Nokea
Pneumatosis, or gas cysts, may form in the wall anywhere along the gastrointestinal tract in some cases, they will produce symptoms such as abdominal discomfort, diarrhea with mucus, and excess flatulence. Treatment of pneumatosis most often involves
- A. Several days of oxygen by face mask
- B. Hyperbaric oxygen
- C. Surgical resection
- D. Treatment of underlying disease
Correct Answer: B
Rationale: The correct answer is B: Hyperbaric oxygen. Hyperbaric oxygen therapy is the most effective treatment for pneumatosis as it helps to reduce gas cysts by increasing oxygen levels in the tissues. This promotes healing and resolution of the condition.
A: Several days of oxygen by face mask - Regular oxygen therapy is not as effective as hyperbaric oxygen in treating pneumatosis.
C: Surgical resection - Surgical resection is not typically the first-line treatment for pneumatosis and is usually reserved for severe cases or complications.
D: Treatment of underlying disease - While treating the underlying disease is important, it may not directly address the gas cysts in the gastrointestinal tract. Hyperbaric oxygen therapy targets the gas cysts specifically.
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enna is a 41-year-old female who presents to the emergency room complaining of sudden hearing loss. She is generally very healthyshe denies any significant medical history, and her only daily medication is a combined oral contraceptive. She does admit that she is just getting over a head cold, but other than that she offers no relevant history. A comprehensive history and physical examination results in a diagnosis of sudden sensorineural hearing loss (SSHL) of unknown origin. The AGACNP knows that the next step in the patients management should include
- A. Acyclovir
- B. Furosemide
- C. Warfarin
- D. Hyperbaric oxygen
Correct Answer: A
Rationale: The correct answer is A: Acyclovir. The rationale is that sudden sensorineural hearing loss (SSHL) can sometimes be associated with viral infections, such as herpes simplex virus. Acyclovir is an antiviral medication that can potentially help treat the underlying viral infection causing SSHL. It is important to address the potential viral etiology before considering other treatments.
Summary of other choices:
B: Furosemide is a diuretic used to treat conditions like high blood pressure and edema, not SSHL.
C: Warfarin is an anticoagulant used to prevent blood clots, not indicated for SSHL.
D: Hyperbaric oxygen therapy is sometimes used for SSHL, but addressing any potential viral infection with Acyclovir would be a more appropriate initial step.
The AGACNP is covering an internal medicine service and is paged by staff to see a patient who has just pulled out his ET tube. After the situation has been assessed, it is clear that the patient will go into respiratory failure and likely die if he is not reintubated. The patient is awake and alert and is adamant that he does not want to be reintubated. The AGACNP is concerned that there is not enough time to establish a DNRthe patient needs to be reintubated immediately and already is becoming obtunded. Which ethical principles are in conflict here?
- A. Veracity and beneficence
- B. Beneficence and nonmalfeasance
- C. Autonomy and beneficence
- D. Justice and autonomy
Correct Answer: C
Rationale: The correct answer is C: Autonomy and beneficence. Autonomy refers to the patient's right to make their own decisions regarding their healthcare. In this case, the patient is refusing reintubation, exercising his autonomy. However, beneficence, the duty to act in the patient's best interest, also comes into play as the patient's refusal could lead to respiratory failure and death. The conflict arises from balancing the patient's autonomy with the healthcare provider's duty to provide beneficial care.
Choices A, B, and D are incorrect because they do not accurately capture the ethical conflict present in the scenario. Veracity (A) refers to truthfulness, which is not the primary issue here. Nonmalfeasance (B) is the duty to do no harm, which is not directly relevant to the conflict between the patient's autonomy and the need for beneficial care. Justice (D) relates to fairness in resource allocation and is not the primary issue in this case.
Mechanism of labor in left occipito-posterior position:
- A. Descent, engagement, flexion, internal rotation
- B. Extension, engagement, internal rotation, external rotation
- C. Flexion, descent, external rotation
- D. Descent, engagement, extension
Correct Answer: A
Rationale: The correct answer is A: Descent, engagement, flexion, internal rotation. In left occipito-posterior position, the fetus descends into the pelvis, engages in the maternal pelvis, undergoes flexion to fit through the birth canal, and internally rotates to align with the pelvis for delivery.
Choice B (Extension, engagement, internal rotation, external rotation) is incorrect because extension is not typically seen in occipito-posterior positions. Choice C (Flexion, descent, external rotation) is incorrect because external rotation is not part of the mechanism in this position. Choice D (Descent, engagement, extension) is incorrect because extension is not typically seen in this position.
Hypoplastic left heart syndrome is characterized by underdevelopment of
- A. Pulmonary veins, ventricles and aortic valve
- B. Left ventricle, atrium and pulmonary vessels
- C. Aortic arch, venacava and right atrium
- D. Left ventricle, aortic valve and arch
Correct Answer: D
Rationale: Rationale:
1. Hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch.
2. The left ventricle is essential for pumping oxygenated blood to the body.
3. Aortic valve controls blood flow from the left ventricle to the aorta.
4. Aortic arch connects the ascending and descending aorta.
Summary:
A - Incorrect, as it includes pulmonary veins not related to hypoplastic left heart syndrome.
B - Incorrect, as it includes structures not primarily affected in this condition.
C - Incorrect, as it does not involve structures related to the left side of the heart.
Vaginal birth after caesarean section is known as
- A. Spontaneous vaginal delivery
- B. Trial of scar
- C. Spontaneous vertex delivery
- D. Trial of birth
Correct Answer: B
Rationale: The correct answer is B: Trial of scar. This term specifically refers to the process of attempting a vaginal birth after a previous caesarean section. It involves monitoring the previous cesarean scar for any signs of complications during labor.
A: Spontaneous vaginal delivery refers to giving birth vaginally without any previous cesarean section.
C: Spontaneous vertex delivery simply describes the position of the baby's head during birth.
D: Trial of birth is not a commonly used term in obstetrics and does not specifically relate to VBAC.