A major predisposing factor to cardiac disease in pregnancy includes
- A. Rheumatic heart disease
- B. Notable peripheral oedema
- C. Easy fatiguability
- D. Basal crepitation
Correct Answer: A
Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.
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The term used to describe a situation whereby the fetal lie keeps varying after 36 gestational weeks is
- A. Unstable lie
- B. Compound lie
- C. Multiple lie
- D. Transverse lie
Correct Answer: A
Rationale: The correct answer is A: Unstable lie. After 36 weeks of gestation, the fetal lie should typically be consistent. An unstable lie refers to a situation where the fetal lie keeps changing position, indicating a potential complication. This can lead to difficulties during labor and delivery.
Summary:
B: Compound lie - Refers to a situation where the fetus is in an abnormal position, such as breech or transverse, alongside another part of the body presenting first.
C: Multiple lie - Not a recognized medical term.
D: Transverse lie - Refers to a situation where the fetus is positioned horizontally across the uterus, which can complicate delivery.
The Brain Trauma Foundation recommends intracranial pressure monitoring for all of the following patients except those with
- A. GCS of 3 to 8 and abnormal head CT
- B. GCS of 3 to 8 and hypotension
- C. GCS of 3 to 8 and > 40 years old
- D. GCS of 3 to 8 and bradycardia
Correct Answer: B
Rationale: The correct answer is B (GCS of 3 to 8 and hypotension) because hypotension is not a specific indication for intracranial pressure (ICP) monitoring according to the Brain Trauma Foundation guidelines. The rationale is that hypotension is a systemic issue affecting overall perfusion, whereas ICP monitoring is specifically for assessing intracranial dynamics.
A, C, and D are incorrect choices because they all involve conditions that could potentially indicate increased intracranial pressure and the need for monitoring. A) Abnormal head CT indicates structural brain injury, C) age > 40 is a risk factor for poor outcomes after traumatic brain injury, and D) bradycardia can be a sign of increased ICP affecting brainstem function. Therefore, these conditions warrant ICP monitoring according to guidelines.
Convulsions in amniotic fluid embolism are confused for
- A. Antepartum eclampsia
- B. Presence of stroke
- C. Pre-existing epilepsy
- D. Postpartum eclampsia
Correct Answer: D
Rationale: The correct answer is D, postpartum eclampsia. In amniotic fluid embolism, convulsions are often mistaken for postpartum eclampsia due to similar symptoms such as seizures and altered mental status. Postpartum eclampsia occurs after delivery, usually within 48 hours, while antepartum eclampsia occurs before delivery. Presence of stroke and pre-existing epilepsy are not directly related to convulsions in amniotic fluid embolism. Thus, D is the correct choice as it closely resembles the presentation of convulsions in amniotic fluid embolism.
The comprehensive serologic assessment of a patient with Cushings syndrome is likely to produce which constellation of findings?
- A. Low potassium, high glucose, high white blood cell count
- B. High sodium, polycythemia, low BUN
- C. Low sodium, low potassium, high BUN
- D. High sodium, high chloride, high RBCs
Correct Answer: A
Rationale: The correct answer is A because in Cushing's syndrome, there is excess cortisol production leading to hyperglycemia (high glucose) and hypokalemia (low potassium). The high white blood cell count is due to the immunosuppressive effects of cortisol. Option B is incorrect as polycythemia is not typically seen in Cushing's syndrome. Option C is incorrect as low sodium and low potassium are not common findings in Cushing's syndrome. Option D is incorrect as high sodium, high chloride, and high RBCs are not typical features of Cushing's syndrome.
The gradual rewarming process in the management of hypothermia neonatorum is aimed at
- A. Providing energy
- B. Preventing shock
- C. Providing comfort
- D. Preventing burns
Correct Answer: B
Rationale: In the management of hypothermia neonatorum, the gradual rewarming process is aimed at preventing shock. Rapid rewarming can lead to vasodilation, causing a sudden drop in blood pressure and potentially leading to shock. Gradual rewarming helps the body adjust slowly to prevent this. Providing energy (Choice A) is not the primary goal of rewarming in hypothermia. Providing comfort (Choice C) is important but not the main purpose of the rewarming process. Preventing burns (Choice D) is not directly related to the rewarming process but is important to ensure the safety of the neonate during the rewarming process.