Nokea
Diagnosis of obstructed labour (Abdominal examination):
- A. Palpation of the abdomen
- B. Tenderness in the lower abdomen
- C. Softening of the cervix
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: Palpation of the abdomen. To diagnose obstructed labor, palpation of the abdomen is essential to assess the position and size of the fetus, as well as the presence of uterine contractions and fetal heart rate. Tenderness in the lower abdomen may indicate other conditions, not necessarily obstructed labor. Softening of the cervix is a sign of impending labor but not specific to obstructed labor. Therefore, palpation of the abdomen is the most appropriate choice for diagnosing obstructed labor.
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Incidental antepartum haemorrhage is also referred to as
- A. Intraplacental haemorrhage
- B. Intrapartum haemorrhage
- C. Extraplacental haemorrhage
- D. Preterm haemorrhage
Correct Answer: C
Rationale: The correct answer is C: Extraplacental haemorrhage. Incidental antepartum haemorrhage refers to bleeding from a source other than the placenta, such as the cervix or vagina, before delivery. Intraplacental haemorrhage (choice A) refers to bleeding within the placenta itself, not outside it. Intrapartum haemorrhage (choice B) occurs during labor and delivery, not before. Preterm haemorrhage (choice D) is not a specific term used to describe antepartum bleeding. Therefore, the correct term for antepartum bleeding from a non-placental source is extraplacental haemorrhage.
In uterine inversion, the last part to be replaced is the
- A. Cervix
- B. Fundus
- C. Isthmus
- D. Body
Correct Answer: B
Rationale: In uterine inversion, the fundus is the last part to be replaced due to its position being the deepest inside the vagina. The fundus is the upper portion of the uterus and is the last part to invert back into its normal position. The cervix, isthmus, and body are parts of the uterus that are more easily replaced during the process of uterine inversion. The fundus being the final part to be replaced ensures the uterus is fully restored to its correct orientation.
In the preoperative assessment of a patient for the likelihood of postoperative risk, ascorbic acid deficiency, anemia, and volume contraction are all risk factors for
- A. Prolonged intubation
- B. Thromboembolism
- C. Delayed wound healing
- D. Atelectasis
Correct Answer: D
Rationale: Step-by-step rationale for why choice D (Atelectasis) is correct:
1. Ascorbic acid deficiency can lead to impaired lung function, increasing the risk of atelectasis.
2. Anemia can cause decreased oxygen-carrying capacity, contributing to atelectasis.
3. Volume contraction can lead to reduced lung expansion, further predisposing to atelectasis.
Summary:
- Choice A (Prolonged intubation): Intubation duration is more related to respiratory complications, not directly linked to the mentioned risk factors.
- Choice B (Thromboembolism): Risk factors like immobility and hypercoagulability are more relevant to thromboembolism.
- Choice C (Delayed wound healing): More associated with factors like malnutrition and impaired immune function rather than the mentioned risk factors.
Which one of the following clinical features indicates neonatal intracranial injury?
- A. An oedematous swelling on the newborn’s scalp that resolves in 48 hours
- B. Notable bleeding between the epicranial aponeurosis & the periosteum
- C. Evidence of excessive molding or abnormal stretching of the fetal head
- D. Peripheral cyanosis as noted by the midwife on the neonate’s peripheries
Correct Answer: C
Rationale: Rationale for choice C:
1. Excessive molding or abnormal stretching of the fetal head can indicate neonatal intracranial injury due to the trauma during birth.
2. This feature suggests possible compression or trauma to the baby's head during delivery.
3. It may lead to intracranial hemorrhage or other injuries, requiring close monitoring and medical intervention.
Summary of other choices:
A. An oedematous swelling resolving in 48 hours is likely a normal finding (cephalohematoma) and not specific to intracranial injury.
B. Notable bleeding between the epicranial aponeurosis & periosteum may indicate cephalohematoma or caput succedaneum, not necessarily intracranial injury.
D. Peripheral cyanosis is related to oxygenation and circulation, not specific to intracranial injury.
In obstructed labor, edema of the vulva presents early due to
- A. Prolonged effort of the mother to push the baby
- B. Pressure applied on cervix by the presenting part
- C. An ill-fitting presenting part pressing on the cervix
- D. Large presenting diameters stretching the vulva
Correct Answer: B
Rationale: The correct answer is B because pressure applied on the cervix by the presenting part in obstructed labor leads to edema of the vulva. This pressure causes obstruction of blood and lymphatic flow in the area, resulting in swelling and edema. Prolonged effort by the mother (choice A) would not directly cause vulvar edema. An ill-fitting presenting part (choice C) may contribute to obstruction but does not explain the mechanism of edema. Large presenting diameters (choice D) stretching the vulva would not directly cause edema without pressure on the cervix.