Nokea
A patient with suspected Cushings syndrome is being evaluated to establish the diagnosis and cause. Patients with an adrenal tumor typically will demonstrate
- A. Low ACTH and low cortisol
- B. Low ACTH and high cortisol
- C. High ACTH and low cortisol
- D. High ACTH and high cortisol
Correct Answer: A
Rationale: The correct answer is A: Low ACTH and low cortisol. In a patient with an adrenal tumor causing Cushing's syndrome, the tumor itself produces excess cortisol independently of ACTH regulation. Therefore, ACTH levels are low due to negative feedback from high cortisol levels. As a result, cortisol levels are high, while ACTH levels are low.
Explanation for other choices:
B: Low ACTH and high cortisol - This suggests primary adrenal insufficiency (Addison's disease), not Cushing's syndrome.
C: High ACTH and low cortisol - This suggests secondary adrenal insufficiency, not Cushing's syndrome.
D: High ACTH and high cortisol - This is contradictory and not physiologically possible in the context of an adrenal tumor causing Cushing's syndrome.
You may also like to solve these questions
The recommended number of chest compressions for neonatal resuscitation is
- A. 60 compressions coordinated with 30 breaths per minute
- B. 3 compressions coordinated with 1 breath per minute
- C. 1 compression coordinated with 3 breaths per minute
- D. 90 compressions coordinated with 30 breaths per minute
Correct Answer: A
Rationale: The correct answer is A: 60 compressions coordinated with 30 breaths per minute. In neonatal resuscitation, the recommended compression-to-ventilation ratio is 3:1. This means 3 compressions are given followed by 1 breath. With a target compression rate of 120 per minute, this translates to 60 compressions coordinated with 30 breaths per minute. Each compression should be at a depth of about one-third the anterior-posterior diameter of the chest. This ratio and rate are crucial for maintaining adequate circulation and oxygenation during neonatal resuscitation.
Choice B: 3 compressions coordinated with 1 breath per minute is too slow and would not provide enough support for the neonate's circulation.
Choice C: 1 compression coordinated with 3 breaths per minute would not provide sufficient compressions to maintain circulation.
Choice D: 90 compressions coordinated with 30 breaths per minute would result in an incorrect compression-to-vent
What is a common cause of oligohydramnios during pregnancy?
- A. Maternal hypertension
- B. Multiple gestations
- C. Premature rupture of membranes
- D. Fetal macrosomia
Correct Answer: C
Rationale: The correct answer is C: Premature rupture of membranes. Oligohydramnios is a condition characterized by low levels of amniotic fluid which can be caused by the premature rupture of membranes, leading to the leakage of amniotic fluid. This condition can result in various complications such as fetal growth restriction and compression of the umbilical cord. Maternal hypertension (choice A) is not a direct cause of oligohydramnios. Multiple gestations (choice B) may lead to polyhydramnios (excessive amniotic fluid) rather than oligohydramnios. Fetal macrosomia (choice D) is associated with increased amniotic fluid levels rather than decreased levels seen in oligohydramnios.
Mother-to-child transmission of TB organisms never occurs during labor.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: TB can be transmitted from an infected mother to her child during labor.
Step 2: The TB bacteria can be present in the mother's respiratory secretions.
Step 3: During labor, the baby can inhale these bacteria and contract TB.
Step 4: Therefore, the statement that mother-to-child transmission of TB organisms never occurs during labor is FALSE.
Summary: Option B is correct because it accurately reflects the possibility of mother-to-child transmission of TB during labor. Option A is incorrect as it contradicts the factual information. Options C and D are not applicable as they provide no information.
The baby dies immediately after birth due to the presence of
- A. Pulmonary stenosis
- B. Aortic coarctation
- C. Truncus arteriosus
- D. Ductus arteriosus
Correct Answer: C
Rationale: The correct answer is C: Truncus arteriosus. In this congenital heart defect, a single large blood vessel arises from the heart instead of the normal two separate vessels (aorta and pulmonary artery). This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygen supply to the body. This condition is incompatible with life, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation are also congenital heart defects but do not typically result in immediate death after birth. Pulmonary stenosis obstructs blood flow to the lungs, while aortic coarctation causes narrowing of the aorta.
D: Ductus arteriosus is a normal fetal blood vessel that connects the pulmonary artery and the aorta but usually closes shortly after birth. Failure of closure can lead to health issues, but it is not typically a cause of immediate death after birth.
Three (3) complications of breech presentation:
- A. Prolonged labor, umbilical cord prolapse, shoulder dystocia
- B. Cesarean delivery, fetal distress, uterine rupture
- C. Preeclampsia, gestational diabetes, low birth weight
- D. All of the above
Correct Answer: A
Rationale: Rationale: Breech presentation increases risks during childbirth. Prolonged labor is common due to the position of the baby. Umbilical cord prolapse occurs when the cord slips through the cervix before the baby, leading to oxygen deprivation. Shoulder dystocia happens when the baby's shoulders get stuck during delivery. Choice A is correct as it directly relates to complications of breech presentation. Choices B, C, and D are incorrect as they do not specifically address the complications associated with breech presentation. Cesarean delivery is often recommended for breech presentation to avoid complications. Uterine rupture is a rare but severe complication that is not directly caused by breech presentation. Preeclampsia, gestational diabetes, and low birth weight are not commonly associated with breech presentation. Therefore, choice A is the correct answer.