervix is more indicative of obstructed labor than plenty of amni